Treatment outcomes of an integrated treatment model for patients with co-occurring opioid use and schizophrenia spectrum disorders.

BACKGROUND

Individuals with schizophrenia spectrum disorders are at elevated risk for developing opioid use disorder and often experience higher substance use rates and morbidity. However, integrated treatment models for such patients remain rare.

OBJECTIVE

This study addresses a gap in clinical knowledge by evaluating outcomes from a dual-diagnosis program tailored for patients with both disorders.

METHODS

This retrospective case series analyzed electronic medical record data from when patients were enrolled in the program through March 1st, 2025 or program discharge.

RESULTS

Seventeen patients attended at least one appointment. All patients had a diagnosis of opioid use disorder. Co-occurring psychotic disorders included schizoaffective disorder (13/17, 76%), schizophrenia (3/17, 18%), and unspecified psychotic disorder (1/17, 6%). On average, patients attended 58.8% of scheduled visits, and 47.1% remained actively enrolled as of 3/1/25. Medication adherence was high, with patients taking prescribed medications for opioid use disorder at 90.5% of visits and antipsychotics at 96.9% of visits. Compared to an equivalent pre-enrollment period, patients showed a significant reduction in emergency department visits (P=0.00051) and inpatient hospitalizations (P=0.00090).

CONCLUSION

Findings suggest that the integrated treatment model could offer benefits for patients with co-occurring opioid use disorder/schizophrenia spectrum disorders; patients had significantly reduced emergency department visit frequency and frequency/duration of hospitalizations. Patients demonstrated high adherence to medications for opioid use disorder and antipsychotics; appointment attendance remains an area for improvement. Further research with larger samples and longer follow-up is warranted.