Evaluating Factors That Contribute to Substance Use and Co-occurring Mental Health Disorders

Clarence White capstone

Substance abuse continues to be heavy social and medical burdens. Many misused drugs can alter a person’s thinking and judgment, leading to health risks, including addiction, impaired driving, and infectious diseases. Substance use disorder (SUD) affects more than 8% of people in the United States at some point in their lives. Prescription opioids, marijuana, psychostimulants like cocaine and methamphetamine and alcohol are the most commonly abused substances in the United States. As the active addiction grows more serious, its social impact on the community expands exponentially in a multitude of ways. Abused drugs act to increase the dopamine in reward regions of the brain. A protein called dopamine transporter helps to clear the dopamine released to restore dopamine homeostasis.  Additionally, individuals who experience a substance use disorder during their lives may also experience a co-occurring mental health disorder or vice versa. 

In order to investigate this in a large and diverse cohort, we will analyze the association between SUDs and other mental health disorders by using All of Us data and risk prediction models.  To this end we will conduct a Longitudinal Cohort Study on participants with SUD and Co-occurring mental health disorders.  This study will evaluate the likelihood that an individual with mental health disorder (depression, anxiety or bipolar) will have a co-occurring substance use disorder (alcohol, opioid, cannabis or cocaine).  The data will be evaluated using logistic regression and an adjusted odds ratio with a 95% confidence interval.  Preliminary analysis of the adjusted odds ratio showed that when patient had severe condition of depression, anxiety, and bipolar, they were more likely to use alcohol, opioid, cannabis, and cocaine, with the exception of decreasing use of cocaine associated with increased anxiety.  When compared with Whites, Black and Hispanic are more likely to use cannabis and cocaine, but less likely to use alcohol and opioid.  Additionally, diabetes, heart failure, and HIV were positively associated with opioid and cannabis use, but they were negatively associated with the increased use of alcohol.

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