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Are Depression and Opioids Connected?

Opioids are a group of drugs used to treat moderate-to-severe pain. These effective painkillers block pain that is being sent and received by nerve cells from the pain site to the brain. They also are used to treat pain from various sources, including surgeries, injuries, and chronic conditions. 

However, opioids may not mix well with depressive disorders, which are also very common in the United States. According to the National Institute of Mental Health, more than 17 million people had a major depressive episode in 2017. 

Short-term, prescribed use of an opioid may not cause problems for people who are vulnerable to depression. However, long-term use, high doses, and opioid abuse could negatively affect on depression. Depression and substance use disorders are closely related. In many cases, people who seek help for addiction often have underlying problems with depression that also need to be addressed. Learn more about the relationship between depression and opioid use.

Short-Term Vs. Long-Term Use

The vast majority of people who take opioids as directed never experience a substance use disorder, especially when it comes to short-term use. Short-term opioid use is usually prescribed to recover from injuries and surgeries. Opioids are given to aid the recovery process by blocking pain symptoms to help patients rest. Opioid medications may be prescribed for any reason, 

from wisdom teeth removal to major surgery. In those cases, opioids may be taken for a few days to a few weeks. Long-term opioid use is more complicated and potentially more dangerous. 

Long-lasting opioid interventions may be prescribed for chronic pain or disease that continually causes pain like cancer. A 2014 review reported that long-term opioid use for chronic pain might be risky, leading to “serious harms.” Opioid prescribing guidelines often discourage its use in people with chronic depression, but it’s still often used to treat depressed patients. A review in 2018 found that depressed patients were slightly more likely to start opioid treatment, and they were twice as likely to advance to long-term opioid treatment. 

Depression and Pain

The higher instance of long-term opioid use among depressed patients might have to do with the relationship between depression and pain. Pain and depression can each cause one another. Pain symptoms can be troubling, leading to depressive symptoms, especially when pain is long-lasting. Depression can also manifest in physical pain symptoms like headaches or muscle pain. 

This relationship can sometimes cause a vicious cycle where it’s hard to escape from either one. Both pain and depression can be improved through diet and exercise. However, pain and symptoms of depression often make you want to stay home in a sedentary position. Without intervention, depression and opioid use may lead to abuse, worsening mental health, and long-term substance issues. 

For this reason, chronic pain and depression may need treatment options that get to the root of underlying issues like mental health problems. It’s also important to explore pain-relief options that don’t increase your risk of developing a substance use disorder. 

Sources

Chou, R., Deyo, R., Devine, B., Hansen, R., Sullivan, S., Jarvik, J. G., … Turner, J. (2014, September). The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30313000

Daniel K. Hall-Flavin. (2019, April 3). Depression can cause pain – And pain can cause depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/pain-and-depression/faq-20057823

National Institute of Mental Health. (2018, February). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml

National Institute of Mental Health. (2019, February). Major Depression. Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml

Sullivan, M. D. (2018, September). Depression Effects on Long-term Prescription Opioid Use, Abuse, and Addiction. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29505419

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