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The Article in Brief
Depression and Prescription Opioid Misuse Among Chronic Opioid Therapy Recipients With No History of Substance Abuse
Mark D. Sullivan , and colleagues
Background Opioid medications are commonly used to treat chronic noncancer pain, but they can be misused. This study examines whether there is an association between depression and misuse of opioids by patients with no history of substance abuse who are receiving chronic opioid therapy.
What This Study Found Patients are much more likely to misuse opioids if they are depressed. This study surveyed 1,334 patients with no history of substance abuse who were on long-term opioid therapy for chronic pain. Patients with moderate and severe depression were more likely to misuse their opioid pain medications for nonpain symptoms compared with patients who were not depressed. Patients with mild, moderate, and severe depression were 1.9, 2.9, and 3.1 times more likely, respectively, than patients who were not depressed to misuse their opioid medications by self-increasing their dose. Other risk factors for misuse include male sex, lower average daily dose, less education, younger age, higher pain severity, and white race.
Implications
- Clinicians should be alert to the risk of patients using opioids to relieve symptoms of depression.
- The authors call for future research to examine whether treatment of depression decreases the risk of opioid misuse.