Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Rehabilitation Counseling

First Advisor

Irmo Marini

Second Advisor

Kim Nguyen-Finn

Third Advisor

Jesus Tanguma


Opioid use disorder (OUD) affects over two million Americans, and over 42,000 Americans perished of opioid overdoses in 2016 (Volkow et al., 2019). During the initial years of the opioid crisis, overdose deaths were primarily attributed to prescription analgesics, heroin, and synthetic opioids. However, it was illicit prescription opioid painkiller use that ranked highest in terms of fatalities (Volkow et al., 2019). The increasing prevalence of opioid use among individuals with mental health disorders is in stark contrast to the ongoing opioid crisis (Prince, 2019). Additionally, there is evidence that individuals undergoing substance use treatment and concurrently suffering from a mental health disorder exhibit inferior treatment outcomes and a lower rate of treatment completion compared to their counterparts without such conditions. Those who have a higher incidence of prior overdose hospitalizations, psychiatric hospitalizations, housing insecurity, incarceration, and psychological issues (low self-esteem, diminished resilience threshold, and life satisfaction) and who also have comorbid mental health disorders and opioid use disorder may have a significantly reduced prognosis for recovery in comparison to those who do not have a severe mental health condition. Inmate status, housing insecurity, and multiple mental health disorder diagnoses are among the demographic factors that predict an increased risk of psychological issues including self-esteem, resilience, and life satisfaction. Personal characteristics such as prior psychiatric hospitalizations and overdose hospitalizations are also examined. The findings of this research, which employed multiple linear regression, indicated a significant relationship between life satisfaction and both housing insecurity and the diagnosis of multiple mental health disorders. Additionally, incarceration status and multiple diagnoses of mental health disorders were significant predictors of resilience. Nevertheless, self-esteem exhibited no correlation with diagnoses of mental health disorders, housing insecurity, or incarceration status.


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