The Connection Between Opioid Usage and Depression
How Opioid Abuse Could Influence Depressive Disorder
The Connection Between Opioid Usage and Depression
How Opioid Abuse Could Influence Depressive Disorder
Table of Contents
Research indicates that there is a relationship between opioids and depression.
To learn more about opioid usage and depression, read on.
What Is Depression?
The National Institute of Mental Health (NIMH) categorizes depression as a mood disorder, meaning it affects how an individual thinks, feels, and participates in daily acts of living (2018).1 For example, those diagnosed with depression and related disorders may find it challenging to sleep on a regular schedule, eat a consistent diet, or make it to work on time.
Depression is a serious mental disorder and is one of the most common mental disorders diagnosed in the United States. While depression can be linked to genetic, biological, environmental, and psychological factors, anyone at any age can be diagnosed with depression.
The National Institute of Mental Health (2018) lists several symptoms of depression, but a few common symptoms of depression include:1
- Feelings of hopelessness
- Fatigue and lack of energy
- Changes in sleep patterns, weight, and appetite
- Loss of interest in activities and favorite hobbies
- Thoughts of death or suicide
What are Opioids?
Opioids are a class of drugs designed to relieve pain. Opioids are classified into two separate categories: illegal and prescription. Illegal opioids include heroin and synthetic opioids such as non-medically based fentanyl. Prescription opioids are given by medical doctors and include drugs such as oxycodone, hydrocodone, codeine, morphine, and more.
The human body has natural opioid receptors that produce a high when endorphins are released during activities such as exercise and eating. When opioids, such as heroin or oxycodone, enter the body, they bind to opioid receptors in the central nervous system and release a high that greatly exceeds that of natural endorphins.
Because the drugs are meant to target the body’s pleasure centers and are highly addictive, even prescription opioids can be misused.2 If opioids are taken in too high of a dose, a life-threatening overdose can occur.
What is Oxycodone?
Oxycodone, also known as OxyContin, is a prescription opioid designed to reduce chronic and acute pain. Oxycodone is typically prescribed only after other forms of pain medication have been exhausted. Oxycodone is legal to use when prescribed by a medical doctor. Still, because of its addictive qualities, it is generally prescribed in low doses, and people using oxycodone are closely monitored.
Can Opioids Cause Depression?
Medical-grade opioids are often prescribed to treat symptoms of chronic pain, but an opioid abuse disorder can still arise even with prescription drugs.
It has been documented that those who use opioids to manage chronic pain are at greater risk of major depression. When individuals take opioids, they experience a pleasurable high that is much more intense than the body’s endorphins. When the body no longer experiences the intense feelings from an opioid, it can feel tired and lack energy, which are common symptoms of depression.3 For this reason, physical dependence on the drug can occur.
Opioids may not distinctly cause depression, but there is a relationship between opioid use and symptoms of depression.4
Does Oxycodone Cause Depression?
Because oxycodone is a common prescription drug for chronic pain, it does increase the risk of developing a depressive disorder. Additionally, pain with no physical cause can be a symptom of depression, so the two are linked in more ways than one.
Studies have shown that long-term use of opioids for chronic pain and other disorders does increase the likelihood of depression and substance use is likely to recur over time.4
Can Opioids Help Depression?
While extended opioid use for chronic pain may lead to a depressive disorder, opioids can, at times, be used to treat depression, though not typically recommended.
People diagnosed with depression may be prescribed an opioid to help compensate for any stressors they face. Additionally, opioids may be prescribed to help regulate their sleep schedule.
However, long-term use of prescription opioids for depressed individuals may also lead to misuse. Misuse could occur because the person feels they need a higher dose to manage sleep and stress. Misuse of a prescription opioid may eventually lead to the use of non-prescription opioids.4
Does Oxycodone Help Depression?
Like other opioid types, oxycodone can be used to help with depression. However, it should only be administered in small, titrated doses to avoid potential physical dependence. If oxycodone is prescribed to help people with depression regulate their sleep patterns or cope with daily life stressors, the doses should be closely monitored by a medical doctor.
How Opioids Effect the Body
Constipation is the most common side effect of opioid use and is reported in up to 95% of those who use opioids. While many of the other side effects of opioids will diminish over time, chronic constipation and its resulting issues will likely be present for the entire time the drug is used.
Other side effects of opioids include, but are not limited to:
- Drowsiness
- Dizziness
- Headaches
- Nausea
- Vomiting
- Hormonal changes
- Increased pain sensitivity
Those who use opioids for extended periods will experience the effects of tolerance. Tolerance is a term used to describe the decreasing effectiveness of a drug over time. In simple terms, the longer the body takes in an opioid, the more used to the drug that the body becomes. As a result, the body needs more of the drug to experience the same effects.5
Common Oxycodone Side Effects
Oxycodone has many side effects, with the most common effect being constipation. Many of the side effects will be noticeable in the beginning but become less intense the longer the drug is taken.
Oxycodone side effects include:
- Dizziness
- Dry mouth
- Headaches
- Nausea
- Sweating
- Vomiting
- Weakness or lack of energy
- Itching sensations (pruritus)
- Drowsiness
While the above are more common side effects, some people who use oxycodone have reported abnormally slow heart rates, low blood pressure, hallucinations, and confusion.6
Opioids Overdose Signs and Symptoms
An opioid overdose is a serious matter. If not identified within its early stages, the individual may suffer severe consequences and even death. While there are several symptoms associated with opioid usage, death can occur from opioids’ effect on breathing.
When taken in high doses, opioids disrupt the brain’s ability to regulate breathing. If someone who uses opioids for prescriptions or has an opioid use disorder displays any of the following signs, seek emergency assistance.
- Pinpoint pupils (very small pupils)
- Becomes unconscious
- Difficulty breathing
Overdose death can be prevented if the individual receives basic hospital treatment and is given the counteracting drug, naloxone. However, naloxone needs to be administered as soon as possible.7
Oxycodone Overdose Signs and Symptoms
The signs and symptoms of oxycodone overdose are the same as non-prescription opioids. When someone too much of the drug, then the oxycodone may inhibit the brain’s function of regulating breathing, and the individual may stop breathing altogether.
If the individual shows the signs of an overdose—small pupils, unconsciousness, or difficulty breathing—get to the hospital immediately for treatment.7
Treating Depression as a Co-Occurring Disorder in Rehab
Substance abuse disorders and mental health disorders are highly comorbid, meaning they often occur together. Because depression and addiction disorders are commonly experienced together, many treatment options are designed to target both disorders simultaneously.
Below are explanations of the common treatments of depression and substance abuse disorders.
Counseling
Individual counseling, especially cognitive-behavioral therapy (CBT), has been shown to help clients with co-occurring disorders.
Detox
Detox, also known as drug withdrawal, describes the period when the opioid completely leaves the body’s system. During this time, the individual often experiences adverse effects and requires support. While in a rehabilitation program, clients will have access to the help and resources they need.
Relapse Prevention
As with any co-occurring disorder, the threat of relapse is always present. When participating in a rehabilitation program, it’s important to have long-term support in place. Additionally, these programs incorporate skill-building exercises that support behavioral and cognitive change so that the client can use those skills later. 8
Support Groups
Support groups, such as Narcotics Anonymous, have been shown to help with the recovery process and reduce substance use.9
Resources
- https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(02)00243-X/fulltext
- https://www.ucsf.edu/news/2018/05/410376/bodys-natural-opioids-affect-brain-cells-much-differently-morphine
- https://doi.org/10.1370/afm.1371
- https://pubmed.ncbi.nlm.nih.gov/29505419/
- https://www.painphysicianjournal.com/current/pdf?article=OTg1&journal=42
- https://www.ncbi.nlm.nih.gov/books/NBK482226/
- https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
- https://www.sciencedirect.com/science/article/abs/pii/S0006322304007425?casa_token=b_4LU1QT200AAAAA:V0jwW9BhvmJljPCfX4ZgDfYFNoSqGKf6o4kL-SZ_a_BPQpDMPqqZUX9Vvd5IKNWzZ6Q2UXUnbAs
- https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(02)00243-X/fulltext
