Opioids are a class of very strong pain relievers. They include drugs like OxyContin (oxycodone), morphine, and Vicodin (hydrocodone and acetaminophen). In 2017, doctors in the United States wrote more than 191 million prescriptions for these drugs.
Doctors typically prescribe opioids to relieve pain after surgery or an injury. While these drugs are very effective pain relievers, they’re also highly addictive.
People who have a mental health condition such as depression or anxiety are more likely to get opioid prescriptions. They’re also at greater risk of developing a dependence on these drugs.
Mental health disorders and opioids
The use of opioids is very common among people with mental health issues. About 16 percent of Americans have mental health disorders, yet they receive more than half of all opioid prescriptions.
People with mood and anxiety disorders are twice as likely to use these drugs than people without mental health problems. They’re also more than three times as likely to misuse opioids.
Having a mental health disorder also increases the odds of staying on opioids long-term. Adults with mood disorders are twice as likely to take these drugs for long periods than those with no mental health issues.
Opioids and depression
A reverse relationship also exists. Evidence suggests that opioid use can contribute to mental health problems.
A 2016 study in the Annals of Family Medicine found that about 10 percent of people prescribed opioids developed depression after a month of taking the drugs. The longer they used opioids, the greater their risk of developing depression became.
What’s behind the connection?
There are a few possible reasons for the link between mental health and opioid dependence:
- Pain is a common symptom in people with mental health disorders.
- People with depression and other mental health issues may use opioids to self-medicate and escape from their problems.
- Opioids may not work as well in people with mental illness, leading to the need for increasingly large doses.
- People with mental illness could have genes that increase their risk of addiction.
- Trauma such as physical or emotional abuse can contribute to both mental illness and drug addiction.
The risks of opioid use
While opioids are effective at relieving pain, they can lead to physical dependence and addiction. Dependence means you need the drug to function well. Addiction is when you continue to use the drug, even though it causes harmful effects.
Opioids are believed to change brain chemistry in a way that makes you need more and more of these drugs to get the same effect. Over time, taking increasingly larger doses leads to dependence. Trying to get off opioids can cause withdrawal symptoms such as sweating, insomnia, nausea, and vomiting.
People who take too many opioids can eventually overdose. Every day, more than 130 people die from opioid drug overdoses in the United States. In 2017, more than 47,000 Americans died from an overdose, according to the National Institute on Drug Abuse. Having a mental illness increases your odds of overdosing.
How to avoid dependence
If you live with depression, anxiety, or another mental health condition, here are a few things you can do to avoid becoming dependent on opioids.
Care for your mental health
Avoid using opioids as a mental health treatment. Instead, see a psychiatrist, psychologist, or other mental health professional to discuss a different therapy that may work for you. Treatment may involve antidepressant medications, counseling, and social support.
If you need to take opioids after surgery or an injury, use only the amount your doctor prescribed. Once you’ve finished the dose or you’re no longer in pain, stop taking the medication. Staying on these drugs for less than two weeks makes you less likely to become dependent on them.
Watch for signs of dependence
If you’re taking larger doses of the opioid to get the desired effect, you may be dependent. Going off the drug will lead to withdrawal symptoms such as irritability, anxiety, vomiting, diarrhea, and shaking. See your doctor or an addiction specialist to help you stop using these drugs.
Opioids are very effective pain relievers. They can be useful for treating short-term pain, such as after surgery or an injury. Yet they can also lead to dependence or addiction when used long- term.
People with depression and other mental health issues are more likely to become dependent on opioids. Using opioids can also increase the risk of developing a mental health problem.
If you have a mental health issue, talk to your doctor before taking opioids. Discuss the risks, and ask whether there are other pain relief options you can try instead.