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Researchers Examine How Opioids Increase Risk of Depression


Author: Shernide Delva

Using opioids may cause an improvement in mood at first, but long term use can seriously increase your risk of depression. According to a Saint Louis University study, long term opioid use was found to increase the vulnerability to depression in many users.

The study, titled “Prescription Opioid Duration, Dose, and Increased Risk of Depression in 3 Large Patient Populations,” was published Jan. 11 in the Annals of Family Medicine. Jeffrey Scherrer, Ph.D. led the study along with his coauthors and they speculate that the effects of using opioids such as changes in neuroanatomy and low testosterone contribute to the increase risk of depression.

“Opioid-related new onset of depression is associated with longer duration of use but not dose,” Scherrer wrote. “Patients and practitioners should be aware that opioid analgesic use of longer than 30 days imposes risk of new-onset depression.”

The study calls for additional research to identify which patients are most vulnerable to opioid-related depression. The data was comprised of opioid users ages 18 to 80 who did not have a diagnosis of depression when they began taking medication.

The study wanted to determine:

  • Whether taking an opioid for a longer period of time is associated with new-onset depression while controlling for dose
  • Whether a higher dose of opioids is associated with new-onset depression after adjusting for duration
  • Whether opioid analgesic use remains associated with new-onset depression after controlling for pain scores in VHA patient data
  • Whether results generalize to two independent health care populations

The results revealed that many of those samples experienced new onset depression after opioid use.

“Findings were remarkably consistent across the three health care systems even though the systems have very different patient characteristics and demographics,” Scherrer said.

Opioids analyzed in the study were codeine, fentanyl, hydrocodone, hydromorphone, levorphanol, meperidine, oxycodone, oxymorphone, morphine and pentazocine. The author noted that the study was limited due to the small sample size, short follow-up times and lack of control group. More research is needed to fully determine the effect opioid use has on long term depression.

Although depression may be a result of opioid use, it also could be a form of post withdrawal syndrome. As mentioned previously, post-acute withdrawal syndrome or PAWS are symptoms recovering addicts have weeks even months after giving up an addiction. PAWS symptoms can be mild or severe and are responsible for causing relapses.

Some symptoms of PAWS include:

  • Mood swings
  • Anxiety
  • Irritability
  • Tiredness
  • Variable energy
  • Low enthusiasm
  • Variable concentration
  • Disturbed sleep

Symptoms of PAWS vary from person to person however can be severe enough to also increase the vulnerability to depression. Depression is not just a state of sadness. It is a chemical imbalance in the brain and seeking professional counseling is one way to help deal with those symptoms of depression.

Opioids change the structure of our brains by recalibrating the way pleasure signals work. Our bodies naturally release dopamine to encourage us to do necessary tasks. For example, eating, sleeping and sex all release pleasure chemicals which encourage us to do those activities over and over again. When a person uses opioids, the brain releases these same chemicals which changes ultimately how our brain responds to things.

Overtime, long term opioid use can result in dependence because we want those happy chemicals back in our brain. However, getting help for your addiction is one of the only true ways to restore yourself back to help. Stop abusing substances and get help today so you can finally be on the right track. No one deserves to suffer in silence.

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