More Than Half Of Opioids Prescribed to People With Mood Disorders

By Kelly Burch 06/27/17

Sympathy may be a factor in a doctor's decision to prescribe opioids to those with depression, anxiety and other mood disorders.

Woman holding a glass of water and pill.

More than half of opioid prescriptions are written for people with mood disorders including anxiety and depression, despite the fact that people with these disorders are more at risk for misusing opioids. 

“If you want to come up with social policy to address the need to decrease our out-of-control opioid prescribing, this would be the population you want to study, because they’re getting the bulk of the opioids, and then they are known to be at higher risk for the bad stuff,” Dr. Brian Sites of Dartmouth-Hitchcock Medical Center told STAT News

Sites is the lead author for a study published this week in the Journal of the American Board of Family Medicine, which found that 51% of opioid prescriptions go to people with mood disorders.

The study also found that 19% of the 38.6 million Americans with mood disorders use prescription opioids, compared to 5% of the general population—a difference that remained even when the researchers controlled for factors such as physical health, pain levels, age, sex and race, STAT reported. The study looked at health data from 51,000 adults. 

Dr. Sites says the results raise concerns about overprescribing for people with mood disorders. “We need to understand if this massive prescribing level is appropriate in actually providing benefit commensurate with the risk,” he said.

He said there could be many reasons why people with mood disorders are given more prescriptions. Research has shown that people with depression are at increased risk for chronic pain. On the other hand, research has also shown that people who misuse opioids are more likely to have mood disorders. 

“It’s known that people with co-occurring behavioral and mental health issues are at high risk for addiction even when prescribed opioids for a bonafide prescription medical use,” Dr. Anna Lembke, a Stanford University psychiatrist and opioid addiction expert, said in relation to a study of people who misuse opioids. 

Sites speculated that doctors may be more sympathetic to patients with mood disorders, making them more likely to prescribe the powerful opioids. Or, he said, patients with mood disorders may more aggressively seek these drugs because they give temporary relief from depression. 

Overall, it's clear that doctors need to better understand the interactions between chronic pain, depression and opioid use. “A lot of pain patients attribute their depression to their pain, but there’s a lot of evidence that depression is playing a role in both the experience of pain and the odds of getting an opioid,” Jeffrey Scherrer, a professor and epidemiologist at Saint Louis University, told STAT

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.