Long-term Use of Painkillers Raises Risk of Depression

Long-term Use of Painkillers Raises Risk of Depression

Long-term use of opioid pain medicine significantly raises the risk of developing major depression, according to a large new study of U.S. veterans.

bigstock-man-taking-medication-13886486Researchers at Saint Louis University studied the medical records of nearly 50,000 veterans who had no history of opioid use or depression, but were subsequently prescribed opioid painkillers.

They found that patients who remained on opioids for 180 days or longer had a 53% increased risk of developing depression compared to patients who never took opioids. Those who used opioids for 90 to 180 days had a 25% greater risk of becoming depressed. The study is being published in Journal of General Internal Medicine.

“These findings suggest that the longer one is exposed to opioid analgesics, the greater is their risk of developing depression,” said Jeffrey Scherrer, PhD, an associate professor of family and community medicine at Saint Louis University and principle investigator of the study.

“Opioids have long been known to allay pain and suffering, but reports of adverse effects are abundant and continue to emerge.”

Scherrer says there is no clear evidence about the mechanism in which opioids may contribute to depression, but there could be several factors that lead to it.

One possibility is that opioids reset the brain’s “reward pathway” to a higher level, elevating the threshold for a person’s ability to experience pleasure from natural rewards such as a food or sex.

Other factors may be side effects from opioids such as adrenal, testosterone and other hormonal changes, or vitamin D and blood glucose deficiencies.

Scherrer says the higher the dose of opioid analgesics, the greater the risk of depression.

“Preliminary evidence suggests that if you can keep your daily dose low, you may be at lower risk for depression,” he said.

Recent studies indicate that the use of prescription opioid pain medicine has quintupled recently. More than 200 million opioid prescriptions were issued to patients in 2009 in the US.

“Even though the risk is not huge, there is enough exposure that we may have a public health problem,” said Scherrer, adding that patients initiating opioid treatment should be monitored for development of depression.

Many previous studies have found a link between chronic pain and depression, with and without the use of opioids.

A recent study by researchers at the University of Toronto found that people who suffer from migraines are about twice as likely to be depressed and have suicidal thoughts. Women and young people with migraines are particularly vulnerable to what Winston Churchill has called “the black dog” of depression.

Authored by: Pat Anson, Editor

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Bill H.

I agree completely with b. j. lawson, especially the spin both the government and media are doing, and why? I read recently where 10% of those taking narcotic medications are doing so for “kicks”. Because of those in the 10% catagory, the other 90% of those that need this type of medication really to survive because of the horrific non-stop pain on a daily basis must suffer terribly because of a few unfortunate, selfish and foolish people. I certainly do understand where a control of potentially harmful drugs such as these are needed, but to over control to the point where many doctors are no longer prescribing the various narcotic medications to their patients because of the hyped up fear being induced by the “powers that be” is so wrong, dangerously wrong! Example: a sufferer of fibromyalgia takes the oxycodones to help relieve this terrible pain that they are in to at least make their lives a bit more tolerable. Their doctor no longer will prescribe their medications because of fear for whatever reasons, the patient is now left with even fewer options that may not work as well if at all. With the constant pain, and no relief in site, their lives are dashed as they can no longer function as well as they did while they were on the narcotic meds, so the only escape route for some will be suicide. Granted, there are nasty side affects from the opiates, but when one is in such heavy pain, the side affects really become a moot point. We as a society should be sympathetic if not empathetic to the needs of those who are suffering terribly, yet to listen to this hateful spin on the evils of Percocet or Oxycotin for example thus removing them completely as many feel they should be, is so wrong and inhumane!

Janice Reynolds RN, BC, OCN, CHPN

Bottom line poor study with unsupportable conclusions-there seems to be an agenda in place as well which taints the evidence (which wasn’t there to start with.
Pain causes depression whether it is because it is not well controlled, the fear you may not be able to get your medications, grief over your life changes, and so much more.

Kimberly Miller

Wouldn’t you be depressed if you were in pain?

Did they ever consider that most injured vets have ptsd in some form, which is accompanied by depression? Also, if injury was from an IED they probably have traumatic brain injury -TBI-which also has a component of depression. I was a nurse taking care of these boys for a long time, & when they do these studies, they forget little details like that!
Also, if someone needs meds to control the pain enuf to function-becuz of a chronic illness or disease, I promise u, there is a depression attached to that illness, when it has already altered your expectations for your life, as well as knowing it wont go away, & in many cases will become worse. THERE is your source of depression-NOT the drugs that bring some form of relief!! Of this, I can personally assure you. Many/most of these studies r done with those taking the meds a year or less. Two years max. They need to talk to people after 5 or 10 years! I personally have taken 12 hr release narcotics since 1997 & the only depression I have trouble with is missing my husband since his death. I learned as a child to accept it when there is a life trauma & reset my expectations for my life, so I may handle it better than some. Do I have depression related to taking narcotics to control my pain for 16 years? Absolutely not. Maybea lack of concurrent, competent counseling at day 1 wud prevent the depression? Right now there just happens to be a serious anti-narcotics drive by the Gov’t, so they add a little ‘spin’ to the stories. It’s their version of prohibition for the 2000’s.
Why not focus on getting abusers counseling & begin making EVERYONE responsible for their own behavior, instead of playing the BLAME GAME? Send drug abusers & sellers to treatment AND jail & let those who need the meds to be able to be as productive as they can be, have them!! I’m just mad at the incompetent way things are being handled!