People with mental health diagnoses may be more likely to take prescription opioids on a long-term basis, according to a study published in the journal Pain. Long-term use of opioids is linked to opioid abuse, and people with mental health conditions may be especially vulnerable to opioid addiction.
Opioid-related deaths reached a record high in 2014. Of more than 47,000 total drug overdose deaths that year, opioids were involved in nearly 29,000.
Opioid Use Among Those with Mental Health Issues
To gather data on opioid use, researchers used information from the Truven Health MarketScan Commercial Claims and Encounters database from 2004-2013. The insurance database uses anonymous patient data from employer, COBRA, and early Medicare plans.
The study looked at 10.3 million patients who filed claims for opioid prescriptions between 2004 and 2013. Investigators then looked for a prior history of mental health and behavioral conditions such as substance abuse, suicide attempts, depression, anxiety, self-injury, and sleep issues. They also tracked previous use of psychoactive drugs such as stimulants, antidepressants, and antipsychotics.
About 1.7% of people who took opioids used the drugs for six months or longer. A history of psychoactive drug use or mental health conditions correlated with increased rates of long-term opioid use. Among people with a previous history of opioid abuse, the risk was nine times as high as controls, while people taking medication for attention-deficit hyperactivity (ADHD) saw an increased risk of about 1.5.Reducing the Risk of Opioid Abuse
The study’s authors suggest knowing who is at a heightened risk of opioid abuse can help physicians screen their patients and choose appropriate medications.
Several recent studies suggest doctors may overprescribe opioids. A previous study found 91% of opioid overdose survivors were prescribed more opioids. Another study found opioid prescription rates for minor surgeries increased between 2004 and 2012.
The Centers for Disease Control and Prevention (CDC) recommends physicians use non-opioid therapies whenever possible, monitor opioid prescription use, and start with low doses, slowly increasing the dosage as necessary.
References:
- Guideline information for providers. (2016, December 16). Retrieved from https://www.cdc.gov/drugoverdose/prescribing/providers.html
- Psychiatric conditions linked to increased risk of long-term opioid use. (2016, December 29). Retrieved from https://www.eurekalert.org/pub_releases/2016-12/wkh-pcl122916.php
- Quinn, P. D., Hur, K., Chang, Z., Krebs, E. E., Bair, M. J., Scott, E. L., . . . D’Onofrio, B. M. (2017). Incident and long-term opioid therapy among patients with psychiatric conditions and medications: A national study of commercial health care claims. Pain, 158(1), 140-148. doi:10.1097/j.pain.0000000000000730
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