Researchers Link Long-Term Opioid Use To Higher Risk Of Depression

By Victoria Kim 01/29/16

The connection may have something to do with lower testosterone levels.


A recent study has demonstrated a link between opioid use and depression. The study monitored tens of thousands of opioid users over a span of seven to ten years, and observed that those using opioids for pain for longer than one month had an increased risk of developing depression.

The link between depression and opioid use held, even when accounting for the contribution of pain to depression. “We really did rigorous control for pain, and we feel strongly that these results are independent of the known contribution of pain to depression,” said Jeffrey Scherrer, study author and an associate professor of family and community medicine at Saint Louis University in Missouri.

The study followed three groups of people. The first group had nearly 71,000 people, the second had nearly 14,000 people, and the third had nearly 23,000 people. The age range was between 18 and 80 years.

The participants started using opioids close to the start of the study and were not depressed at the time. The opioids included in the study were codeine, fentanyl, hydrocodone, hydromorphone, levorphanol, meperidine, oxycodone, oxymorphone, morphine, and pentazocine.

For seven to ten years, the researchers followed up with the participants: 12% of the first group, 9% of the second group, and 11% of the third group developed depression during this time.

The study found that the longer people used opioids, the greater their risk of depression. For example, among the 71,000 participants in the first group, 11.6% of those who used opioids for one day to one month developed depression. Of those who used opioids for one to three months, 13.6% developed depression. Of those who used opioids for longer than three months, 14.4% developed depression.

The same pattern was observed in the second group. The longer they used, the more prone to depression they became.

The reason why long-term use of opioids is linked to depression is yet unclear, but Scherrer said it may have something to do with lowered testosterone levels. “We know that chronic opioid use leads to low testosterone in males and females, and that is known to be related to poor mood,” Scherrer told Live Science.

Another possible reason, said Scherrer, is depression associated with substance abuse. Some patients “may start to lose control and develop early symptoms of [opioid] misuse, which is known to be related to depression,” said Scherrer.

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Victoria is interested in anything that has to do with how mind-altering substances impact society. Find Victoria on LinkedIn or Tumblr