Depression & Opioid Use

Opioid analgesics, or simply opioids, are drugs that provide pain relief. They include natural opioids (opiates) like morphine, semi-synthetic opioids like heroin, and synthetic opioids like fentanyl. They can treat various types of pain, including chronic pain and pain following surgery.

Over 16 million people worldwide suffer from opioid use disorder, also called opioid addiction. This condition is especially common among those who have depression.

The Link Between Depression & Opioid Use

Depression, also known as major depressive disorder or MDD, is a mood disorder that causes persistent sadness and/or loss of interest in activities. 

Opioids can cause brain changes that increase the risk of depression. In a 2016 study of prescription opioid use, 10 percent of people developed depression a month after starting opioids. 

On the other hand, people who already have depression are over three times more likely to abuse opioids than the general public. This may be because:

• opioid medications can make you feel relaxed and happy, so some depressed patients abuse them to self-medicate
• many depressed patients are prescribed opioids for pain management because depression can cause headaches, back pain, cramps, and other forms of physical pain
• depression and opioid abuse share common risk factors, including genetics, stress, and trauma
• research suggests that depression dysregulates the endogenous opioid system (an internal system consisting of opioid substances that occur naturally in the body), meaning depressed patients are more likely to seek out opioids

Opioid abuse usually leads to opioid use disorder. This disorder makes you feel like you can’t control your use of opioids. It can also be caused by chronic opioid use prescribed by a doctor. 

No matter which condition appeared first, a person who suffers from both depression and opioid use disorder will be given a dual diagnosis. Also known as comorbidity, a dual diagnosis requires specialized treatment.

Symptoms Of Depression & Opioid Use

To receive a dual diagnosis, you must display symptoms of both depression and opioid use disorder. 

According to the Centers for Disease Control and Prevention (CDC), the most common symptoms of depression include:

• persistent sadness
• loss of interest in activities once enjoyed
• anxiety
• guilt
• hopelessness
• irritability
• trouble concentrating
• trouble sleeping
• lack of energy
• changes in weight and/or appetite
• unexplainable aches or pains
• thoughts of suicide

The most common symptoms of opioid use disorder include:

• experiencing intense cravings for opioids
• experiencing mood swings
• falling behind at work or school due to opioid use
• neglecting relationships due to opioid use
• needing increasingly larger amounts of opioids to feel the desired effects
• experiencing withdrawal symptoms, such as anxiety or nausea, when you don’t use opioids
• wanting to stop using opioids but feeling unable to

Treatment For Depression & Opioid Use

If you struggle with opioid misuse alongside depression (or any other mental illness), you should likely attend a dual diagnosis treatment program. These programs treat both substance abuse and other mental health disorders.

They offer comprehensive treatment services such as:

Medical Detox

Often the first part of treatment, medical detox helps you slowly and safely stop using opioids. 

During detox, a team of health care professionals will monitor your health 24/7. In some cases, they’ll prescribe non-opioid medications, such as anti-nausea medications or sleep aids, to ease certain withdrawal symptoms.

Therapy

Therapy can help you manage both your depression and your opioid use disorder. The most common forms of therapy in a dual diagnosis program include:

• cognitive behavioral therapy, where you can learn to change unhealthy behaviors, identify drug use triggers, and develop healthy coping skills
• family therapy, where you and your loved ones can learn how to maintain good mental health and support your recovery
• group therapy, where you can connect with other people who are recovering from substance use problems, depression, and other mental health concerns, such as trauma or anxiety disorders

Medication-Assisted Treatment (MAT)

In MAT, doctors can help you stay off opioids by prescribing medications that treat opioid use disorder. These prescription drugs include:

• buprenorphine, a partial opioid agonist that can reduce withdrawal symptoms and cravings by activating the same receptors that other opioids activate
• methadone, an opioid agonist that, like buprenorphine, can reduce withdrawal symptoms and cravings by activating opioid receptors
• clonidine, a blood pressure medication that can reduce withdrawal symptoms but not cravings

Psychiatry

Psychiatrists can help treat your depression by prescribing antidepressants. If you abuse opioids to self-medicate your depression, antidepressants can help prevent relapse by reducing your depression symptoms. Some people with depression also benefit from anti-anxiety medications. 

To learn more about treatment for depression and opioid misuse, please reach out to an Ark Behavioral Health specialist.