Treating depression linked to reducing chronic opioid use

Treating depression among patients with chronic prescription opioid use may help wean the patients off opioids, according to a study published in the British Journal of Psychiatry.

Researchers used 2000 to 2012 medical record data from the Veterans Health Administration to identify a random sample of 500,000 patients with at least one outpatient visit in both fiscal years 1999 and 2000. The researchers excluded patients with an HIV or cancer diagnosis. The patients had at least one yearly visit between 2000 and 2001, during which they did not have a medical record depression diagnosis. All patients developed depression after 90-plus days of continuous prescription opioid use.

The researchers compared the odds of opioid cessation between patients with anti-depressant adherence versus non-adherence.

The study shows chronic opioid use patients with depression who adhered to anti-depressants were more likely to stop taking opioids.

"We can't be sure that a decrease in depression led to patients' choosing to stop opioid use and we know prospective studies are needed," said Jeffrey Scherrer, PhD, professor of family and community medicine at Saint Louis University and study lead author. "Depression can worsen pain and is common in patients who remain long-term prescription opioid users. Our study should encourage clinicians to determine if their non-cancer pain patients are suffering from depression and aggressively treat patients' depression to reduce opioid use."

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