Opioid overdoses, depression linked

Opioid overdoses, depression linked
In a new paper, Laura Schwab Reese points out a strong link between opioid overdoses and depression. Credit: Purdue University/Rebecca Wilcox

The link between mental health disorders and substance abuse is well-documented. Nearly one in 12 adults in the U.S is depressed, and opioid-related deaths are skyrocketing. As these numbers continue to climb, some mental health professionals have started to wonder if there's a link between the two.

According to a new study published in Social Psychiatry and Psychiatric Epidemiology, the link is strong.

"For every additional 1 percent of the population that has a depression diagnosis, we see between a 25 and 35 percent increase in the number of opioid overdose deaths," said Laura Schwab Reese, an assistant professor of and kinesiology at Purdue University, who led the study. "We thought maybe suicide was driving this, but we sectioned out unintentional overdose and found that the relationship continued."

More than 72,000 Americans died of drug overdoses in 2017, mostly from opioids. The Trump administration declared the crisis a public health emergency in October 2017, but the end is still out of sight. This, coupled with rising rates of depression and a lack of access to for many, is proving to be deadly.

Schwab Reese and Madeline Foley, a student at Riverdale Country School, analyzed data from the Centers for Disease Control and Prevention on from 2011 to 2015. Rates of opioid-related deaths were generally stable from 2011 to 2013, but increased substantially in the two following years.

Data on depression was collected by a telephone survey of more than 400,000 people across the country. About 19 percent of respondents reported a depression diagnoses in 2015—up from 17.5 percent in 2011.

"We know from prior literature that people who are depressed are more likely to be prescribed opioids, but also that people who are prescribed opioids are more likely to become depressed," said Schwab Reese. "We need to recognize that this is probably a bidirectional relationship."

The solution, said Schwab Reese, is twofold. Doctors should screen for depression and discuss the risk with patients before prescribing opioids. Because nearly two-thirds of opioid overdoses involve prescription medications, doctors could play a significant role in preventing opioid misuse and depression.

Second, Americans need better access to mental health care.

More than 40 million Americans have a mental health condition, and more than half of them don't receive treatment. In West Virginia, the state with the highest number of -related deaths in 2015, nearly a million people live in areas with a shortage of mental health care providers. The U.S. would need an additional 3,000 providers to meet American's needs, according to another study.

"We can't say this person had and that led to an overdose—this was a population-level analysis," said Schwab Reese. "To me, that means we need a population-level response."

Explore further

Opioid deaths 1999 to 2015 may be dramatically underestimated

More information: Madeline Foley et al, Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011–2015, Social Psychiatry and Psychiatric Epidemiology (2018). DOI: 10.1007/s00127-018-1594-y
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User comments

Oct 03, 2018
"More than 72,000 Americans died of drug overdoses in 2017, mostly from opioids"

-and most of these were from illegal chinese fentanyl.

They are selling single pills with several times the quantity needed to kill. So the intent must be to kill as many as possible. Not only is it wasting product, but eliminating the consumer base. Economically it makes no sense.

And so it must be NBC warfare. This is no different than mailing envelopes full of anthrax to millions of Americans. This is an act of war. Why arent we treating it that way? Are the politics of the day intended to divert our attention from THIS?

This is not happening elsewhere...

"Estonia had the highest rate of overdose deaths in Europe in 2015—102.7 per million population, five times the European average (20.3)"

-Is it related to the tariffs? The cyberwar? What is the advantage gained? Where are the penalties? Where is the counterattack???

Oct 04, 2018
The 33,329 deaths from methadone and natural or semisynthetic opioids (including heroin) outweighs the 19,413 deaths from synthetic opioids including fentanyl AND others (2016 data) https://www.kff.o...-opioid/ .
Not that I'm stating that you are a liar, but I'm going to need some evidence for both the fentanyl claim and the chinese claim.

As for the insinuation that a state actor must be behind it simply based on the "fact" that some pills might have several times a lethal dose is laughable. A big part of the actual problem, not the made-up version in Otto's head, is that expensive heroin is being cut with cheap fentanyl. And so we have to factor in drug dealers that aren't quite smart enough to figure out the correct cut ratio or use the correct mixing procedure but are smart enough not to try the resulting product on themselves.

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