Opioid Use Disorder Among Clients of Community Mental Health Clinics

Prevalence, Characteristics, and Treatment Willingness

Published in: Psychiatric Services, Volume 73, Issue 3, pages 271–279 (March 2022). doi: 10.1176/appi.ps.202000818

Posted on RAND.org on June 01, 2022

by Allison J. Ober, Sarah B. Hunter, Colleen M. McCullough, Isabel Leamon, Michael McCreary, Ivan Beas, Alanna Montero, Derjung M. Tarn, Elizabeth Bromley, Brian Hurley, et al.

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Objective

The authors examined the prevalence of co-occurring opioid use disorder and willingness to engage in treatment among clients of eight Los Angeles County Department of Mental Health outpatient clinics.

Methods

Adults presenting for an appointment over a 2-week period were invited to complete a voluntary, anonymous health survey. Clients who indicated opioid use in the past year were offered a longer survey assessing probable opioid use disorder. Willingness to take medication and receive treatment also was assessed.

Results

In total, 3,090 clients completed screening. Among these, 8% had a probable prescription (Rx) opioid use disorder and 2% a probable heroin use disorder. Of the clients with probable Rx opioid use or heroin use disorder, 49% and 25% were female, respectively. Among those with probable Rx opioid use disorder, 43% were Black, 33% were Hispanic, and 12% were White, and among those with probable heroin use disorder, 24% were Black, 22% were Hispanic, and 39% were White. Seventy-eight percent of those with Rx opioid use disorder had never received any treatment, and 82% had never taken a medication for this disorder; 39% of those with heroin use disorder had never received any treatment, and 39% had never received a medication. The strongest predictor of willingness to take a medication was believing that it would help stop opioid use (buprenorphine, ß=13.54, p=0.003, and naltrexone long-acting injection, ß=15.83, p<0.001).

Conclusions

These findings highlight the need to identify people with opioid use disorder and to educate clients in mental health settings about medications for these disorders.

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