In Canada, nearly 200,000 people have an opioid use disorder (OUD). Of these, between 16-32% also live with comorbid depression (MDD). MDD can worsen medical, psychiatric and social prognoses by increasing the risk of continued drug misuse, suicidality, and overdose. MDD and OUD can also impact each other, which hampers proper management of both disorders.
This research program aims at improving OUD and MDD treatments by studying three central concepts, namely OUD medical consequences, OUD treatment and MDD treatment. We will evaluate the impact of MDD on risk behaviours for hepatitis C infection by analyzing data from a cohort of people who inject drugs. We will also assess the impact of MDD on opioid agonist treatment efficacy using data drawn from a randomized pragmatic clinical trial evaluating the effectiveness of methadone and buprenorphine/naloxone on opioid use. We will also explore the impact of opioid agonist treatments on depressive symptomatology. Finally, we assessed preferences of patients with depressive symptoms and OUD in terms of MDD treatments and clinical trial designs with an online survey, using a discrete choice experiment approach.
These studies will improve our understanding of the interrelationship between MDD and OUD. We will be able to identify the people who are most likely to engage in risk behaviours therefore improving referral to preventive interventions. In addition, our results will help identify the best treatment for OUD in the context of comorbid MDD. Finally, the survey will facilitate the development of a clinical trial on the effectiveness of MDD treatments by promoting the involvement of OUD patients in research. In short, this research program has the potential to increase the accessibility and quality of treatment available for people with OUD and MDD.