People who misuse opioid drugs often struggle with poor mental health. Researchers say close to 60% of people with opioid misuse had a concurrent mental health diagnosis.[1]
Doctors call these issues co-occurring or comorbid, meaning that both conditions strike the same person at the same time.
Treatment programs aim to address both issues simultaneously, ensuring that drug use doesn't worsen due to an unaddressed mental health issue or vice versa. Untangling which came first isn't as important as ensuring both problems are treated with equal care and concern.
Opioids bind to opioid receptors in the brain and body, reducing pain sensation while also causing sedation, constipation, and slowing breathing. They are also highly addictive since people can experience a short-lasting euphoria and a relief of negative mood or anxiety, reinforcing further use.
Illicit drugs such as heroin and fentanyl are opioids. So are prescription pain medications such as these:
More than half of the opioid prescriptions in the United States are given to people with anxiety and depression.[2]
Opioid use disorder (OUD) is the clinical term used to describe what happens when people start using opioids problematically.
OUD is linked with poor mental health because opioid use can cause and heighten depression and anxiety. These diagnoses can also hasten the onset of OUD.
Among people with OUD, anxiety disorder is present in a third and major depressive disorder in almost a quarter.[3]
People with OUD may work hard to keep their issue hidden, but some signs of OUD include the following:
Some of these symptoms could be caused by mental health issues, so it can be hard to determine what's at the root of a person's distress. Treating both the psychiatric disorder and OUD in someone who suffers from both issues is essential. If that doesn’t happen, it will be much more difficult to recover from either condition.
Yes. Psychiatric disorders like depression, anxiety and post-traumatic stress disorder predispose people who use or misuse opioids to develop OUD.[4]
In the short term, opioids may dull or numb some of the symptoms of a mental health disorder. People may use opioids as a form of self-medication, especially if they are not getting treatment for their anxiety or depression.[5] However, in the long term, a person may escalate the frequency of use and an OUD may thus develop. [6]
Yes. Use of opioids can trigger anxiety and depression through a variety of mechanisms. Opioid use and subsequent withdrawal can cause neurobiologic changes in the brain that can lead to anxiety, insomnia, and depression, In addition, social consequences of of use such as job loss, strains on relationships or financial hardships can all lead to decreased quality of life that can then lead to depression, anxiety or other mental health concerns. There is ample evidence that certain individuals with more complex mental health disorders such as bipolar or schizophrenia might have an initial first episode that is precipitated by use of drugs or alcohol.
The key to recovery is to treat OUD and the underlying mental health problem simultaneously. Treatment teams use a combination of medications plus counseling to do this.
OUD responds to medications such as buprenorphine, naltrexone, or methadone. If symptoms associated with the mental health disorder don’t resolve with medication treatment of the opioid use disorder, a trial of antidepressant medications may also be recommended by your doctor.
Selective serotonin reuptake inhibitors, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and anti-psychotics are all common classes of medications used to treat depression, anxiety, PTSD, and more complex mental conditions such as bipolar disorder or schizophrenia.
Depression, anxiety, and PTSD are all treated differently from one another, each with its own options for evidence-based treatment. However, several therapeutic modalities deserve mention here because they work across multiple diagnoses:
Bicycle Health is an organization that treats opioid use disorder through telehealth, offering patients affordable and evidence-based care with a first-line treatment for opioid use disorder: Suboxone (buprenorphine/naloxone).
Our therapists and medical personnel are well-liked by patients, and readily available.
Want to know more about how starting on Suboxone could interact with preexisting mental health disorders? Schedule a meeting with our experts or call us today at (844) 943-2514.
