Treatment of Substance Use Disorders Among Women of Reproductive Age by Depression and Anxiety Disorder Status, 2008-2014

Abstract

Background: Comorbid substance use disorder and mental health conditions are common in women of reproductive age. We sought to understand the prevalence of substance use and substance use disorder by depression and anxiety disorder status and the independent association between depression and anxiety disorder status with receiving substance use treatment. Materials and Methods: A sample of 106,142 women ages 18-44 years was drawn from the 2008 to 2014 National Survey on Drug Use and Health. Differences in demographics, substance use, substance use disorders, and treatment by major depressive episode (MDE), and anxiety disorder status, were assessed with chi-squared tests. The independent association between MDE and anxiety disorder with substance use treatment was assessed with adjusted prevalence ratios. Results: Women with MDE and/or anxiety disorder had higher prevalence of substance use and substance use disorder than women with no MDE or anxiety disorder (p < 0.001). Less than a quarter of women with substance use disorders and both MDE and anxiety disorder received mental health and substance use treatment. After adjustment, women with substance use disorder and MDE and anxiety disorder, MDE only, or anxiety disorder only were more likely to receive substance use treatment (respectively, 2.4, 1.6, and 2.2 times) than women with no MDE or anxiety disorder (p < 0.001). Conclusions: Women with MDE and/or anxiety disorder are significantly more likely to suffer from substance use and substance use disorders than their counterparts. Integrating substance use treatment services and mental health services in settings frequently visited by reproductive-aged women may increase receipt of combined treatment.

Keywords: anxiety; depression; substance use disorder; treatment; women.

FIG. 1.

The prevalence of varying types of substance use disorder^a among reproductive-aged women by MDE and anxiety disorder status^b (n = 106,142). aSubstance use disorder is defined as abuse and/or dependence of any substance use (n = 12,625); alcohol (n = 10,033); illicit drugs (cocaine, hallucinogens, heroin, inhalants, and marijuana) (n = 3,345); and nonmedical prescription drugs (n = 1,655). ^bDifferences assessed with Pearson’s chi-squared tests. *p < 0.0001. MDE, major depressive episode.