Untreated depression and non-medical use of prescription pain relievers: findings from the National Survey on Drug Use and Health 2008-2014
Abstract
OBJECTIVES: Despite growing concerns for non-medical use of prescription pain relievers (NMUPPRs), little is known about the role of comorbid, untreated depressive disorders. METHODS: We examined past year rates of NMUPPRs and major depressive episode (MDE), using data between 2008 and 2014 from the National Survey on Drug Use and Health for both youths (12-17 years) and adults (18 or older). Prevalence estimates with 95% confidence intervals were computed. Stratified analyses and generalized linear models were run to examine the association between NMUPPRs and MDE, controlling for treatments received for mental health and/or substance misuse. In order to explore whether MDE effect might change by treatment received, a model with an interaction term including MDE and treatment was fit. RESULTS: Among respondents, about 9% (youths) and 7% (adults) reported past year MDE and about 6% (youths), and 4% (adults) NMUPPRs. About 1.2% (youths) and 0.7% (adults) reported both MDE and NMUPPRs. Those with past year MDE were more likely to report NMUPPRs (RR, 95%CI: 2.60, 2.42-2.80, and 2.64, 2.47-2.82, for youths and adults). Considering the any treatment/MDE interaction on NMUPPRs, MDE risk ratio for subjects who received some treatment (youths: adjusted risk ratio (ARR) = 1.15; adults: ARR = 1.25) was about 70-80% as compared with their untreated counterpart (youths: ARR = 1.57; adults: ARR = 1.54). The likelihood of reporting NMUPPRs amongst respondents who did not receive any treatment was higher for those with past year MDE (main effect: youths ARR = 1.57, p < 0.001; adults ARR = 1.54, p < 0.001). CONCLUSION: Unrecognized and untreated depressive disorders should be considered for prevention, treatment, and policy implications in order to tackle NMUPPRs epidemic.
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Two studies used psychotherapy in addition to medications, including cognitive behavior therapy.
“Two studies used psychotherapy in addition to medications, including cognitive behavior therapy (Curry et al. 2012; Carra ` et al. 2019).”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Carra et al. 2019
One study examined substance use treatment.
“One study examined substance use treatment (Carra ` et al. 2019).”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Carra et al. 2019
Similar findings were reported for non-bipolar depressive disorders in both prospective and retrospective between-group examinations.
“Similar findings were reported for non-bipolar depressive disorders in both prospective and retrospective between-group examinations (Curry et al. 2012; Carra ` et al. 2019).”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Carra ` et al. 2019
Only two studies met the search criteria for effects of treating MDD pharmacologically on the development of SUDs.
“The research was limited on the effects of treating MDD pharmacologically on the development of SUDs as only two studies met our search criteria (Curry et al. 2012; Carra ` et al. 2019).”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Carra et al. 2019
Individuals treated for MDD were significantly less likely to report use of nonmedical prescription pain relievers than individuals not treated for MDD.
“They found that individuals treated for MDD were significantly less likely to report the use of nonmedical prescription pain relievers than individuals who were not treated for MDD.”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Carra et al. 2019
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2022) · doi:10.1176/appi.books.9780890425787 · Cited by 23,476 · see citing works
Relationship between Nonmedical Prescription-Opioid Use and Heroin Use
Compton, W. M., Jones, C. M., & Baldwin, G. T. (2016) · New England Journal of Medicine · doi:10.1056/nejmra1508490 · Cited by 1,044 · see citing works
Medication-Assisted Therapies — Tackling the Opioid-Overdose Epidemic
Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014) · New England Journal of Medicine · doi:10.1056/nejmp1402780 · Cited by 1,014 · see citing works
Relieving pain in America: a blueprint for transforming prevention, care, education, and research
(2012) · Choice Reviews Online · doi:10.5860/choice.49-6323 · Cited by 1,004 · see citing works
The US National Comorbidity Survey Replication (NCS‐R): design and field procedures
Kessler, R. C., Berglund, P. A., Chiu, W. T., Demler, O., Heeringa, S. G., Hiripi, E., Jin, R., Pennell, B., Walters, E. E., Zaslavsky, A. M., et al. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.167 · Cited by 832 · see citing works
Kroenke, K., Wu, J., Bair, M. J., Krebs, E. E., Damush, T. M., & Tu, W. (2011) · The Journal of Pain · doi:10.1016/j.jpain.2011.03.003 · Cited by 573 · see citing works
INTERPRETATION AND CHOICE OF EFFECT MEASURES IN EPIDEMIOLOGIC ANALYSES1
Greenland, S. (1987) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114593 · Cited by 546 · see citing works
Opioid receptors: Distinct roles in mood disorders
Lutz, P.-E., & Kieffer, B. L. (2013) · Trends in Neurosciences · doi:10.1016/j.tins.2012.11.002 · Cited by 542 · see citing works
Psychiatric disorders in patients with fibromyalgia. A multicenter investigation.
Epstein, S., Kay, G., Clauw, D., Heaton, R., Klein, D., Krupp, L., Kuck, J., Leslie, V. M., Masur, D., Wagner, M., et al. (1999) · Psychosomatics · doi:10.1016/s0033-3182(99)71272-7 · Cited by 417 · see citing works
Han, B., Compton, W. M., Jones, C. M., & Cai, R. (2015) · JAMA · doi:10.1001/jama.2015.11859 · Cited by 366 · see citing works
Comorbid Chronic Pain and Depression: Who Is at Risk?
Miller-Matero, L. R., & Caño, A. (2009) · Journal of Pain · doi:10.1016/j.jpain.2008.12.007 · Cited by 323 · see citing works
Huang, B., Dawson, D. A., Stinson, F. S., Hasin, D. S., Ruan, W. J., Saha, T. D., Smith, S. M. R., Goldstein, R. B., & Grant, B. F. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0708 · Cited by 306 · see citing works
Annual surveillance report of drug-related risks and outcomes -- United States, 2017
Mattson, C. L., Schieber, L. Z., Scholl, L., Rudd, R. A., Seth, P., Xu, L., Wilson, N. O., & Paulozzi, L. J. (2017) · Cited by 305 · see citing works
Martins, S. S., Fenton, M. C., Keyes, K. M., Blanco, C., Zhu, H., & Storr, C. L. (2012) · Psychological Medicine · doi:10.1017/s0033291711002145 · Cited by 283 · see citing works
Swinkels-Meewisse, I., Roelofs, J., Oostendorp, R. A. B., Verbeek, A. L. M., & Vlaeyen, J. W. S. (2005) · Pain · doi:10.1016/j.pain.2005.10.005 · Cited by 246 · see citing works
Meerwijk, E. L., Ford, J. M., & Weiss, S. J. (2012) · Brain Imaging and Behavior · doi:10.1007/s11682-012-9179-y · Cited by 227 · see citing works
Saha, T. D., Kerridge, B. T., Goldstein, R. B., Chou, S. P., Zhang, H., Jung, J., Pickering, R. P., Ruan, W. J., Smith, S. M., Huang, B., et al. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15m10386 · Cited by 222 · see citing works
Young, A. M., Glover, N. G., & Havens, J. R. (2012) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2012.01.011 · Cited by 174 · see citing works
McGovern, M. P., Lambert-Harris, C., Gotham, H. J., Claus, R. E., & Xie, H. (2014) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-012-0449-1 · Cited by 126 · see citing works
Brunette, M. F., Asher, D., Whitley, R., Lutz, W. J., Wieder, B., Jones, A. M., & McHugo, G. J. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.9.989 · Cited by 122 · see citing works
Pain symptoms in depression: definition and clinical significance
Katona, C., Peveler, R., Dowrick, C. F., Wessely, S. C., Feinmann, C., Gask, L. L., Lloyd, H., Williams, A. C. D. C., & Wager, E. (2005) · Clinical Medicine · doi:10.7861/clinmedicine.5-4-390 · Cited by 121 · see citing works
Goldner, E. M., Lusted, A., Roerecke, M., Rehm, J., & Fischer, B. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.11.022 · Cited by 102 · see citing works
Rethinking chronic pain in a primary care setting
Stanos, S. P., Brodsky, M., Argoff, C. E., Clauw, D. J., D’Arcy, Y. M., Donevan, S. D., Gebke, K. B., Jensen, M. P., Clark, E. L., McCarberg, B. H., et al. (2016) · Postgraduate Medicine · doi:10.1080/00325481.2016.1188319 · Cited by 101 · see citing works
McCabe, S. E., Teter, C. J., Boyd, C. J., Wilens, T. E., & Schepis, T. S. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.17m11958 · Cited by 79 · see citing works
Fischer, B., Lusted, A., Roerecke, M., Taylor, B., & Rehm, J. T. (2012) · Journal of Pain · doi:10.1016/j.jpain.2012.07.013 · Cited by 77 · see citing works
Prescription Pain Reliever Abuse and Dependence Among Adolescents: A Nationally Representative Study
Wu, L.-T. T., Ringwalt, C. L., Mannelli, P., & Patkar, A. A. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31817eed4d · Cited by 68 · see citing works
Schepis, T. S., & Hakes, J. K. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03520.x · Cited by 65 · see citing works
Understanding the Psychosocial Profile of Women with Fibromyalgia Syndrome
Shuster, J., McCormack, J., Riddell, R. P., & Toplak, M. E. (2009) · Pain Research and Management · doi:10.1155/2009/134808 · Cited by 57 · see citing works
Carrà, G., Scioli, R., Monti, M. C., & Marinoni, A. (2006) · European Addiction Research · doi:10.1159/000090429 · Cited by 55 · see citing works
Self-citationA systematic review of the motivations for the non-medical use of prescription drugs in young adults
Drazdowski, T. K. (2016) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.01.011 · Cited by 53 · see citing works
Dorner, T. E., Alexanderson, K. A. E., Svedberg, P., Tinghög, P., Ropponen, A., & Mittendorfer‐Rutz, E. (2015) · Psychological Medicine · doi:10.1017/s003329171500197x · Cited by 47 · see citing works
Carrà, G., Crocamo, C., Borrelli, P., Popa, I., Ornaghi, A., Montomoli, C., & Clerici, M. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.11.021 · Cited by 40 · see citing works
Self-citationBlanco, C., Rafful, C., Wall, M. M., Jin, C. J., Kerridge, B., & Schwartz, R. P. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.07.011 · Cited by 40 · see citing works
Graham, K., Cheng, J. M., Bernards, S., Wells, S. L., Rehm, J. T., & Kurdyak, P. A. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716664884 · Cited by 39 · see citing works
Lo, C. C., Monge, A. N., Howell, R. J., & Cheng, T. C. (2013) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2013.763561 · Cited by 35 · see citing works
Dual Diagnosis—Policy and Practice in Italy
Carrà, G., & Clerici, M. (2006) · American Journal on Addictions · doi:10.1080/10550490500528340 · Cited by 27 · see citing works
Self-citationCampbell, U. B., Gatto, N. M., & Schwartz, S. (2005) · Epidemiologic Perspectives & Innovations · doi:10.1186/1742-5573-2-1 · Cited by 25 · see citing works
Fischer, B., Murphy, Y., Kurdyak, P. A., & Goldner, E. M. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.06.053 · Cited by 17 · see citing works
Animal models for opioid addiction drug discovery
Grenald, S. A., Largent‐Milnes, T. M., & Vanderah, T. W. (2014) · Expert Opinion on Drug Discovery · doi:10.1517/17460441.2014.966076 · Cited by 16 · see citing works
Pjanic, I., Messerli‐Bürgy, N., Bachmann, M., Siegenthaler, F., Hoffmann‐Richter, U., & Znoj, H. (2013) · Disability and Rehabilitation · doi:10.3109/09638288.2013.837971 · Cited by 12 · see citing works
Hobden, B., Carey, M. L., Bryant, J., Sanson‐Fisher, R., & Oldmeadow, C. J. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.09.013 · Cited by 1 · see citing works
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Moro, M. F., Calamandrei, G., Poli, R., Mattei, V. E. D., Perra, A., Kurotschka, P. K., Restrepo, A., Romano, F., Torre, G. L., Preti, E., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.867080 · Cited by 51 · see citing works
Wilens, T. E., Woodward, D. W., Ko, J. D., Berger, A. F., Burke, C., & Yule, A. M. (2022) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2022.0016 · Cited by 26 · see citing works
Luo, C., Chen, K., Doshi, R., Rickles, N. M., Chen, Y., Schwartz, H., & Aseltine, R. H. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269809 · Cited by 15 · see citing works
Sanger, N., Bhatt, M., Singhal, N., Panesar, B., D’Elia, A., Trottier, M., Shahid, H., Hillmer, A., Baptist-Mohseni, N., Roczyki, V., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00812 · Cited by 10 · see citing works
Miramontes, A. B., Moure-Rodríguez, L., Díaz-Geada, A., Carbia, C., Cadaveira, F., & Caamaño‐Isorna, F. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00880 · Cited by 8 · see citing works
Rao, V., Lanni, S. R., Yule, A. M., DiSalvo, M., Stone, M., Berger, A. F., & Wilens, T. E. (2023) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2023.100007 · Cited by 5 · see citing works
Yule, A. M., Kim, A., Burns, K., DiSalvo, M., Rao, V., Stone, M., Lanni, S. R., & Wilens, T. E. (2025) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2025.100149 · Cited by 1 · see citing works
Fakour, M., Roshanpajouh, M., & Abdolmaleki, A. (2026) · Current Addiction Reports · doi:10.1007/s40429-026-00730-6
Substance Misuse Prevalence and Risk Factors in Adolescents and Young Adults With Depression
Toce, M. S., Porter, J. J., Lim, J. K., & Bourgeois, F. T. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.39343
- Authors
- Carrà, G., Bartoli, F., Galanter, M., & Crocamo, C.
- Affiliations
- University College London (GB)
- University of Milano-Bicocca (IT)
- NYU Langone Health (US)
- Corresponding author
- Crocamo, Cristina
- Venue
- Postgraduate Medicine
- Publisher
- Informa UK Limited
- Published
- 2018-11-27
- Volume
- 131
- Issue
- 1
- Pages
- 52-59
- ISSN
- 0032-5481 (ISSN-L)
- 1941-9260
- OpenAlex
- W2901278582
- Cited by
- 9
- References
- 42
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2022: 3 · 2020: 2
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Postgraduate Medicine (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Funders
- not funded
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- untreated depression, major depressive episode, opioid misuse, comorbidities, psychotherapy, youth, adults, National Survey on Drug Use and Health
- MeSH terms
- Adolescent, Adult, Aged, Child, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Health Surveys, Humans, Male, Middle Aged, Prevalence, Substance-Related Disorders, Prescription Drugs, Young Adult
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