Boston–Patients with common depressive or anxiety disorders are more likely to use opioids regularly than individuals not suffering these disorders, according to a study involving more than 9,000 patients.
"Between 10% and 20% of the general population has chronic, nonmalignant pain, and recent efforts have been made to liberalize the use of opioids for this pain," commented Mark D. Sullivan, MD, PhD. "We know that psychiatric disorders are associated with increased pain complaints and may play a role in the use of opioids, but the role of such disorders in the general population treated with opioids for chronic, noncancer pain is unclear."
Using data from the Healthcare for Communities program, researchers accessed a respondent pool of 9,585 individuals. Those reporting cancer diagnoses other than skin cancer within the past three years were excluded, leaving a sample of 9,279 patients.
Two hundred fifty-two (2.7%) of the respondents reported regularly using prescribed opioids in the previous 12 months at a frequency of at least several times per week for one month or more. The independent variable in the study was the prevalence of common psychiatric disorders within the previous 12 months, Dr. Sullivan reported at the 2005 annual meeting of the American Pain Society. These included major depression, dysthymia, generalized anxiety disorder and panic disorder.
A total of 45% of individuals who reported regular opioid use had a common mental disorder in the previous 12 months. Of these patients, 28.7% also reported having major depression, 17.6% reported panic disorder, 14.7% reported dysthymia and 11.3% reported generalized anxiety. All of these comorbidities were highly significant, according to Dr. Sullivan, Professor of Psychiatry and Behavioral Sciences, Adjunct Professor of Medical History and Ethics at the University of Washington School of Medicine in Seattle.
In addition, patients who used opioids regularly were more likely to have taken benzodiazepines and antidepressants compared to those not using opioids regularly. Also, 14.3% of patients reporting illicit drug use were regular opioid users.
"Common psychiatric disorders increase the likelihood of association with regular opioid therapy. To my knowledge, this is the first population-based data of psychiatric comorbidity for patients receiving regular prescribed opioid medication," said Dr. Sullivan.