Association of Combined Opioid and Marijuana Use with Major Depressive Disorder among Adults with Chronic Conditions in the United States (US)
Author(s)
Tiffany Graham, MS1, R. Constance Wiener, PhD2, Sophie Mitra, PhD3, Lakshmi Sraddha Pedaprolu, High School4, Jennifer Fix, PhD1, Hao Wang, MD, PhD5, Chan Shen, PhD6, Usha Sambamoorthi, MA, PhD1;
1UNTHSC, Fort Worth, TX, USA, 2West Virginia University, Morgantown, WV, USA, 3Fordham University, Bronx, NY, USA, 4Frisco ISD, Plano, TX, USA, 5JPS Health Network, Fort Worth, TX, USA, 6Pennsylvania State University, Hershey, PA, USA
1UNTHSC, Fort Worth, TX, USA, 2West Virginia University, Morgantown, WV, USA, 3Fordham University, Bronx, NY, USA, 4Frisco ISD, Plano, TX, USA, 5JPS Health Network, Fort Worth, TX, USA, 6Pennsylvania State University, Hershey, PA, USA
OBJECTIVES: Chronic pain management often involves the use of opioids and, increasingly, marijuana, which is perceived to have pain-relieving properties. With the legalization of marijuana in many US states, the combined use of opioids and marijuana (co-use) has become more prevalent. While both substances have been independently associated with major depressive disorder (MDD), the association of co- use with MDD remains underexplored. This study investigated the association of co-use (opioids+marijuana)with MDD among adults with chronic conditions in the US.
METHODS: Cross-sectional analysis of 35,585 adults(aged 24 years or older) representing ~129.8 million from 2022 National Survey of Drug Use and Health. Past-year opioids and marijuana use were grouped into: 1)Co-use of opioids and marijuana;2) opioid only; 3)marijuana only; and 4) neither. DSM-5 criteria defined past-year major depression -felt depressed or lost interest or pleasure in daily activities for ≥2 weeks in the past year and experiencing ≥5 of 9 symptoms during the same 2-week period. Rao-Scott Chi-square tests and multivariable logistic regression analyses that accounted for complex survey design were used to test the association of co-use with MDD after controlling for sex, age, race and ethnicity, social determinants of health, obesity, alcohol, smoking, multimorbidity, COVID-19 related mental health, and past-year benzodiazepine use.
RESULTS: Overall, 7.7% reported co-use;21% reported opioid use; and 13.5% reported marijuana use. Past year MDD was highest among those with co-use(17.4%) followed by marijuana only (12.9%); opioid only(7.6%) and neither (4.8%). In fully adjusted logistic regression, co-use had the strongest association with past year MDD(AOR=1.80,95% CI=1.47, 2,21)followed by marijuana only(AOR=1.49,95% CI=1.26,1.77) and opioid only(AOR=1.27, 95%CI=1.08, 1.49) compared to "neither" group.
CONCLUSIONS: Co-use was associated with higher odds of MDD. Care plans prioritizing non-opioid treatments may be needed for chronic disease management to reduce the risk of adverse mental health outcomes.
METHODS: Cross-sectional analysis of 35,585 adults(aged 24 years or older) representing ~129.8 million from 2022 National Survey of Drug Use and Health. Past-year opioids and marijuana use were grouped into: 1)Co-use of opioids and marijuana;2) opioid only; 3)marijuana only; and 4) neither. DSM-5 criteria defined past-year major depression -felt depressed or lost interest or pleasure in daily activities for ≥2 weeks in the past year and experiencing ≥5 of 9 symptoms during the same 2-week period. Rao-Scott Chi-square tests and multivariable logistic regression analyses that accounted for complex survey design were used to test the association of co-use with MDD after controlling for sex, age, race and ethnicity, social determinants of health, obesity, alcohol, smoking, multimorbidity, COVID-19 related mental health, and past-year benzodiazepine use.
RESULTS: Overall, 7.7% reported co-use;21% reported opioid use; and 13.5% reported marijuana use. Past year MDD was highest among those with co-use(17.4%) followed by marijuana only (12.9%); opioid only(7.6%) and neither (4.8%). In fully adjusted logistic regression, co-use had the strongest association with past year MDD(AOR=1.80,95% CI=1.47, 2,21)followed by marijuana only(AOR=1.49,95% CI=1.26,1.77) and opioid only(AOR=1.27, 95%CI=1.08, 1.49) compared to "neither" group.
CONCLUSIONS: Co-use was associated with higher odds of MDD. Care plans prioritizing non-opioid treatments may be needed for chronic disease management to reduce the risk of adverse mental health outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD98
Topic
Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Mental Health (including addition)