Comorbidity and co-prescription patterns of people with serious mental illness in methadone maintenance may
complicate theirtreatment and have not been studied. The goal of this study was
to examine the care and characteristics of people with serious mental illness inmethadone maintenance treatment nationally in the Veterans Health
Administration (VHA).
Using national VHA data from FY2012, bivariate and multiple logistic
regression analyses were used to compare veterans in methadonemaintenance treatment wo had a serious mental illness (schizophrenia,
bipolar disorder, or major affective disorder) to patients in methadonemaintenance treatment without serious mental illness and
patients with serious mental illness who
were not in methadone maintenance treatment.
Only a small fraction of patients with serious mental illness were receiving methadone maintenance treatment (0.65%),
but a relatively large proportion in methadone maintenance treatment had
a serious mental illness (33.2%). Compared to patients without serious mental illness, patients with serious mental illness in methadone maintenance treatment were
more likely to have been homeless, to have had a recent psychiatric hospitalization,
to be over 50% disabled, and to have had more fills for
more classes of psychotropic drugs. Compared to other patients with serious mental illness, patients with serious mental illness in methadone maintenance treatment were
more likely to have a drug abuse diagnosis and to reside in large urban areas.
One-third of patients in methadone maintenance treatment have serious mental illness and more frequent psychiatric comorbidity,
and they are more likely to use psychiatric and
general health services and
fill more types of psychiatric prescriptions.
Further study and clinical awareness of potential drug-drug interactions in this
high medication and service using population are needed.
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