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  • Prevalence of co-occurring mental illness and substance use disorder, and association with overdose: a linked data cohort study among residents of British Columbia, Canada.

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    Author(s)
    Keen, Claire
    Kinner, Stuart A
    Young, Jesse T
    Jang, Kerry
    Gan, Wenqi
    Samji, Hasina
    Zhao, Bin
    Krausz, Michael
    Slaunwhite, Amanda
    Griffith University Author(s)
    Kinner, Stuart A.
    Year published
    2021
    Metadata
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    Abstract
    AIMS: To estimate the treated prevalence of mental illness, substance use disorder (SUD), and dual diagnosis, and the association between dual diagnosis and fatal and non-fatal overdose, among residents of British Columbia, Canada. DESIGN: A retrospective cohort study using linked health, income assistance, corrections, and death records. SETTING: British Columbia (BC), Canada PARTICIPANTS: 921,346 BC residents (455,549 males and 465,797 females) aged 10 and older. MEASUREMENTS: Hospital and primary care administrative data were used to identify a history of mental illness only, SUD only, dual diagnosis, or no history of SUD ...
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    AIMS: To estimate the treated prevalence of mental illness, substance use disorder (SUD), and dual diagnosis, and the association between dual diagnosis and fatal and non-fatal overdose, among residents of British Columbia, Canada. DESIGN: A retrospective cohort study using linked health, income assistance, corrections, and death records. SETTING: British Columbia (BC), Canada PARTICIPANTS: 921,346 BC residents (455,549 males and 465,797 females) aged 10 and older. MEASUREMENTS: Hospital and primary care administrative data were used to identify a history of mental illness only, SUD only, dual diagnosis, or no history of SUD or mental illness (2010-2014), and overdoses resulting in medical care (2015-2017). We calculated crude incidence rates of non-fatal and fatal overdose by dual diagnosis history. Andersen-Gill and competing risks regression were used to examine the association between dual diagnosis and non-fatal and fatal overdose, respectively, adjusting for age, sex, comorbidities, incarceration history, social assistance, history of prescription opioid and benzodiazepine dispensing, and region of residence. FINDINGS: Of the 921,346 people in the cohort, 176,780 (19.2%), 6147 (0.7%) and 15269 (1.7%) had a history of mental illness only, SUD only, and dual diagnosis, respectively. 4,696 (0.5%) people experienced 688 fatal and 6,938 non-fatal overdoses. In multivariable analyses, mental illness only, SUD only, and dual diagnosis were associated with increased rate of non-fatal (hazard ratio (95%CI): 1.8(1.6-2.1), 9.0(7.0-11.5), 8.7(6.9-10.9), respectively) and fatal overdose (1.6(1.3-2.0), 4.3(2.8-6.5), 4.1(2.8-6.0), respectively) compared with no history. CONCLUSIONS: In a large sample of residents of British Columbia (Canada), approximately one in five people had sought care for a substance use disorder or mental illness in the past five years. The rate of overdose was elevated in people with a mental illness alone, higher again in people with a substance use disorder alone, and highest in people with a dual diagnosis. The adjusted hazard rates were similar for people with substance use disorder only and people with a dual diagnosis.
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    Journal Title
    Addiction
    DOI
    https://doi.org/10.1111/add.15580
    Copyright Statement
    © 2021 Society for the Study of Addiction. This is the peer reviewed version of the following article: Prevalence of co-occurring mental illness and substance use disorder, and association with overdose: a linked data cohort study among residents of British Columbia, Canada, Addiction, 2021, which has been published in final form at https://doi.org/10.1111/add.15580. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
    Note
    This publication has been entered as an advanced online version in Griffith Research Online.
    Subject
    Biomedical and clinical sciences
    Psychology
    complex disorder
    drug overdose
    mental illness
    substance use disorder
    Publication URI
    http://hdl.handle.net/10072/404703
    Collection
    • Journal articles

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