Specific Mental Disorder Comorbidities and MOUD Receipt for Opioid Misuse: Lower Receipt for Persons with Psychotic Disorders

Objective: Medications for opioid use disorder (MOUD) have shown promise in facilitating positive treatment outcomes for those with comorbid mental disorders. However, whether MOUD receipt differs by specific mental disorder comorbidities has not been thoroughly investigated. To address this gap, the present study examined associations of specific mental disorder comorbidities with MOUD among discharges from outpatient substance use treatment. Methods: Data came from the 2016–2022 Treatment Episode Dataset-Discharges (TEDS-D). The analytic sample included 12,219 adult outpatient treatment discharges with comorbid OUD and mental disorders (mood disorder, anxiety disorder, or psychotic disorder comorbidity). Multilevel logistic regression models with random intercepts for state were used to examine associations between type of mental disorder and planned MOUD, adjusting for opioid-related, treatment-related, sociodemographic and state-level MOUD availability covariates. Results: When adjusting for covariates, discharges with depressive disorders (AOR = 1.48, 95% CI = 1.19–1.85) and anxiety disorders (AOR = 1.43, 95% CI = 1.14–1.80) had higher odds of MOUD than discharges with psychotic disorders. Conclusions: These findings signify the influence of specific mental disorder diagnoses with MOUD access. Disparities in access for those with comorbid psychotic disorders warrant further investigation.