Opioids are medications used to relieve the intensity of pain and improve mood, albeit only for a short period. As about 100 million Americans are suffering from chronic pain, opioid painkillers are usually the most recommended treatment.

When misused, however, the drug can consequently lead to dangerous addiction, overdose and then, death.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of deaths due to opioid overdose rose from 4.5 percent in 2003 to 7.8 percent per 100,000 overdose deaths in 2013. This means every day, 46 people die from an opioid overdose in the United States.

Now, a new study conducted by researchers from Saint Louis University (SLU) discovered that long term use of opioid increases a person's risk of depression.

Long Term Use Of Opioid, But Not Overdose

SLU Associate Professor Jeffrey Scherrer and his colleagues explained that using opioid for more than 30 days can result in changes in neuroanatomy, or the organization of the nervous system, and reduction in testosterone levels.

Surprisingly, though, the SLU team found that the link is independent of the known contribution of pain to depression, and that the opioid dose did not affect the association.

"Opioid-related new onset of depression is associated with longer duration of use but not dose," said Scherrer.

Scherrer and his team collected about 107,000 patient records from 2000 to 2012 from the Henry Ford Health System (HFHS), the Baylor Scott & White Health (BSWH) and the Veterans Health Administration (VHA). The patients involved in the study were new opioid users, ranging from 18 to 80 years old, and had no diagnosis of depression before taking the medication.

In a previous study, Scherrer found that patients who increased their opioid doses to treat chronic pain were more susceptible to have higher levels of depression. His team's new findings expounded on several points:

  • whether the duration of opioid use is linked to the onset of depression while controlling for dose;
  • whether a higher dose is linked to the onset of depression after changing the duration;
  • whether opioid use remains linked to the onset of depression after controlling pain scores in the data;
  • and whether the results of the study generalize to two health care populations.

Scherrer said their findings were consistent across the BSWH, the VHA and the HFHS health care systems even though each had very different patient demographics and characteristics.

In the end, Scherrer said doctors need to inform patients that opioid analgesic use of more than 30 days inflicts risks of new-onset depression.

The team's findings are published in the journal Annals of Family Medicine.

Photo: Ano Lobb | Flickr

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