Engagement in treatment for depression among people who inject drugs in Baltimore, Maryland

Research output: Contribution to journalArticle

Abstract

Introduction: Mental health care may mitigate negative consequences related to substance use and bolster engagement in care for drug dependence. Despite the increased risk of depression among people who inject drugs (PWID), the longitudinal relationship of depression symptoms with depression and drug treatment utilization in this population remains uncharacterized. Methods: Data on depressive symptoms and depression treatment from current and former PWID in the ALIVE (AIDS Linked to the IntraVenous Experience) community-based cohort who had ≥3 study visits from July 2005 to June 2016 were included. We used logistic regression analysis with generalized estimating equations to examine factors associated with depression treatment in the 12 months following reported major depressive symptoms (CES-D ≥ 23) in the absence of treatment. We further examined the association between depression, depression treatment, and subsequent engagement in drug treatment among those with active substance use or alcohol dependence. Results: Of the 1544 participants, 34% were female, the median age was 51 years, and 91% were African-American. PWID reported major depressive symptoms at 22% of study visits. In adjusted analysis, acute emergency care, suicidal ideation, and recent alcohol or drug treatment were positively associated with initiating depression treatment. Depression was positively associated with subsequent treatment for substance dependence among those actively using (aOR = 1.30, 95% CI: 1.10–1.53). Conclusions: PWID experience a high burden of depressive symptoms with significant unmet need of treatment for depression. Our findings suggest that mental health providers should bolster connections to chronic disease and alcohol and drug treatment providers.

Original languageEnglish (US)
Pages (from-to)107-112
Number of pages6
JournalJournal of Substance Abuse Treatment
Volume106
DOIs
StatePublished - Nov 1 2019

Fingerprint

Baltimore
Depression
Pharmaceutical Preparations
Therapeutics
Substance-Related Disorders
Mental Health
Alcohols
Drug Utilization
Anti-HIV Agents
Suicidal Ideation
Emergency Medical Services
African Americans
Alcoholism

Keywords

  • Depression
  • Depression treatment
  • Observational cohort studies
  • People who inject drugs
  • Substance dependence treatment

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

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title = "Engagement in treatment for depression among people who inject drugs in Baltimore, Maryland",
abstract = "Introduction: Mental health care may mitigate negative consequences related to substance use and bolster engagement in care for drug dependence. Despite the increased risk of depression among people who inject drugs (PWID), the longitudinal relationship of depression symptoms with depression and drug treatment utilization in this population remains uncharacterized. Methods: Data on depressive symptoms and depression treatment from current and former PWID in the ALIVE (AIDS Linked to the IntraVenous Experience) community-based cohort who had ≥3 study visits from July 2005 to June 2016 were included. We used logistic regression analysis with generalized estimating equations to examine factors associated with depression treatment in the 12 months following reported major depressive symptoms (CES-D ≥ 23) in the absence of treatment. We further examined the association between depression, depression treatment, and subsequent engagement in drug treatment among those with active substance use or alcohol dependence. Results: Of the 1544 participants, 34{\%} were female, the median age was 51 years, and 91{\%} were African-American. PWID reported major depressive symptoms at 22{\%} of study visits. In adjusted analysis, acute emergency care, suicidal ideation, and recent alcohol or drug treatment were positively associated with initiating depression treatment. Depression was positively associated with subsequent treatment for substance dependence among those actively using (aOR = 1.30, 95{\%} CI: 1.10–1.53). Conclusions: PWID experience a high burden of depressive symptoms with significant unmet need of treatment for depression. Our findings suggest that mental health providers should bolster connections to chronic disease and alcohol and drug treatment providers.",
keywords = "Depression, Depression treatment, Observational cohort studies, People who inject drugs, Substance dependence treatment",
author = "Becky Genberg and Jacquie Astemborski and Treisman, {Glenn Jordan} and Alexia Anagnostopoulos and Mehta, {Shruti Hemendra} and Kirk, {Gregory D} and Abraham, {Alison Gump}",
year = "2019",
month = "11",
day = "1",
doi = "10.1016/j.jsat.2019.09.001",
language = "English (US)",
volume = "106",
pages = "107--112",
journal = "Journal of Substance Abuse Treatment",
issn = "0740-5472",
publisher = "Elsevier Inc.",

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T1 - Engagement in treatment for depression among people who inject drugs in Baltimore, Maryland

AU - Genberg, Becky

AU - Astemborski, Jacquie

AU - Treisman, Glenn Jordan

AU - Anagnostopoulos, Alexia

AU - Mehta, Shruti Hemendra

AU - Kirk, Gregory D

AU - Abraham, Alison Gump

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Introduction: Mental health care may mitigate negative consequences related to substance use and bolster engagement in care for drug dependence. Despite the increased risk of depression among people who inject drugs (PWID), the longitudinal relationship of depression symptoms with depression and drug treatment utilization in this population remains uncharacterized. Methods: Data on depressive symptoms and depression treatment from current and former PWID in the ALIVE (AIDS Linked to the IntraVenous Experience) community-based cohort who had ≥3 study visits from July 2005 to June 2016 were included. We used logistic regression analysis with generalized estimating equations to examine factors associated with depression treatment in the 12 months following reported major depressive symptoms (CES-D ≥ 23) in the absence of treatment. We further examined the association between depression, depression treatment, and subsequent engagement in drug treatment among those with active substance use or alcohol dependence. Results: Of the 1544 participants, 34% were female, the median age was 51 years, and 91% were African-American. PWID reported major depressive symptoms at 22% of study visits. In adjusted analysis, acute emergency care, suicidal ideation, and recent alcohol or drug treatment were positively associated with initiating depression treatment. Depression was positively associated with subsequent treatment for substance dependence among those actively using (aOR = 1.30, 95% CI: 1.10–1.53). Conclusions: PWID experience a high burden of depressive symptoms with significant unmet need of treatment for depression. Our findings suggest that mental health providers should bolster connections to chronic disease and alcohol and drug treatment providers.

AB - Introduction: Mental health care may mitigate negative consequences related to substance use and bolster engagement in care for drug dependence. Despite the increased risk of depression among people who inject drugs (PWID), the longitudinal relationship of depression symptoms with depression and drug treatment utilization in this population remains uncharacterized. Methods: Data on depressive symptoms and depression treatment from current and former PWID in the ALIVE (AIDS Linked to the IntraVenous Experience) community-based cohort who had ≥3 study visits from July 2005 to June 2016 were included. We used logistic regression analysis with generalized estimating equations to examine factors associated with depression treatment in the 12 months following reported major depressive symptoms (CES-D ≥ 23) in the absence of treatment. We further examined the association between depression, depression treatment, and subsequent engagement in drug treatment among those with active substance use or alcohol dependence. Results: Of the 1544 participants, 34% were female, the median age was 51 years, and 91% were African-American. PWID reported major depressive symptoms at 22% of study visits. In adjusted analysis, acute emergency care, suicidal ideation, and recent alcohol or drug treatment were positively associated with initiating depression treatment. Depression was positively associated with subsequent treatment for substance dependence among those actively using (aOR = 1.30, 95% CI: 1.10–1.53). Conclusions: PWID experience a high burden of depressive symptoms with significant unmet need of treatment for depression. Our findings suggest that mental health providers should bolster connections to chronic disease and alcohol and drug treatment providers.

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