Chronic Pain Patients with Depression More Likely to Receive Opioids

Researchers Worry about Opioid Use for Depressed Patients with Chronic Pain
Chronic Pain Patients with Depression More Likely to Receive Opioids

Patients suffering from chronic pain and depression are three times more likely to receive long-term prescriptions for opioid medications than chronic sufferers who are not depressed, according to a new study expressing concerns about the potential implications of increased opioid use among the depressed population.

Published in the November-December issue of the journal General Hospital Psychiatry, the study analyzed the medical records of tens of thousands of patients enrolled with two insurers between 1997 and 2005. Long-term opioid use was described in terms of prescriptions of 90 days or longer, while the insurers included Kaiser Permanente and Group Health, which the study detailed as covering about 1 percent of the U.S. population.

In addition to learning about the widespread opioid prescription rate for patients with chronic pain and depression, the researchers noted how depressed patients are most often excluded as a high risk group in controlled trials on opioid addiction. According to the study, roughly 10 percent to 20 percent of the population suffers from depression, making the lack of inclusion of depressed patients in opioid addition trials especially worrisome to the researchers.

Opioids (also known as narcotics) are potent analgesic drugs that may be prescribed to treat severe episodes of chronic pain, which is often associated with feelings of depression in patients. Examples of opioids that may be prescribed for chronic back pain and neck pain include oxycodone (Oxycontin, Percocet, Percodan), hydromorphone (Dilaudid) and hydrocodone (Vicodin).

Prior to this new study, there has been much debate about prescribing opioids for chronic pain. In general, opioids can be effective in treating severe back pain for short periods of times (less than two weeks); however, these drugs can be highly addictive and used beyond their indications, causing some doctors to hesitate to prescribe them.

In August 2009, a study published in the journal Population Health Management reinforced the dangers of opioid prescriptions. This study examined nearly 100,000 toxicology tests of 500,000 patients who had been prescribed opioids for chronic pain, and found that only 25 percent of the patients used their opioid medications as indicated while 27 percent of the patients had higher drug levels than expected, suggesting opioid abuse.

As part of the conclusion in the new study featured in this month’s General Hospital Psychiatry, researchers also detailed the importance of opioid prescriptions for chronic pain and depression not becoming a sole replacement for other treatments of mental disorders.

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