Long-term use of prescription-based painkillers increases the risk of depression, researcher finds

October 31, 2013, Saint Louis University

Opioid analgesics, or prescription-based narcotic pain killers, have long been known to reduce pain, but reports of adverse effects and addiction continue to surface. Now, a team of investigators led by a Saint Louis University researcher has discovered a link between chronic use of pain-relieving medication and increase in the risk of developing major depression.

The study, which was published in the Journal of General Internal Medicine on October 31 analyzed medical record data of about 50,000 veterans who had no history of opioid use or , and were subsequently prescribed opioid killers.

According to the findings, patients who started and remained on opioids for 180 days or longer were at a 53 percent increased risk of developing a new episode of depression, and those using opioids for 90-180 days were at a 25 percent increased risk compared to patients who never took opioids for longer than 1-89 days.

"These findings suggest that the longer one is exposed to , the greater is their risk of developing depression," said Jeffrey Scherrer, Ph.D. 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 are abundant and continue to emerge."

Scherrer said even though there is no clear evidence about the mechanisms by which opioids may contribute to the development of depression in a patient, there could be several factors that lead to it.

Some of these include opioid-induced resetting of the brain's 'reward pathway' to a higher level, which means the chronic use of narcotic can elevate the threshold for a person's ability to experience pleasure from natural rewards such as a food or sexual activity.

Other factors may include body aches months and years after the use of has stopped, side effects such as adrenal, testosterone and vitamin D deficiencies and glucose dysregulation.

The study also suggests that 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.

Scherrer notes that even though a minority of patients take these pain killers chronically, they are at risk of developing depression that can affect their quality of life and ability to cope with .

He said recent studies indicate that the use of prescription opioid analgesics has quintupled recently and that more than 200 million 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," he said.

Explore further: Long-term opioid use associated with increased risk of depression

More information: link.springer.com/article/10.1 … 07/s11606-013-2648-1

Related Stories

Long-term opioid use associated with increased risk of depression

January 12, 2016
Opioids may cause short-term improvement in mood, but long-term use imposes risk of new-onset depression, a Saint Louis University study shows.

Scientist finds higher opioid doses associated with increase in depression

February 13, 2015
Patients who increased doses of opioid medicines to manage chronic pain were more likely to experience an increase in depression, according to Saint Louis University findings in Pain.

Opioids increase risk of death when compared to other pain treatments

June 14, 2016
Long-acting opioids are associated with a significantly increased risk of death when compared with alternative medications for moderate-to-severe chronic pain, according to a Vanderbilt study released today in JAMA.

Many patients continue using opioids months after joint replacement

May 31, 2016
Many patients undergoing hip or knee replacement are still taking prescription opioid pain medications up to six months after surgery, reports a study in Pain, the official publication of the International Association for ...

Significant pain increases the risk of opioid addiction by 41 percent

July 22, 2016
What do we really know about the relationship between the experience of pain and risk of developing opioid use disorder? Results from a recent study - the first to directly address this question—show that people with moderate ...

Chronic low back pain linked to higher rates of illicit drug use

July 21, 2016
People living with chronic low back pain (cLBP) are more likely to use illicit drugs—including marijuana, cocaine, heroin, and methamphetamine—compared to those without back pain, reports a study in Spine.

Recommended for you

Early physical therapy can reduce risk, amount of long-term opioid use, study finds

December 14, 2018
Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new ...

Early postpartum opioids linked with persistent usage

December 14, 2018
Vanderbilt researchers have published findings indicating that regardless of whether a woman delivers a child by cesarean section or by vaginal birth, if they fill prescriptions for opioid pain medications early in the postpartum ...

Shortcut strategy for screening compounds with clinical potentials for drug development

December 4, 2018
Developing a new drug often takes years and costs hundreds of millions of dollars. A shortcut has now been reported in a study led by City University of Hong Kong (CityU), which can potentially reduce the time and costs of ...

Drug wholesalers drove fentanyl's deadly rise, report concludes

December 4, 2018
Fentanyl, a powerful synthetic opioid implicated in nearly 29,000 overdose deaths in the United States last year, most likely spread because of heroin and prescription pill shortages, and also because it was cheaper for drug ...

Global review reports on administration of children's antibiotics

December 4, 2018
Researchers analyzing the sales of oral antibiotics for children in 70 high- and middle-income countries found that consumption varies widely from country to country with little correlation between countries' wealth and the ...

Opioid prescriptions from dentists linked to youth addiction risk

December 3, 2018
Teens and young adults who receive their initial opioid prescriptions from their dentists or oral surgeons are at increased risk for opioid addiction in the following year, a study from the Stanford University School of Medicine ...

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

Reruho
not rated yet Nov 02, 2013
Let us ask the question, is the fact they have chronic pain the real cause of their depression and not the medication? Was this question ever explored?
As a chronic pain sufferer, I see this as another way to limit access to the medication that can allow me to live a somewhat normal life.

mjp
not rated yet Nov 13, 2013
Their future of unending pain, 24/7, forever till they die, is the cause of their depression, not the pain relievers. My spouse has been in Chronic pain for over 15 years.
The fact that there are many (who use drugs for entertainment) that profit from this disease ,(which includes many doctors), the true sufferers have been demonized, those who deserve it the least. Present them with an alternative and they will be the first off the medications.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.