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Higher opioid doses can lead to depression and the longer you take them the worse it will be
Pain specialists have suspected for years that opioid painkillers are somehow related to symptoms of depression in chronic pain patients. A new study published in the medical journal Pain shows that those suspicions were indeed correct.
As chronic pain patients increase their dosage of opioid medications, says the study from Saint Louis University, they are more likely to risk the symptoms of depression or increase the symptoms of an existing depression.
But a follow-up study shows that it actually may be how long you take opioids, not how much you take, that is the real cause of increased depression. Analyses of thousands of VA patient records showed that the longer that chronic pain patients took opioids – regardless of the dosages – the greater were the chances of depression setting in or getting worse.
Jeffrey Scherrer, Ph.D., associate professor for family and community medicine at Saint Louis University, said that since the study was published in Pain, his group has conducted additional analysis of a large VA patient data base with the support of NIH funding.
The researchers wanted to see what the relationship was between duration of opioid use and the dose of opioid. Did these two factors interact? Do they have an additive effect on risk of depression?
“Our results support the conclusion that most of the risk of depression is driven by the duration of use and not the dose,” Scherrer said.
The researchers explained that the initial findings that increasing the dosage of opioids appeared to increase the risk of depression was hiding the real causes. Chronic pain patients who take opioids over long terms, Scherrer explained, tend to increase their dosages because of the buildup of tolerance. As the tolerance increases, patients require higher doses to achieve the same level of effectiveness.
“Thus, a strong potential explanation of our finding that increasing opioid dose increases risk of depression could be that the patients who increase dose were the longer using patients. This is logical as longer use is associated with tolerance and a need to increase opioids to achieve pain relief,” he said.
One of the goals of the continuing research is to discover more about the possible relationships between opioid dosages and the length of time taking them with new depression vs. stirring up past episodes of depression. Such data could help both pain management physicians and patients fine tune therapies to head off potential bouts of depression.
“We hope to find risk factors such as opioid misuse that could be in the pathway from chronic opioid use to new onset depression,” Scherrer said. “This would expand the targets for intervention to limit the risk of depression in patients who need long-term opioid therapy.”
One of the many pleasures we experience here at Novus is sharing in the lightening and brightening of patients as they shed the months or years of depressing opioid dependence. Helping patients get free from the effects of opioids is a serious activity, but we all enjoy the huge smiles at the end of those few crucial days of Novus life-changing medical opioid detox.
If you or someone you care about is in trouble with opioids – heroin, methadone or narcotic painkillers like oxycodone, hydrocodone, hydromorphone and all the others, don’t hesitate to call us here at Novus. We’ll do our expert best to answer all your questions.
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