Abuse of opioid drugs linked to mood and anxiety disorders

Mood and anxiety disorders such as bipolar, panic disorder and major depressive disorder appear to be highly associated with non-medical prescription opioid use. The results of a new study appeared in the Journal of Psychological Medicine.

“Lifetime non-medical prescription opioid use was associated with the incidence of any mood disorder, major depressive disorder, bipolar disorder and all anxiety disorders. Non-medical opioid-use disorder due to non-medical prescription opioid use was associated with any mood disorder, any anxiety disorder, as well as with several incident mood disorders and anxiety disorders,” said Silvia Martins, MD, PhD, lead author of the study and an associate scientist with the Bloomberg School’s Department of Mental Health.

“However, there is also evidence that the association works the other way too. Increased risk of incident opioid disorder due to non-medical use occurred among study participants with baseline mood disorders, major depressive disorder, dysthymia and panic disorder, reinforcing our finding that participants with mood disorders might use opioids non-medically to alleviate their mood symptoms. 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-use disorder,” Dr. Martims added.

Then investigators used data from the National (USA) Epidemiologic Study on Alcohol and Related Conditions (NESARC), a longitudinal face-to-face survey of individuals aged 18 years and older between 2001 to 2002 and 2004 to 2005. They evaluated subjects for a history of psychiatric disorders.

They defined non-medical use of prescription opioids as use of a prescription opioid without a prescription or in greater amounts more often or longer than prescribed or for a reason other than instructed by the prescribing physician.

They used standard logistic regression analysis of the data to determine whether lifetime non-medical prescription opioid use and opioid disorders due to this use predicted incident mood and anxiety disorders, as well as the reverse.

The investigators concluded that their findings show a bi-directional pathway between non-medical prescription opioid use and opioid-use disorder due to non-medical use and several mood and anxiety disorders.

“With the current increased use of non-medical prescription drugs, especially among adolescents, the association with future psychopathology is of great concern. Using opioids, or even withdrawal from opioids, might precipitate anxiety disorders, suggesting that there is a subgroup of people who are vulnerable to future development of anxiety disorders,” said Carla Storr, ScD, an author of the study and an adjunct professor with the Bloomberg School’s Department of Mental Health.