Opioids have long been used as pain relievers, however, many individual use opioids for its euphoric properities, especially those who suffer from depression. A resent 2012 study done by Grattan and collegues at the University of Washington school of Medicine in Seattle has shown an increased risk of opioid misuse in patients with depressive symptoms with no previous substance abuse disoders.
We have chosen this study mainly because it only included subjects with no previous history of substance abuse and is based on data obtained from interviewing 1,334 patients on Chronic Opioid Therapy for non-cancer pain. In this study, depressive symptoms of patients receiving long-term opioid therapy were evaluated using the 8-item Patient Health questionnaire (PHQ-8) and has yielded the following results (Grattan, A. Sullivan, M. D. Saunders, K. W. Campbell, C. I. Von Korff, M.R. 2012).
36.9% of patients without depression missused opioid for non pain symptoms .....compared with
42.2% of patients with mild depression missused opioids
47.2% of patients with moderate depression misused opioids and
51.8% of patients with severe depression
"A recent study of elderly adults supports the association of current depressive symptoms and opioid misuse. Research has shown that patients with depression were more likely to initiate and continue opioid therapy than were patients who were not depressed. Moreover, patients with current depressive symptoms are more likely to take opioids for non pain symptoms and to take extra medications (Grattan et al, 2012)." This study alludes to a strong link between depression and the misuse of opioids. Therefore, with the existence of such evidence why are opioids still prescribed to patients with depression. The obvious answer is to manage pain, but shouldn't alternative ways of chronic pain management such as physical therapy, mindfulness training/wellness programs be discussed with patient together with the risks (such as dependence liability) associated with opioid use; especially if the patients have preexisting mental health conditions?
Opioids have long been used as pain relievers, however, many individual use opioids for its euphoric properities, especially those who suffer from depression. A resent 2012 study done by Grattan and collegues at the University of Washington school of Medicine in Seattle has shown an increased risk of opioid misuse in patients with depressive symptoms with no previous substance abuse disoders.
We have chosen this study mainly because it only included subjects with no previous history of substance abuse and is based on data obtained from interviewing 1,334 patients on Chronic Opioid Therapy for non-cancer pain. In this study, depressive symptoms of patients receiving long-term opioid therapy were evaluated using the 8-item Patient Health questionnaire (PHQ-8) and has yielded the following results (Grattan, A. Sullivan, M. D. Saunders, K. W. Campbell, C. I. Von Korff, M.R. 2012).
"A recent study of elderly adults supports the association of current depressive symptoms and opioid misuse. Research has shown that patients with depression were more likely to initiate and continue opioid therapy than were patients who were not depressed. Moreover, patients with current depressive symptoms are more likely to take opioids for non pain symptoms and to take extra medications (Grattan et al, 2012)."
This study alludes to a strong link between depression and the misuse of opioids. Therefore, with the existence of such evidence why are opioids still prescribed to patients with depression. The obvious answer is to manage pain, but shouldn't alternative ways of chronic pain management such as physical therapy, mindfulness training/wellness programs be discussed with patient together with the risks (such as dependence liability) associated with opioid use; especially if the patients have preexisting mental health conditions?