title: Patterns of major depression and nonmedical use of prescription opioids in the United States.
abstract: BACKGROUND
  Recent epidemiologic studies have shown that nonmedical use of prescription opioids (NMUPO) and major depression frequently co-occur. Comorbid forms of drug use and mental illness such as NMUPO and depression pose a greater disease burden than either condition alone. However, sociodemographic and substance use differences between individuals with either NMUPO or depression and those with comorbid conditions have not yet been fully investigated.
  
  
  METHODS
  Data came from the 2011 and 2012 National Survey on Drug Use and Health (NSDUH). Adolescents and adults were examined independently because of differences in screening for major depressive episodes (MDE). Weighted multinomial logistic regression investigated differences between persons with either past-year NMUPO (4.0%) or MDE (5.5%) and those with comorbid NMUPO and MDE (0.6%), compared to persons with neither condition.
  
  
  RESULTS
  Females were more likely than males to report either MDE-alone and comorbid NMUPO and MDE, whereas adult men were marginally more likely to report NMUPO-alone (not significant among adolescents). Polydrug use and alcohol use disorders were more pronounced among those with comorbid NMUPO and MDE than persons with either NMUPO-alone or MDE-alone. Persons with independent and comorbid NMUPO and MDE were more likely to report lower income and unemployment versus employment.
  
  
  CONCLUSIONS
  This study found that independent and comorbid NMUPO and MDE were disproportionately clustered with burdens of lower socioeconomic position, suggesting that a population-based approach to address NMUPO would target these social determinants of health, whereas a high-risk approach to prevention should be tailored to females experiencing MDE symptoms and polydrug users.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1513, New York, NY 10032, United States. Electronic address: dsf2130@columbia.edu.
authors.forename: David S
authors.initials: DS
authors.lastname: Fink
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1513, New York, NY 10032, United States.
authors.forename: Ranran
authors.initials: R
authors.lastname: Hu
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1513, New York, NY 10032, United States. Electronic address: mc3226@columbia.edu.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cerdá
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1513, New York, NY 10032, United States. Electronic address: kmk2104@cumc.columbia.edu.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI 02912, USA. Electronic address: brandon_marshall@brown.edu.
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.affiliation: Boston University School of Public Health, 715 Albany Street-Talbot 301, Boston, MA 02118, United States. Electronic address: sgalea@bu.edu.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1513, New York, NY 10032, United States. Electronic address: ssm2183@columbia.edu.
authors.forename: Silvia S
authors.initials: SS
authors.lastname: Martins
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000009:adverse effects; D002648:Child; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Addiction; Illegal drug use; Major depressive disorder; Nonmedical use of prescription opioids; Polydrug use