Depression and Opiate Addiction: The Connection

It is not uncommon for clients in recovery to report that their addiction began with depression. Rather than seek out therapeutic treatment and antidepressants – or when antidepressants were ineffective and therapy was not as helpful as desired – many turned to the use of painkillers and other drugs in an effort to escape depression symptoms.

But this is not the only connection between depression and opiate painkillers. According to a new study published in the journal Annals of Family Medicine, the use of prescription painkillers for more than one month may increase the risk of developing depression. For those who struggle with chronic pain, the pain itself may be a cause of the depression ,but so too may be the painkillers used to treat that pain, report researchers.

Jeffrey Scherrer of Saint Louis University in Missouri was an author of the study. He said: “We really did rigorous control for pain, and we feel strongly that these results are independent of the known contribution of pain to depression.”

More than 100,000 people were included in the study, all of whom began taking opiate painkillers around the beginning of the study and none struggled with depression. The study followed their progress for 7-10 years. It was found that the longer a person took opiate painkillers, the more likely it was that the person would develop depression.

Though the study identified a link between painkiller use and depression, the cause is as yet unknown.

Have You Been Screened for Depression?

The Department of Health and Human Services recommends that all adults be screened for depression. Should initial screenings indicate a heightened risk of depression, then medical personnel can screen for other issues (substance abuse, addiction, and underlying medical disorders) and be able to help the client to manage any and all symptoms.

Additionally, the Washington Post reports that the US Preventative Services Task Force recommends that women undergo a depression screening during pregnancy and in the months after giving birth. In their report published in JAMA, they wrote that major depressive disorder is linked to an increased risk of suicide and negatively impacts a person’s ability to manage the issues associated with other co-occurring health disorders: “Depression has a major effect on quality of life for the patient and affects family members, especially children.”

Depression screenings are often given in the form of a written questionnaire and include questions followed by a rating scale. Patients are asked to read a statement and then circle a number that corresponds with whether or not they agree with that statement or if it resonates in their lives. For example, a screening statement might read, “I find it difficult to take pleasure in things I once enjoyed,” or “I blame myself for things that go wrong.”

Treatment for Depression and Addiction

For those who are struggling with depression and a substance use disorder, no matter which one came first, it is important to seek treatment that can effectively treat both issues at the same time. Co-occurring mental health and addiction disorders are often deeply enmeshed. That is, the symptoms of one can often trigger the symptoms of the other. This makes it difficult, if not impossible, to truly heal from one disorder while allowing the other one to continue untreated.

For example, someone who attempts to stop taking painkillers but still struggles with depression will likely be tempted to relapse whenever depression symptoms strike. Similarly, someone living with a painkiller addiction who seeks treatment for depression will likely find that the depression symptoms are resistant to treatment.

Comprehensive care for the co-occurring disorders of painkiller addiction and depression should include:

  • Medical detox to manage physical withdrawal symptoms
  • Thorough evaluation and assessment to identify all medical, behavioral, and mental health issues
  • A treatment plan that is personalized to address the issues identified during the evaluation process
  • Traditional therapies that provide for research-based care
  • Alternative therapies that offer unique approaches to understanding and managing underlying trauma and related symptoms
  • Holistic therapies that help to mitigate stress and improve overall wellness
  • Medications (e.g., antidepressants) if necessary
  • Continued medical care if chronic pain is part of the equation
  • Aftercare and long-term support for both disorders

Persistence and Time

It takes time to build a new life under the best of circumstances, and when a person is struggling with co-occurring disorders, persistence and patience are especially needed. Continued engagement with therapy and support groups, with the goal of remaining drug- and alcohol-free, can help clients to remain connected to sober principles and get the support they need to keep going when challenges arise.

Similarly, remaining actively involved in a progress-oriented treatment plan for depression is essential. Though it can take time to work out the details, such as what medications and at what doses will be most effective and which therapies will allow for the most insight and growth, it is well worth the effort. Clients who stay engaged with their recoveries, working through difficulties and plateaus when needed, find that their ability to find contentment and balance in life is increased.

If you, or someone you love, are struggling with depression in addition to a dependence on painkillers or an addiction to any substance, treatment can help. Learn more about the options available in treatment and how we can support you and your family in recovery today.