The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study
Abstract
Background In light of the increased rates of Prescription Opioid (PO) misuse and associated mortality in several developed countries in recent years, efforts have been made to identify populations who may be at increased risk for misuse of POs. Though the association between depression and PO misuse among pain patients is well documented, little is known regarding the effects of severity of depression on rates of misuse. In this study we explored rates of PO misuse among chronic pain patients screening positive for depression according to level of severity.Methods Participants included chronic pain patients receiving POs (N = 554). All participants were screened for depression using the Patient Health Questionnaire (PHQ-9; cut-off scores of 5, 10, 15, and 20 for mild, moderate, moderate-severe and severe depression, respectively) and for opioid misuse using the Current Opioid Misuse Measure (COMM). Logistic regression analyses controlling for additional sociodemographic and clinical factors were conducted.Results Participants who screened positive for depression were at significantly increased odds to screen positive for opioid misuse (Adjusted Odds Ratio (AOR) = 3.63; 95% Confidence Interval (CI) = 1.71-7.7) compared to those without depression. Severity of depression was significantly associated with increased odds for opioid misuse for moderate (AOR = 3.71; 95% CI = 1.01-13.76), moderate-severe (AOR = 6.28; 95% CI = 1.6-24.57) and severe (AOR = 14.66; 95% CI = 3.28-65.52) depression but not among those who screened positive for mild depression (AOR = 1.49; 95% CI = 0.39-5.68).Limitations Cross-sectional study.Conclusions Our results highlight the need to properly asses and address level of severity of co-morbid depression among chronic pain patients receiving POs.
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Patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse.
“Previous studies have consistently found that patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse [80,81,82,83,84,85,86,87,88,89,90].”
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- Authors
- Feingold, D., Brill, S., Goor-Aryeh, I., Delayahu, Y., & Lev-Ran, S.
- Affiliations
- Lev Hasharon Hospital (IL)
- Tel Aviv Sourasky Medical Center (IL)
- Tel Aviv University (IL)
- Corresponding author
- Feingold, Daniel
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 235
- Pages
- 293-302
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2800031204
- Cited by
- 69
- References
- 84
- Citations by year
- 2025: 3 · 2024: 11 · 2023: 5 · 2022: 13 · 2021: 14 · 2020: 11 · 2019: 10 · 2018: 2
- FWCI
- 8.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- prescription opioid misuse, depression severity, chronic pain, anxiety, comorbid depression, PHQ-9
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Analgesics, Opioid, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Opioid-Related Disorders, Pain Measurement, Psychiatric Status Rating Scales, Surveys and Questionnaires, Socioeconomic Factors, Young Adult, Chronic Pain, Prescription Drug Misuse, Medical Marijuana
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