Recent studies have determined that over 52 percent of the 115 million opioid prescriptions written each year were prescribed to a patient with a mental health disorder.
This statistic is even more staggering when you discover that only 16 percent of the United States population has a mental health disorder. In addition, 19 percent of the people with mental health disorders are responsible for more than half of the country’s opioid prescriptions.
Though this fraction of the population is small, it represents the greatest percentage of people taking an opioid for pain. This exposes an already vulnerable population to a very addictive medication.
Mental Health Disorders and the Body
Chronic pain can cause depression over time, but depression can exacerbate pain as well. This causes patients to enter a vicious cycle of depression and pain. Chronic pain often begins with an illness or injury. Once the pain is present, it can alter your entire life.
Imagine having the ability to work, enjoy an active lifestyle, and participate in activities with your friends and family suddenly taken away from you. This is the reality of those facing chronic pain on a daily basis.
WebMd lists increased stress levels, decreased energy, and lack of mental clarity as common symptoms of chronic pain. WebMd also points out that 61 percent of people with depression suffer from chronic pain and 25 percent of people with chronic pain have depression.
These two medical conditions should be treated together for best results. If you address one issue, but not the other, it can prevent the untreated issue from improving. A dual diagnosis approach works best for these types of co-occurring health issues.
Opioid Addiction and Pain Management
The problem of opioid addiction plagues many people in America. People who are depressed may experience short-term relief for their depression symptoms after taking an opioid. Once the medication starts to weaken in their system, they are more likely to abuse the medication to alleviate their depression symptoms, instead of the pain it was prescribed for.
Mark Sullivan, a professor of psychiatry at the University of Washington, and other researchers from Washington and California determined that people with depression were twice as likely to misuse opioids.
Another study confirmed and expanded on these findings and also determined that people with depression were more likely to continue opioid use after their pain was gone.
How to Prevent Opioid Abuse in People with Mental Health Disorders
It is important for patients to speak with their doctor about their pain and their history of mental illness. Patients should be vocal and comfortable discussing their dual diagnosis and treatment options for both.
It is equally important that doctors ask probing questions about both pain and mental illness to determine the underlying cause of pain. This will help determine the best method to treat the problem without increasing the patient’s risk for becoming opioid dependent.
Opioid Abuse Prevention Tips For Doctors
When a doctor evaluates a patient, even if the patient is a long-term one, he or she needs to ask probing, open-ended questions. These questions should focus on the pain, identifying the underlying causes of pain, and the patient’s mental health and overall well-being. This will help a physician better diagnose a patient to address the underlying health issues without putting the patient at risk of developing an addiction.
Once physiological causes are ruled out, a doctor should evaluate the patient for mental health disorders to determine if the patient is experiencing any stress or problems in their personal life and try to gain a better understanding of his or her mental state.
If possible, alternative therapies may be recommended to treat the cause of the pain and prevent prescription abuse. If medication is necessary to treat the pain, a physician may prescribe less addictive pain medications first. For example, NSAIDs or a corticosteroid are good choices for an injury. Opioids should only be prescribed if there are no other options.
Opioid Abuse Prevention Tips For Patients
If you have a mental health disorder or suspect you may have one, discuss this with your healthcare provider. He or she needs to know about your mental health to best treat your chronic pain. Depression and anxiety can cause pain and intensify the pain from an injury.
You have a right to be proactive where your health is concerned. If a doctor suggests or offers pain medication, ask your doctor for alternative therapies for your pain. You may benefit from physical therapy or chiropractic care. These methods do not contribute to your pain and may reduce or eliminate your pain without the need for dangerous opioids or other pain medications.
If medication is necessary, ask for a medication with a lower risk of addiction and ones that may improve the underlying cause of the pain. Anti-inflammatory drugs can greatly reduce pain from an injury by reducing inflammation in the body. Other medications can target pain related to depression or anxiety. Discuss these options with your provider.
The Stigma of Mental Health Disorders
About one in five Americans has been or will be diagnosed with a mental health disorder. A stigma surrounds mental health and it often prevents people from voicing their concerns. It is important for both doctors and patients to remove this stigma surrounding mental health disorders in order to help reduce opioid abuse.
If people are afraid to speak about their mental health concerns, major problems can go undetected or an injury or illness can exacerbate a mental health disorders. This exposes people with an undiagnosed mental health disorder to the unnecessary risk of becoming dependent on opioids.
Mental health disorders and opioid addiction often go hand-in-hand, so it is important that they are treated equally and together so that a full is possible. If you have any questions or concerns about your mental health and opioid addiction, discuss them with your doctor. It may be a difficult conversation, but managing your long-term mental health and pain are worth the remporary discomfort.
About the author:
Nicole earned her doctoral degree in Psychology with an emphasis on marriage and family therapy at California School of Professional Psychology. Her doctoral thesis was a grounded theory study exploring the role of alienation and connectedness in the life course of addiction. She specializes in treating addiction and trauma. She is certified in DBT and EMDR, two of the most highly regarded evidence-based methods in psychotherapy. Dr. Doss is a strong LGBT advocate and provides open and affirming support to her LGBT clients.
Dr. Doss’s earlier education included graduating cum laude from the University of California, Irvine in June of 2007 with a Bachelor’s degree in Psychology. While there, she received honors recognition by Psi Chi and Golden Key honor societies.
Nicole has been working with alcoholics and addicts in our California drug and alcohol rehab center as an advisor and counselor for many years. She is passionate about providing quality counseling and care to her clients. Her main focus is on integrating the 12 Step and disease models of addiction with experiential therapeutic theory. She is married to Greg; they have two adorable sons together and an energetic yellow Labrador Retriever.