Opioid Use Disorders Treatment Related Disparities in Patients with Psychiatric Illness

Authors: Caroline Nielson, Connor Baird
Mentors: Robert Kagabo
Insitution: Utah Tech University

Opioid Use Disorders Treatment Related Disparities in Patients with Psychiatric Illness

Authors: Caroline Nielson, Connor Baird, Robert Kagabo, PhD, MSW, MPH

Abstract

Background

This study is a review of peer-reviewed articles of Opioid Use Disorders (OUD) treatment among individuals with psychiatric illness. OUD is a subset of substance use disorders (SUD) that is chronic and a growing public health concern. There were 47,000 opioid-related deaths in 2018 in the US; OUD is responsible globally for 68% of the drug-related deaths. OUD can result from either prescribed or non-prescribed opioid use. Some populations such as individuals with psychiatric illness have high rates of prescription opioids yet face opioid use treatment and research-related disparities. This review study examines OUD treatment and research-related disparities among patients with psychiatric illness with the goal to improve treatment among this vulnerable population.

Methods

Using PubMed and PsycINFO databases, we performed a search of journal articles regarding OUD treatment which were published between 2010 and 2023. We then completed a review of the journal articles using narrative overview guidelines. All articles reviewed were from randomized controlled trial (RCT) studies. Examples of search terms used include OUD treatment and mental health; OUD and psychiatric illness RCT studies; and opioid use treatment and mental health. Studies included were those of OUD treatment among individuals with psychiatric illness and or with a DSM5 or DSM4 diagnosis. Any studies that did not include OUD treatment and, or a DSM diagnosis, or RCT design were excluded. To avoid duplication, only one journal article from a study was included.

Results

There were 18 journal articles reviewed that met the inclusion criteria. Treatment periods ranged from 8-24 weeks. Generally, studies excluded individuals with diagnoses such as schizophrenia, schizoaffective disorders, or other serious mental health diagnoses. Several studies included participants with a DSM5 or DSM4 diagnosis of OUD, while excluding individuals with other psychiatric or substance use disorders. Most of the studies used pharmacological treatments and only a few studies had combined pharmacological and behavioral treatments. The common medicines in pharmacological treatments were methadone, buprenorphine, and naltrexone.

Conclusion

OUD treatment and research related disparities exist among individuals with psychiatric illness, yet this is the population who suffer most from OUD. Additional studies regarding OUD treatment among individuals with psychiatric illness are needed to improve OUD treatments and reduce OUD-related morbidity and mortality rates.