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Abstract

Background: Mental health and substance use disorder (SUD) are often concurrent and comorbid disorders that share several causal factors. This study aims to provide evidence of factors that impact participant reported experiences of serious depression and serious anxiety among a cohort of individuals receiving injectable opioid agonist treatment (iOAT). Methods: This study utilized data from a longitudinal retrospective cohort study of individuals receiving iOAT (i.e. diacetylmorphine and hydromorphone) in Vancouver, Canada from 2016-2018. The primary outcomes of serious depression and serious anxiety were ascertained via participant self-report in the psychiatric domain of the European Addiction Severity Index (EuropASI). Analyses utilized Generalized Linear Mixed Models with random intercepts and Penalized Quasi-Likelihood (GLMMPQL) method of inference to examine associations between several factors and the outcomes of depression and anxiety. Results: Of the 131 participants included in the analyses, the average age was 49.04 years (SD = 9.32), 31% self-identified as female, 30% self-identified as Indigenous (Métis, Inuit, First Nations), 55% reported a chronic medical problem, and mean number of reported days using illicit opioids was 5.97 days (SD = 7.72). Adjusted analysis of serious depression demonstrated significant associations between poorer physical health, recent illicit opioid use, emotional abuse, and free time spent alone. Likewise, adjusted analysis of serious anxiety identified significant associations with age, recent illicit benzodiazepine use, poorer physical health, and social problems. Conclusion: Several factors were identified as associated with the outcomes of serious depression and serious anxiety. As iOAT care continues to expand, there is a clear need for person-centered care (PCC) initiatives that can consider the unique needs of clients experiencing depression and anxiety while providing integrated psychotherapeutic and pharmacological supports.