Understanding the vicious link between depression and opioid abuse

Understanding the vicious link between depression and opioid abuse

Opioids are generally prescribed for the treatment of moderate to severe pain. They include drugs like oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine and fentanyl, as well as illicit substances like heroin. These medications trigger a range of pleasurable effects by stimulating certain regions of the brain involved with the reward system.

Unfortunately, opioids work on patients by masking the pain and not by eradicating the problem from the root. Though they may succeed in temporarily uplifting a person’s mood, they increase the risk of developing depression. According to the National Survey on Drug Use and Health (NSDUH) in a 2016 survey, an estimated 11.8 million people misused opioids in the past year, with approximately 2.1 million people suffering from an opioid use disorder (OUD).

With such a large number of people dependent on opioids, the risk of experiencing depression increases manifold. Biologically, the long-term abuse of opioids, especially painkillers, leads to changes in neuroanatomy that leads to depression. A new study found out the relationship between opioids and depression to emphasize upon the need to integrate screening of opioid disorder as a contributor to a mood disorder like depression.

The United States is in the grip of an opioid epidemic. The consequences of opioid abuse have been devastating and are on the rise due to liberal prescription of opioid painkillers by medical practitioners. Therefore, it becomes necessary to understand the multiple repercussions of opioids, especially the fact that the consumption of opioids for over 30 days imposes the risk of OUD.

Long-term opioid use increases risk of depression

During the research, conducted by Jeffrey Scherrer, Ph.D., associate professor in Family and Community Medicine at Saint Louis University, and his co-authors, they collected a huge volume of medical records from three data sets of patients between ages 18 and 80 who were under opioid treatment between 2000 and 2012. It was published in the journal Annals of Family Medicine

Apparently, these patients were new opioid users, not diagnosed with depression at the time of the starting of their treatment of pain. The data sets comprised 70,997 Veterans Health Administration (VHA) patients, 13,777 Baylor Scott & White Health (BSWH) and 22,981 patients from Henry Ford Health System (HFHS).

The study found that 12 percent of the VHA patients, 9 percent of the BSWH patients and 11 percent of the HFHS patients experienced new-onset depression after the long-term use of opioid analgesics. Across all the patient groups, longer duration of opioid use was linked with depression after controlling for pain and daily morphine equivalent doses (MEDs).

The risk increased depending on the period of opioid use. The opioids included in the study were codeine, fentanyl, hydrocodone, hydromorphone, levorphanol, meperidine, oxycodone, oxymorphone, morphine and pentazocine. The findings were exceptionally uniform across the three sets of data despite the differences in characteristics and demographics of the patients.

Opioids just mask pain

This study has been able to expose yet another adverse outcome of extended opioid use. Although the link between opioid abuse and depression is still less understood, this revelation will encourage medical practitioners and patients to keep a tab on the consumption of opioids.

With the increase risk of developing a coexisting disorder due to opioid abuse, it often becomes difficult for patients and medical practitioners to determine an effective intervention. As mentioned above, the authors advise clinicians to consider the role of opioid analgesics  and not just pain as a potential risk factor in the development of depression in patients. However, additional research is required to identify the patients who maybe more vulnerable to opioid-related depression.

If you need help from a mental health professional for depression and opioid dependence, contact the Dual Diagnosis Helpline. Call at our 24/7 helpline number 855 981-6047 or chat online with our experts to get details about the finest dual diagnosis programs in your vicinity. Our representatives will help you in finding the best dual diagnosis rehab centers where such problems are managed through holistic treatment plans that help individuals lead happier and productive lives.

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