TY - JOUR
KW - Analgesics, Opioid/therapeutic use
KW - Humans
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - Retrospective Studies
KW - Veterans
KW - Veterans Health
KW - Comorbid substance use disorders
KW - Methamphetamine use
KW - opioid use
KW - polysubstance use
KW - Stimulant use
KW - substance use disorders
AU - S. C. Warfield
AU - C. Bharat
AU - R. M. Bossarte
AU - D. DePhilippis
AU - M. Farrell
AU - M. Hoover Jr
AU - S. Larney
AU - P. Marshalek
AU - R. McKetin
AU - L. Degenhardt
A1 - 
AB - BACKGROUND: Identifying solutions to the continued rise in overdose deaths is a public health priority. However, there is evidence of change in recent substance type associated with morbidity and mortality. To better understand the continued rise in overdose deaths, in particular those attributed to opioid and stimulant use disorders, increased knowledge of patterns of use is needed. METHODS: Retrospective cohort study of Veterans diagnosed with an opioid or stimulant use disorder between 2005 and 2019. The outcome of interest was diagnosis of substance use disorders, specifically examining combinations of opioid and stimulant use disorders among this population. RESULTS: A total of 1932,188 Veterans were diagnosed with at least one substance use disorder (SUD) during the study period, 2005 through 2019. While the annual prevalence of opioid use disorder (OUD) diagnoses increased more than 155%, OUD diagnoses absent of any other SUD diagnosis increased by an average of 6.9% (95% CI, 6.4, 7.5) per year between 2005 and 2019. Between 2011 and 2019, diagnoses of co-morbid methamphetamine use disorder (MUD) and OUD increased at a higher rate than other SUD combinations. CONCLUSIONS: The prevalence of comorbid SUD, in particular co-occurring opioid and methamphetamine use disorder, increased at a higher rate than other combinations between 2005 and 2019. These findings underscore the urgent need to offer patients a combination of evidence-based treatments for each co-morbid SUD, such MOUD and contingency management for persons with comorbid opioid and methamphetamine use disorders.
AD - University of Illinois, College of Medicine, One Illini Drive, Peoria, IL, 61605, USA; Injury Control Research Center, West Virginia University, 886 Chestnut Ridge Road, Morgantown, WV 26506, USA; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Ave, Canandaigua, NY 14424, USA. Electronic address: skelly88@uic.edu.; National Drug & Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.; Injury Control Research Center, West Virginia University, 886 Chestnut Ridge Road, Morgantown, WV 26506, USA; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Ave, Canandaigua, NY 14424, USA; Department of Behavioral Medicine and Psychiatry, West Virginia University, 930 Chestnut Ridge Road, Morgantown, WV 26506, USA.; Center of Excellence in Substance Addiction Treatment and Education (CESATE), VA Puget Sound Healthcare System, Seattle Division, 1660 S. Columbian Way, Seattle, WA 98108, USA; Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA.; National Drug & Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, 400 Fort Hill Ave, Canandaigua, NY 14424, USA.; National Drug & Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, Quebec H3t 1J4, Canada; Université de Montréal Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec H3t 1J4, Canada.; Department of Behavioral Medicine and Psychiatry, West Virginia University, 930 Chestnut Ridge Road, Morgantown, WV 26506, USA.; National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2052, Australia.; Nation(TRUNCATED)
BT - Drug and alcohol dependence
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CY - Ireland
DO - 10.1016/j.drugalcdep.2022.109310
JF - Drug and alcohol dependence
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Identifying solutions to the continued rise in overdose deaths is a public health priority. However, there is evidence of change in recent substance type associated with morbidity and mortality. To better understand the continued rise in overdose deaths, in particular those attributed to opioid and stimulant use disorders, increased knowledge of patterns of use is needed. METHODS: Retrospective cohort study of Veterans diagnosed with an opioid or stimulant use disorder between 2005 and 2019. The outcome of interest was diagnosis of substance use disorders, specifically examining combinations of opioid and stimulant use disorders among this population. RESULTS: A total of 1932,188 Veterans were diagnosed with at least one substance use disorder (SUD) during the study period, 2005 through 2019. While the annual prevalence of opioid use disorder (OUD) diagnoses increased more than 155%, OUD diagnoses absent of any other SUD diagnosis increased by an average of 6.9% (95% CI, 6.4, 7.5) per year between 2005 and 2019. Between 2011 and 2019, diagnoses of co-morbid methamphetamine use disorder (MUD) and OUD increased at a higher rate than other SUD combinations. CONCLUSIONS: The prevalence of comorbid SUD, in particular co-occurring opioid and methamphetamine use disorder, increased at a higher rate than other combinations between 2005 and 2019. These findings underscore the urgent need to offer patients a combination of evidence-based treatments for each co-morbid SUD, such MOUD and contingency management for persons with comorbid opioid and methamphetamine use disorders.
PP - Ireland
PY - 2022
SN - 1879-0046; 0376-8716
SP - 109310
T1 - Trends in comorbid opioid and stimulant use disorders among Veterans receiving care from the Veterans Health Administration, 2005-2019
T2 - Drug and alcohol dependence
TI - Trends in comorbid opioid and stimulant use disorders among Veterans receiving care from the Veterans Health Administration, 2005-2019
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 35101816
U3 - 10.1016/j.drugalcdep.2022.109310
VL - 232
VO - 1879-0046; 0376-8716
Y1 - 2022
Y2 - Mar 1
ER -