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Anxiety and depression among opiate users who misuse substances during treatment

Published online by Cambridge University Press:  13 June 2014

Robert Stapleton  and
Catherine Comiskey
Robert Stapleton
Affiliation:
Mathematics Department, National University of Ireland, Maynooth, Co. Kildare, Ireland
Catherine Comiskey*
Affiliation:
School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier St, Dublin 2, Ireland
*
*Correspondence Email: catherine.comiskey@tcd.ie
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Abstract

Objectives: While treatment is known to improve drug and crime outcomes for opiate users, there is debate in the literature about the longitudinal effects of substance misuse and the comorbidity of mental health problems. We sought to describe and model anxiety and depression outcomes during opiate substance misuse treatment.

Methods: The first national, longitudinal treatment outcome study of 404 opiate users entering a new episode of inpatient or outpatient treatment and followed up at one and three years and assessed using the Maudsley Addiction Profile instrument.

Results: A total of 404 opiate users were recruited representing approximately 8.2% of all new treatments and 17% of all new methadone treatments at national level in Ireland in 2003. At three years 97% (n = 392) were followed-up. At one year, analysis revealed the odds of experiencing depression was between five and 15 times the odds for opiate users who also used cocaine than non cocaine using opiate users, but this had decreased at three years. At three years those who were drug free, that is, not in treatment and not using illicit drugs, were less likely to experience feeling hopeless about the future than those in treatment or those not in treatment and using, but they were also more likely to experience feeling tense. Those in treatment were more likely to feel lonely.

Conclusion: The concurrent misuse of cocaine and other substances during opiate treatment and the stage of the treatment pathway are associated with anxiety and depression among opiate users in treatment. These client factors need to be considered when implementing individualised treatment care plans.

Keywords

TreatmentOpiatesCocaineAnxietyDepression
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 1 , March 2011 , pp. 6 - 12
Copyright
Copyright © Cambridge University Press 2011

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References

1.Woody, GE, Blaine, J. Depression in narcotic addicts: Quite possibly more than a chance association. In: Dupont, RL, Goldstein, A, O'Donnell, J, Brown, B (Eds). Handbook on drug abuse. Washington, DC: US Government Printing Office, 1979: 277–285Google Scholar
2.Üstun, TB, Ayuso-Mateos, JL, Chatterji, S, Methers, C, Murray, CJL. Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004; 184: 386–392.CrossRefGoogle ScholarPubMed
3.Kessler, R, McGonagle, K, Zhao, Set al.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 1994; 51: 8–19.CrossRefGoogle ScholarPubMed
4.Wittchen, H-U, Jacobi, F. Size and burden of mental disorders in Europe – a critical review of appraisal of 27 studies. Eur J Neuropharmacol 2005; 15: 357–376.CrossRefGoogle ScholarPubMed
5.Brienza, RS, Stein, MD, Chen, MHet al.Depression among needle exchange program and methadone maintenance clients. J Substance Abuse Treat 2000; 18: 331–337.CrossRefGoogle ScholarPubMed
6.Brooner, RK, King, VL, Kidorf, M, Schmidt, CW Jr, Bigelow, GE. Psychiatric and substance use comorbidity among treatment seeking opioid abusers. Arch Gen Psychiatry 1997; 54: 71–80.CrossRefGoogle ScholarPubMed
7.Havard, A, Teesson, M, Darke, S, Ross, J. Depression among heroin users: 12-Month outcomes from the Australian Treatment Outcome Study (ATOS). J Substance Abuse Treat 2006; 30: 355–362.CrossRefGoogle ScholarPubMed
8.Marsden, J, Gossop, M, Stewart, D, Rolfe, A, Farrell, M. Psychiatric symptoms among clients seeking treatment for drug dependence: Intake data from the National Treatment Outcome Research Study. Br J Psychiatry 2000; 176: 285–289.CrossRefGoogle ScholarPubMed
9.Rounsaville, BJ, Weissman, MM, Crits-Cristoph, K, Wilber, C, Kleber, H. Diagnosis and symptoms of depression in opiate addicts: Course and relationship to treatment outcome. Arch Gen Psychiatry 1982; 39: 151–156.CrossRefGoogle ScholarPubMed
10.Merrikangas, K, Mehta, R, Molnar, BEet al.Comorbidity of substance use disorders with mood and anxiety disorders: results of the international consortium in psychiatric epidemiology. Addictive Behaviour 1998; 23: 893–907.CrossRefGoogle Scholar
11.Teesson, M, Hall, W, Lynskey, M, Degenhardt, L. Alcohol and drug-use disorders in Australia: implications of the National Survey of Mental Health and Wellbeing. Aust NZ J Psychiatry 2000; 34: 206–213.CrossRefGoogle ScholarPubMed
12.Jané-Llopis, E, Matytsina, I. Mental health and alcohol, drugs and tobacco: a review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs. Drug Alcohol Rev 2006; 25: 515–536.CrossRefGoogle ScholarPubMed
13.Nunes, EV, Rounsaville, BJ. Comorbidity of substance use with depression and other mental disorders: from Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV) to DSM-V. Addiction 2006; 101: 59–96.CrossRefGoogle Scholar
14.Best, D, Gossop, M, Man, L, Finch, R, Greenwood, J, Strang, J. Accidental and deliberate overdose among opiate addicts in methadone maintenance treatment: Are deliberate overdoses systematically different? Drug Alcohol Rev 2000; 19: 213–216.CrossRefGoogle Scholar
15.Chatham, LR, Knight, K, Joe, GW, Simpson, DD. Suicidality in a sample of methadone maintenance patients. Am J Drug Alcohol Abuse 1995; 21: 345–361.CrossRefGoogle Scholar
16.Harris, EC, Barraclough, B. Suicide as an outcome for mental disorders. Br J Psychiatry 1997; 170: 205–228.CrossRefGoogle ScholarPubMed
17.Darke, S, Degenhardt, L, Mattick, R. Mortality amongst illicit drug users: epidemiology, causes and intervention. Cambridge University Press: Cambridge, 2006.CrossRefGoogle Scholar
18.Hickman, M, Hope, V, Coleman, Bet al.Assessing IDU prevalence and health consequences (HCV, overdose and drug-related mortality) in a primary care trust: implications for public health action. J Public Health 2009; 31: 374–382.CrossRefGoogle Scholar
19.Maxwell, JC, Pullum, TW, Tannert, K. Deaths of clients in methadone treatment in Texas, 1994-2002. Drug Alcohol Dependence 2005; 78: 73–81.CrossRefGoogle ScholarPubMed
20.Rehm, J, Frick, U, Hartwig, C, Gutzwiller, F, Gschwend, P, Uchtenhagen, A. Mortality in heroin assisted treatment in Switzerland 1994-2000. Drug Alcohol Dependence 2005; 79: 137–143.CrossRefGoogle ScholarPubMed
21.Kessler, R. The epidemiology of dual diagnosis. Biol J Psychiatry 2004; 456: 730–737.CrossRefGoogle Scholar
22.Hasin, D, Nunes, E, Meydan, J. Comorbidity of alcohol, drug and psychiatric disorders: epidemiology. In: Kranzler, HR, Tinsley, JA, Eds. Dual Diagnosis and Treatment: substance abuse and comorbid disorders. New York: Marcel Dekker, 2004: 1–30.Google Scholar
23.Marsden, J, Gossop, M, Stewart, Det al.The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome. Addiction 1998; 93: 1857–67.CrossRefGoogle ScholarPubMed
24.Stapleton, RD, Comiskey, C. Alcohol usage and associated treatment outcomes for opiate users entering treatment in Ireland. Drug Alcohol Dependence 2010; 107: 56–61.CrossRefGoogle ScholarPubMed
25.Comiskey, C, Stapleton, R. Treatment pathways and longitudinal outcomes for opiate users: Implications for treatment policy and planning. Drugs: Education, Prevention & Policy 2010; 17(6): 707–717Google Scholar
26.Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, Goodwin, FK. Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse: Results From the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511–2518.CrossRefGoogle ScholarPubMed