Comorbidity of opioid-related and anxiety-related symptoms and disorders
Open accessAbstract
Opioid use disorder and anxiety disorders co-occur at strikingly high rates, and this comorbidity is marked by a more severe clinical presentation and poorer prognosis for treatment. Given the substantial morbidity and mortality associated with these two disorders, it is imperative to understand factors related to the high rates of co-occurrence in order to inform the development of specialized treatments for this population. Several lines of study suggest that simultaneously addressing opioid-related and anxiety-related symptoms and processes, particularly intolerance of distress and pain-related anxiety, may yield improved outcomes for this high risk, vulnerable population. Future work is needed to identify other novel mechanisms as well as develop specialized treatments to augment standard medication-assisted treatment.
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Opioid use and anxiety disorders frequently co-occur and patients with elevated anxiety are more likely to relapse and/or drop out of opioid treatment as well as experience psychological distress.
“For example, opioid use and anxiety disorders frequently co-occur and patients with elevated anxiety are more likely to relapse and/or drop out of opioid treatment as well as experience psychological distress (e.g., pain intolerance, distress intolerance).(Langdon et al., 2019)”
From A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders (2024) · cites this paper as Langdon et al., 2019
The Introduction reports frequent co-occurrence, and “Impact of Comorbidity on Treatment Outcomes” says elevated anxiety may be associated with relapse or premature treatment discontinuation. The paper discusses distress intolerance, but does not establish that patients with elevated anxiety are more likely to experience it; its “Distress Intolerance” section reports that distress intolerance was not associated with measured pain tolerance. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredRecent reviews have highlighted the lack of research regarding psychological interventions for patients with comorbid anxiety and opioid use and the potential of psychological interventions to be paired with medication to address both anxiety and opioid use concurrently.
“Recent reviews have highlighted the lack of research regarding psychological interventions (e.g., Integrated CBT) for patients with comorbid anxiety and opioid use and specifically the potential of psychological interventions to be paired with medication (e.g., suboxone) to address both anxiety and opioid use concurrently.(Dugosh et al., 2016; Langdon et al., 2019)”
From A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders (2024) · cites this paper as Langdon et al., 2019
Anxiety sensitivity, emotion dysregulation, pain-anxiety, distress intolerance, and acceptance are transdiagnostic vulnerability factors for opioid-related and anxiety-related disorders.
“recent research has addressed transdiagnostic vulnerability factors [95], and specifically, anxiety sensitivity [96], emotion dysregulation [97], pain-anxiety [89], distress intolerance [98], and acceptance [39,40,41] as in the present study.”
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Additional file 2 of Quantifying prescribed high dose opioids in the community and risk of overdose
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Additional file 1 of Quantifying prescribed high dose opioids in the community and risk of overdose
Schofield, J., Steven, D., Foster, R., Matheson, C., Baldacchino, A., McAuley, A., & Parkes, T. (2021) · Figshare · doi:10.6084/m9.figshare.14833060
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Additional file 3 of Quantifying prescribed high dose opioids in the community and risk of overdose
Schofield, J., Steven, D., Foster, R., Matheson, C., Baldacchino, A., McAuley, A., & Parkes, T. (2021) · Figshare · doi:10.6084/m9.figshare.14833066
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- Authors
- Langdon, K. J., Dove, K., & Ramsey, S.
- Affiliations
- Brown University (US)
- Stonehill College (US)
- Corresponding author
- Langdon, Kirsten J
- Venue
- Current Opinion in Psychology
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 30
- Pages
- 17-23
- ISSN
- 2352-250X (ISSN-L)
- PMC
- PMC6609499
- OpenAlex
- W2947167025
- Cited by
- 53
- References
- 63
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 11 · 2020: 3 · 2019: 2
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (54GM115677)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- opioid use disorder, anxiety disorders, comorbidities, pain-related anxiety, medication-assisted treatment, treatment outcomes, dual diagnosis
- MeSH terms
- Anxiety Disorders, Humans, Opioid-Related Disorders, Pain, United States, Comorbidity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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