Trial reportJournal of substance use and addiction treatment2026
Stimulant use and increased severity of opioid use disorder and mental illness in patients with co-occurring disorders.
Trial report in Journal of substance use and addiction treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
Funding
Abstract
backgroundAmong individuals with opioid use disorder (OUD) and co-occurring mental illness, stimulant co-use may be associated with more severe symptoms and less treatment utilization. We sought to understand the association of stimulant use with social needs and OUD and mental illness severity and treatment.
methodsThis cross-sectional study used baseline data from a randomized controlled trial of collaborative care for primary care patients with OUD and co-occurring depression and/or posttraumatic stress disorder (PTSD). We categorized stimulant use (cocaine/methamphetamine) into daily use (20 or more days), non-daily use (1-19 days), and no use (0 days). We conducted comparisons across measures of social needs and OUD and mental illness severity and treatment through one-way analysis of variance for continuous variables and chi-square tests for categorical/binary variables.
results123 (15.4%) participants used stimulants daily, 164 (20.6%) reported non-daily use, and 510 (64%) used no stimulants. When comparing participants by stimulant use, we found differences in education (p = 0.020), housing status (p < 0.001), legal problems (p < 0.001), recent overdose (p < 0.001), overdose risk (p < 0.001), MOUD use (p < 0.001), depression/PTSD symptoms (p < 0.001), and receipt of therapy (p = 0.004) or medication (p < 0.001) for depression/PTSD with all differences demonstrating more unmet social needs, greater OUD and mental illness severity, and lower treatment utilization for participants using stimulants.
conclusionsAmong primary care patients with OUD and co-occurring depression/PTSD, individuals using stimulants experienced a higher disease burden and decreased utilization of care across multiple measures. These associations suggest that clinicians should specifically address stimulant use in the context of co-occurring OUD and mental illness.
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