New findings from an American research group underscore the relatively frequent overlap between prescription opioid misuse and major depression in American men and women.
Misuse of opioid medications is the most common form of prescription drug abuse in the U.S. Major depression (major depressive disorder) is a severe and relatively common form of diagnosable depressive illness. In a study published in May 2015 in the journal Drug and Alcohol Dependence, researchers from three American universities assessed the degree of overlap between major depression and prescription opioid misuse in U.S. adults. These researchers also sought to identify specific segments of the population most likely to have simultaneous issues with depression and improper opioid medication consumption.
Prescription Opioid Misuse
Doctors, public health officials and researchers commonly use two terms to identify a pattern of improper opioid medication intake: prescription opioid misuse and prescription opioid abuse. In certain contexts, the terms are equivalent. However, experts in the field may also use the term prescription opioid abuse to refer to diagnosable problems with non-addicted opioid intake that are severe enough to require medical treatment. For this reason, many experts make efforts to clearly distinguish between abuse and misuse. Whether or not he or she has diagnosable problems with abuse, a person engaged in prescription opioid misuse consumes an opioid medication outside of the guidelines set forth by his or her doctor or consumes an opioid medication without a prescription.
Recent findings from the federal Substance Abuse and Mental Health Services Administration point to a rate of opioid medication misuse in the U.S. that’s higher than the combined rate for the other three most commonly misused medication types (sedative-hypnotic sedatives, sedative-hypnotic tranquilizers and prescription stimulants). While many people associate access to opioid substances with purchases from drug dealers, most individuals who misuse prescription opioids get their supplies from a relative or friend without spending any money. Other common sources include a single prescribing doctor and a friend or relative who requires payment for providing access. Drug dealers and other strangers provide just 4.3 percent of the total availability of opioid medications.
Most people who use the word depression are knowingly or unknowingly referring to major depression, a particularly serious and sometimes debilitating form of depressive illness characterized by severely “down” or negative states of mind that last for at least two weeks at a time. Close to 7 percent of American adults have diagnosable symptoms of this disorder in any given year. Women are diagnosed much more often than men, although some of this gender disparity likely comes from overdiagnosis in women and/or underdiagnosis in men. Teenagers develop major depression about 50 percent as often as adults. While some individuals experience just one bout of major depression in their lifetimes, many others experience recurring bouts over time.
Degree of Overlap
In the study published in Drug and Alcohol Dependence, researchers from Columbia University, Brown University and Boston University used data from the 2011 and 2012 versions of the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) to estimate how often people involved in prescription opioid misuse have diagnosable cases of major depression. The researchers used the same data set to help identify those segments of the population with the highest chances of developing these overlapping health problems. This is especially important since a depressed person engaging in opioid medication misuse has a greater level of risk for adverse outcomes than a person only affected by depression or a person who only misuses prescription opioids.
The researchers concluded that 4 percent of the NSDUH participants misused an opioid medication in the previous year. They also concluded that 5.5 percent of the participants met the criteria for a major depression diagnosis. In addition, the researchers concluded that 0.6 percent of the study participants had overlapping issues with prescription medication misuse and major depression. This seemingly small number actually represents a substantial number of Americans dealing with depression or engaged in opioid misuse.
The researchers concluded that women and teenage girls have the highest risks for overlapping problems with major depression and prescription opioid misuse. Conversely, men have slightly higher chances of misusing opioid medications in the absence of major depression. Other groups with relatively elevated risks for combined major depression and opioid medication misuse include people with diagnosable alcohol problems, people who consume multiple types of mind-altering substances, people who lack jobs and people with relatively limited financial resources.