Opioids are prescribed to relieve pain but are often abused. People who take opioids for nonmedical uses are at increased risk for substance dependency and significant neurologic damage. Researchers have discovered a clear link between opioid misuse and anxiety and mood problems, but the relationship is still unclear. To better understand how opioids affect mood and anxiety problems, Silvia S. Martins of the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health in Maryland conducted a follow up to one of her previous studies.
Martins sought to determine if opioid use caused mood and anxiety problems (precipitation theory), if mood problems led to opioid abuse (self-medication theory), or if these issues shared relational influences. For instance, heavy drug use could trigger bipolar, manic, depressive, or anxious episodes in individuals already predisposed to these mental health challenges. People with a family history of mental illness who misuse opioids may be more vulnerable to experiencing symptoms, especially if they are under psychological stress. Therefore, Martins examined each of these directional relationships in a sample of over 34,000 adults who were part of a larger, national study. She assessed the relationships between moods and substance based on interviews conducted with the participants in 2001(Time 1) and again 3 years later (Time 2).
The analysis revealed that all of the participants who had used opioids nonmedically at Time 1 were at increased risk for anxiety, depression, mood issues, and bipolar at Time 2. The study also uncovered a clear link between mood issues and opioid abuse. Specifically, a lifetime history of generalized anxiety or depression and mood problems at Time 1 led to opioid use at Time 2 in all of the participants. Martins also discovered that opioid use at Time 1 increased the risk of anxiety problems at Time 2. In addition, she found that individuals with mood problems, such as panic, depression, and dysthymia at Time 1 were more likely to use opioids at Time 2 than those without. “Thus, early identification and treatment of mood and anxiety disorders might reduce the risk for self-medication with prescription opioids and the risk of future development of an opioid disorder.” Finally, Martins also found that there was a shared relationship between mood/anxiety issues and opioid use in some of the participants. Overall, these results expand the existing body of research on substance use and mood problems and can help clinicians identify coexisting problems or risk factors in clients facing these issues.
Martins, S. S., Fenton, M. C., Keyes, K. M., Blanco, C., Zhu, H., Storr, C. L. (2012). Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: Longitudinal evidence from the national epidemiologic study on alcohol and related conditions. Psychological Medicine, 42.6, 1261-1272.
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