Higher doses of painkillers like Vicodin or OxyContin have been linked to higher rates of depression in patients, according to a study published in the journal Pain. There was no cause and effect found, however. When 355 patients sought treatment for low back pain and received medication for that purpose, the patients with the higher doses of narcotic painkillers were more likely to report experiencing depression as well. The research team was led by Jeffrey Scherrer, an associate professor for family and community medicine at Saint Louis University. His team writes that the study findings may “inform prescribing and pain management” and aid prescribing physicians in better gauging what dosage of painkillers will be most effective in patients who report symptoms of depression. Researchers said “that most of the risk of depression is driven by the duration of use and not the dose” and that it may be “that the patients who increase dose were the longer-using patients.” Additionally, the research contributes to the conversation on the link between the experience of depression and co-occurring substance abuse in patients, according to the US Department of Health and Human Services.
When prescribed opiate painkillers to treat pain, initially, a low dose of the substance may be sufficient in helping patients to manage their symptoms. But over time, if pain persists, a higher dose may be necessary. This is due to the building of tolerance that occurs as the body adjusts to a certain level of the medication in the body. A larger dose may be able to overcome the tolerance and create the original pain-relieving effects – but only for a while. After a time, it will again be necessary to increase the dose when the body again adjusts.
Depression and Chronic Pain
Dealing with a chronic illness of any kind, including chronic pain, can often cause depression. High doses and long-term use of these drugs are linked to depression disorders, perhaps because it is simply difficult to deal with chronic pain for years on end with no real relief despite medical attention. Difficulty managing the impact that a chronic illness has on one’s ability to function in life, maintain relationships, and focus on positive things may be the real issue driving the depression disorder, with no real connection to the medication itself.
It may also be that depression was an issue for the patients prior to the development of the lower back pain. It is not uncommon for patients who struggle with depression to also experience a number of aches and pains or to complain of illness. It is also exceedingly common for patients living with any mental health disorder, including depression, to attempt to “treat” the symptoms they experience themselves rather than seek medical care. Some do this by abusing alcohol or taking drugs; others may abuse their prescriptions for addictive narcotics, seeking out the medications whether or not they genuinely need them to address pain. Unfortunately, painkillers do not treat depression, and getting high off the drugs regularly in an attempt to feel better will often end in an addiction, which will only exacerbate depression symptoms.
Painkiller Abuse and Addiction
Abuse of prescription painkillers for any reason can quickly lead to addiction, especially if it is done with any regularity and in increasing doses.
Prescription painkiller abuse includes any of the following behaviors:
- Taking any prescription opiate without a prescription
- Taking a dose larger than prescribed or taking that dose more frequently than recommended
- Crushing the pills prior to swallowing them, snorting them, or dissolving them in water and injecting them
- Attempting to increase the effect of the painkillers by drinking alcohol or taking other drugs
- Filling a doctor’s prescription multiple times at different pharmacies
- Getting more than one prescription for narcotics from different doctors for the purposes of treating the same issue
- Going to the emergency room for more medications or asking for emergency refills
Any of these behaviors are indications of a painkiller abuse problem, which can cause overdose or addiction.
Treatment for Painkiller Addiction and Depression
Painkillers are very commonly prescribed in the United States, and depression is one of them most commonly diagnosed mental health disorders. This means that if you are struggling with both depression and painkiller dependence, you are far from alone. The existence of co-occurring disorders means that it is recommended that you seek treatment for both issues at the same time. Attempting to quit abusing pills without treating depression or attempting to treat depression while still taking painkillers will be largely ineffective. Instead, addressing how the two disorders are connected and learning how to manage the depression symptoms while also stopping the use of painkillers and managing any chronic pain issue holistically is the best option. Dual diagnosis treatment, or treatment for both of your diagnoses, should include:
- Medical detox to help you stop taking painkillers and all other drugs of choice safely
- Evaluation that helps you to determine if there are any other issues that should be addressed during treatment (e.g., anxiety, family problems, etc.)
- Individualized treatment that offers a range of therapies chosen to address the specific challenges you face in recovery
- Aftercare support that provides you with continued mental health treatment and relapse prevention as you build a new life for yourself without painkiller abuse
If you are struggling with depression and painkiller abuse, immediate treatment is recommended. Learn more about your options today.