Depression is a mental disorder that can affect almost every aspect of your life. It can be difficult to maintain your career, social life, and hobbies when your brain is telling you to stay home and stay in bed. Depression can change your mood and make you feel apathetic to everything around you. It can even make you physically tired. Unfortunately, depression affects millions of people each year. According to the Anxiety and Depression Association of America, 322 million people around the world have a depressive disorder.
Opioids are a common prescription remedy for a variety of symptoms including pain that often comes with depressive disorders. Your brain is a powerful thing, and it can even cause psychological problems to manifest in physical symptoms. People with anxiety and depression may experience body aches and pains that can be extremely unsettling. A little more than half of all opioid prescriptions go to people who have depression, anxiety, or mood disorders. Opioids and depression can complicate treatment when they are mixed, but chronic pain and depression often happen at the same time. Is opioid therapy a viable option for people with depression?
Depression doesn’t disqualify you for opioid treatment, but it’s an option that may come with some very serious side effects. If possible, opioids should be avoided if you’ve been diagnosed with depression. If you don’t have any other options, here are some valuable factors you should know.
Opioids affect the brain in a way that’s different than typical nervous system depressants like alcohol or benzodiazepines, but they do have effects that suppress the central nervous system. Natural opioids in the brain are designed to bind to specific opioid receptors and block pain signals and increase the release of dopamine. Depression seems to be linked to opioid use. One study looked at the development of new-onset depression in people who were long-term opioid users. The study concluded that using opioids for longer than 30 days can be a risk for developing new-onset depression.
But what about people who already have depression and are looking for chronic pain treatment? A 2018 review, noted that depressed patients were only slightly more likely to start using opioid medications but were twice as likely to transition to the long-term use of opioids. Depression can cause or worsen pain symptoms and opioids may be seen as an escape from those symptoms. One study noted that opioid use and depression were associated regardless of pain severity.
The U.S. Centers for Disease Control and Prevention (CDC) has noted that the amount of opioids prescribed has dramatically increased. But has pain also increased? They report, “Even as the amount of opioids prescribed and sold for pain has increased, the amount of pain that Americans report has not similarly changed.” However, the number of American’s suffering from depression has increased.
Because of this, many believe that treating the rise in depression can help address the opioid crisis in the United States.
Depression and addiction in general also have a close relationship. People who struggle with a substance use disorder are likely to have a co-occurring problem with depression. Conversely, depression is a risk factor for developing an addiction. The causes for developing a substance use disorder are complicated, and it’s difficult to pinpoint any one factor as a definitive cause, even in individual cases.
Drugs and alcohol are often seen as a way to self-medicate for mental health problems. That means people turn to psychoactive substances to treat problems without consulting a doctor or despite a doctor’s recommendation. Self-medication may not always be a conscious decision. Opioids produce euphoric effects, and many people may seek them out for recreational use. But after using them, a person might realize it affords them temporary relief from depression symptoms. Dopamine levels increase and lift your mood and outlook, while physical euphoria makes you feel extremely relaxed.
What started as a recreational or social drug turns into a self-treatment for negative emotional symptoms. Users begin taking the drug to feel normal. Even people that are using legal prescription opioids may be encouraged to continue using opioids long-term, even after their pain symptoms have subsided.
However, opioids aren’t typically an effective treatment for depression. Instead, they can worsen mental health problems. Substance use disorders are often associated with mental health problems. According to the National Institute on Drug Abuse, around half of people with a mental health disorder will also deal with a substance use problem at some point in their lifetime.
This could be caused by a variety of factors life the need to self-medicate, overlapping factors like a trauma that cause both disorders, or issues that are caused by addiction. People who have severe substance use disorders can experience social problems, job loss, marital issues, financial ruin, and legal trouble. These consequences of addiction can trigger feelings of guilt, inadequacy, shame, and desperation that lead to depression. Plus, people who are addicted to opioids and other drugs are in a constant struggle to satiate their addiction. Otherwise, withdrawal symptoms can cause uncomfortable mental and physical problems, including anxiety and depression.
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In addiction treatment, co-occurring mental health issues often have to be treated at the same time as substance use problems. When you first enter an addiction treatment program, you will go through an intake and assessment process that’s designed to identify your needs in treatment. Effective treatment needs to be able to address medical, psychological, social, financial, and legal issues.
Anxiety and Depression Association of America. (n.d.). Depression. Retrieved from https://adaa.org/understanding-anxiety/depression
Caruso, C. (2017, June 26). 51 percent of opioid prescriptions go to people with depression and anxiety. Retrieved from https://www.statnews.com/2017/06/26/opioids-depression-anxiety/
U.S. Centers for Disease Control and Prevention. (2018, December 19). Prescription Opioid Data. Retrieved from https://www.cdc.gov/drugoverdose/data/prescribing.html
Fox, M. (2018, May 10). More teens, young adults get depression diagnoses, insurance co finds. Retrieved from https://www.nbcnews.com/health/health-news/major-depression-rise-among-everyone-new-data-shows-n873146
Goesling, J., Henry, M. J., Moser, S. E., Rastogi, M., Hassett, A. L., Clauw, D. J., & Brummett, C. M. (2015, September). Symptoms of Depression Are Associated With Opioid Use Regardless of Pain Severity and Physical Functioning Among Treatment-Seeking Patients With Chronic Pain. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26080041
National Institute on Drug Abuse. (2018, August). Comorbidity: Substance Use Disorders and Other Mental Illnesses. Retrieved from https://www.drugabuse.gov/publications/drugfacts/comorbidity-substance-use-disorders-other-mental-illnesses
Scherrer, J. F., Salas, J., Stock, E. M., Ahmedani, B. K., Sullivan, M. D., Burroughs, T., . . . Laurel A. Copeland. (2015, June 29). Jeffrey F. Scherrer. Retrieved from http://www.annfammed.org/content/14/1/54
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