TY - JOUR
AU - M. A. Parker
AU - B. K. Ahmedani
AU - H. H. Yeh
A1 - 
AB - BACKGROUND: Substance use disorders (SUDs) are highly associated with other mental health conditions and disparities exist across sociodemographic characteristics. We aimed to estimate the incidence of specific SUDs and comorbidities with United States electronic health record data. METHODS: We harnessed data from the All of Us Research Program cohort from Jan 1, 2017 to Jun 30, 2022 (N = 266,472). We identified newly documented SUDs after a two-year washout period, along with related mental health diagnoses. Multivariate logistic regression models estimated associations between incident SUDs and comorbidities. RESULTS: Participants included 160,792 females (60.3%) aged 51.6 years on average [SD= 16.7]. The incidence of any SUD was 4.8%; among these, 74.4% had at least one mental health comorbidity. Alcohol (1.6%) and cannabis use (1.6%) disorders were the most common. Individuals with newly documented SUDs (vs. non-SUD) were more often male, Black, socioeconomically disadvantaged, and unmarried (all p < 0.001). Overall, anxiety (25.3%) and depression (23.1%) were the most frequent comorbidities, though the prevalence of comorbid mental health conditions ranged from 48% to 77% across SUD subtypes. Most other mental health conditions were associated with elevated odds of newly documented SUDs (AOR range=4.6-9.7, p < 0.001), particularly for stimulant, cocaine, and opioid use disorders. CONCLUSIONS: Newly documented SUDs in this diverse cohort frequently co-occurred with other mental health conditions, with diagnostic patterns varying across sociodemographic groups. Findings underscore the importance of integrated behavioral health screening and interventions that account for comorbidity. These patterns further highlight the need for strategies that enhance equitable access to prevention and treatment for individuals with SUDs.
AD - Department of Epidemiology & Biostatistics, School of Public Health, Bloomington, IN, United States. Electronic address: map2@iu.edu.; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, MI, United States.
AN - 42068725
BT - Drug Alcohol Depend
C5 - Opioids & Substance Use
DA - 07/2026
DO - 10.1016/j.drugalcdep.2026.113175
DP - NLM
ET - 20260423
JF - Drug Alcohol Depend
LA - eng
N2 - BACKGROUND: Substance use disorders (SUDs) are highly associated with other mental health conditions and disparities exist across sociodemographic characteristics. We aimed to estimate the incidence of specific SUDs and comorbidities with United States electronic health record data. METHODS: We harnessed data from the All of Us Research Program cohort from Jan 1, 2017 to Jun 30, 2022 (N = 266,472). We identified newly documented SUDs after a two-year washout period, along with related mental health diagnoses. Multivariate logistic regression models estimated associations between incident SUDs and comorbidities. RESULTS: Participants included 160,792 females (60.3%) aged 51.6 years on average [SD= 16.7]. The incidence of any SUD was 4.8%; among these, 74.4% had at least one mental health comorbidity. Alcohol (1.6%) and cannabis use (1.6%) disorders were the most common. Individuals with newly documented SUDs (vs. non-SUD) were more often male, Black, socioeconomically disadvantaged, and unmarried (all p < 0.001). Overall, anxiety (25.3%) and depression (23.1%) were the most frequent comorbidities, though the prevalence of comorbid mental health conditions ranged from 48% to 77% across SUD subtypes. Most other mental health conditions were associated with elevated odds of newly documented SUDs (AOR range=4.6-9.7, p < 0.001), particularly for stimulant, cocaine, and opioid use disorders. CONCLUSIONS: Newly documented SUDs in this diverse cohort frequently co-occurred with other mental health conditions, with diagnostic patterns varying across sociodemographic groups. Findings underscore the importance of integrated behavioral health screening and interventions that account for comorbidity. These patterns further highlight the need for strategies that enhance equitable access to prevention and treatment for individuals with SUDs.
PY - 2026
SN - 0376-8716 (Print); 0376-8716
SP - 113175
ST - Incidence of substance use disorders and comorbidities in the All of Us Research Program
T1 - Incidence of substance use disorders and comorbidities in the All of Us Research Program
T2 - Drug Alcohol Depend
TI - Incidence of substance use disorders and comorbidities in the All of Us Research Program
U1 - Opioids & Substance Use
U3 - 10.1016/j.drugalcdep.2026.113175
VL - 284
VO - 0376-8716 (Print); 0376-8716
Y1 - 2026
ER -