The United States is currently experiencing both a mental health (MH) and an opioid epidemic. People with bleeding disorders are not immune to these issues. In fact, recent studies have shown that adults with hemophilia have high rates of depression (Manchikanti et al., 2012), and both depression and anxiety are under-diagnosed in people with hemophilia (Iannone et al., 2012).

People with inherited bleeding disorders are at risk for both acute and chronic pain (Witkop et al., 2019). Chronic exposure to opioids to treat pain can lead to dependency and a potential substance use disorder (van Genderen et al., 2006). Additionally, individuals who are prescribed opioids, especially for longer than five days, are at greater risk of chronic opioid use (Fleming et al., 2007).

These risk factors, combined with the fact that people with bleeding disorders are often denied from inpatient/residential substance use disorder (SUD) and MH treatment facilities, make it important for providers of people with bleeding disorders to regularly conduct MH and SUD assessments and intervene early if indicated. Provider awareness and involvement are essential to ensuring that patients with bleeding disorders receive adequate and appropriate behavioral health treatment.