Depression Effects on Long-term Prescription Opioid Use, Abuse, and Addiction

Sullivan, Mark D.

doi:10.1097/ajp.0000000000000603

Cited by 196Opioid Use Disorder TreatmentPain Management and Opioid UseSubstance Abuse Treatment and Outcomes

Depression Effects on Long-term Prescription Opioid Use, Abuse, and Addiction

Sullivan, Mark D.·2018·The Clinical Journal of Pain

DOI 10.1097/ajp.0000000000000603

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Abstract

Objectives: Treatment guidelines discourage long-term opioid treatment for patients with chronic pain and major depression, but this treatment occurs commonly, producing higher daily doses, longer duration, and more adverse events. Materials and Methods: Review of prospective cohort, retrospective cohort, and other observational studies of the relation between depression and opioid use, abuse, and addiction. Results: Depressed patients initiate opioid therapy slightly more often than nondepressed patients, but are twice as likely to transition to long-term use. This adverse selection of high-risk patients with depression into long-term high-dose opioid therapy seems to be a process of self-selection. Opioids may be used by patients with chronic pain and depression to compensate for a reduced endogenous opioid response to stressors. Depressed patients seem to continue opioid use at lower pain intensity levels and higher levels of physical function than do nondepressed patients. In studies that carefully control for confounding by indication, it has been shown that long-term opioid therapy increases the risk of incident, recurrent, and treatment-resistant depression. Depressed patients may tend to overuse opioids because they use them to treat insomnia and stress. Depression also seems to increase the risk of abuse or nonmedical use of prescription opioids among adults and adolescents. This increased rate of nonmedical opioid use may be the path through which depression increases the risk of opioid use disorder among patients with chronic pain. Discussion: It is not possible to understand long-term opioid therapy for chronic pain without understanding the close and multifaceted relationship of this therapy with depression.

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Long-term opioid use increases the incidence, recurrence, and risk of treatment-resistant depression.
“Long-term opioid use increases the incidence, recurrence, and risk of treatmentresistant depression. 10”
From Decision Support and Behavioral Health for Reducing High-Dose Opioids in Comorbid Chronic Pain, Depression and Anxiety: Stepped-Wedge Cluster Randomized Trial (2024) · cites this paper as [10]
Patients with depression are more likely to initiate opioid therapy, transition to long-term use, and continue opioids at lower levels of pain intensity.
“Sullivan etal. report that patients with depression are more likely to initiate opioid therapy, transition to long-term use, and continue opioids at lower levels of pain intensity. 10”
From Decision Support and Behavioral Health for Reducing High-Dose Opioids in Comorbid Chronic Pain, Depression and Anxiety: Stepped-Wedge Cluster Randomized Trial (2024) · cites this paper as [10]
Prior studies have shown associations between depression and long-term opioid use at lower levels of pain intensity and higher levels of physical function among patients with depression compared with patients without depression.
“prior studies have already shown associations between depression and long-term opioid use at lower levels of pain intensity and higher levels of physical function among patients with depression compared to patients without depression.”
From Decision Support and Behavioral Health for Reducing High-Dose Opioids in Comorbid Chronic Pain, Depression and Anxiety: Stepped-Wedge Cluster Randomized Trial (2024) · cites this paper as [10]

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CDC Clinical Practice Guideline for Prescribing Opioids for Pain <b>—</b> United States, 2022
Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7103a1 · Cited by 1,886 · see citing works
Preoperative opioid use is associated with worse patient outcomes after Total joint arthroplasty: a systematic review and meta-analysis
Goplen, C. M., Verbeek, W., Kang, S. H., Jones, C., Voaklander, D. C., Churchill, T. A., & Beaupré, L. A. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2619-8 · Cited by 254 · see citing works
Pain Management Best Practices from Multispecialty Organizations During the COVID-19 Pandemic and Public Health Crises
Cohen, S. P., Baber, Z., Buvanendran, A., McLean, B. C., Chen, Y., Hooten, W. M., Laker, S. R., Wasan, A. D., Kennedy, D. J. “. J. ”., Sandbrink, F., et al. (2020) · Pain Medicine · doi:10.1093/pm/pnaa127 · Cited by 189 · see citing works
Which Psychological Factors Are Involved in the Onset and/or Persistence of Musculoskeletal Pain? An Umbrella Review of Systematic Reviews and Meta-Analyses of Prospective Cohort Studies
Martínez-Calderón, J., Flores-Cortés, M., Morales‐Asencio, J. M., & Luque-Suárez, A. (2020) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000838 · Cited by 98 · see citing works
Association of opioid misuse with anxiety and depression: A systematic review of the literature
Rogers, A. H., Zvolensky, M. J., Ditre, J. W., Buckner, J. D., & Asmundson, G. J. G. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.101978 · Cited by 85 · see citing works
A Systematic Review of the Relative Frequency and Risk Factors for Prolonged Opioid Prescription Following Surgery and Trauma Among Adults
Pagé, M. G., Kudrina, I., Zomahoun, H. T. V., Croteau, J., Ziegler, D., Ngangue, P., Martin, É., Fortier, M., Boisvert, E. E., Beaulieu, P., et al. (2019) · Annals of Surgery · doi:10.1097/sla.0000000000003403 · Cited by 86 · see citing works
Heterogeneity-aware and communication-efficient distributed statistical inference
Duan, R., Ning, Y., & Chen, Y. (2021) · Biometrika · doi:10.1093/biomet/asab007 · Cited by 81 · see citing works
Patient outcomes after opioid dose reduction among patients with chronic opioid therapy
Hallvik, S. E., Ibrahimi, S. E., Johnston, K. A., Geddes, J., Leichtling, G. J., Korthuis, P. T., & Hartung, D. M. (2021) · Pain · doi:10.1097/j.pain.0000000000002298 · Cited by 75 · see citing works
Opioid system influences gut-brain axis: Dysbiosis and related alterations
Rueda‐Ruzafa, L., Cruz, F., Cardona, D., Hone, A. J., Molina‐Torres, G., Sánchez‐Labraca, N., & Román, P. (2020) · Pharmacological Research · doi:10.1016/j.phrs.2020.104928 · Cited by 64 · see citing works
Morphine‐mediated release of miR‐138 in astrocyte‐derived extracellular vesicles promotes microglial activation
Liao, K., Niu, F., Hu, G., Yang, L., Dallon, B. W., Villarreal, D. J., & Buch, S. J. (2020) · Journal of Extracellular Vesicles · doi:10.1002/jev2.12027 · Cited by 57 · see citing works
Prescription opioid misuse among middle-aged and older adults in the United States, 2015–2016
Han, B. H., Sherman, S. E., & Palamar, J. J. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2019.02.018 · Cited by 59 · see citing works
Unintended consequences of COVID-19 safety measures on patients with chronic knee pain forced to defer joint replacement surgery
Cisternas, A. F., Ramachandran, R., Yaksh, T. L., & Nahama, A. (2020) · PAIN Reports · doi:10.1097/pr9.0000000000000855 · Cited by 49 · see citing works
Identification and Management of Opioid Use Disorder in Primary Care: an Update
Donroe, J. H., Bhatraju, E. P., Tsui, J. I., & Edelman, E. J. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-01149-0 · Cited by 46 · see citing works
European clinical practice recommendations on opioids for chronic noncancer pain – Part 2: Special situations*
Škvarč, N. K., Morlion, B. J., Vowles, K. E., Bannister, K., Buchsner, E., Casale, R., Chenot, J., Chumbley, G. M., Drewes, A. M., Dom, G., et al. (2021) · European Journal of Pain · doi:10.1002/ejp.1744 · Cited by 44 · see citing works
The Insomnia-Addiction Positive Feedback Loop: Role of the Orexin System
Fragale, J. E. C., James, M. H., Avila, J. A., Spaeth, A. M., Aurora, R. N., Langleben, D. D., & Aston‐Jones, G. (2021) · Monographs in clinical neuroscience/Frontiers of neurology and neuroscience/Monographs in neural sciences · doi:10.1159/000514965 · Cited by 42 · see citing works
Medical Use and Misuse of Prescription Opioids in the US Adult Population: 2016–2017
Griesler, P. C., Hu, M., Wall, M. M., & Kandel, D. B. (2019) · American Journal of Public Health · doi:10.2105/ajph.2019.305162 · Cited by 38 · see citing works
Opioid epidemic: lessons learned and updated recommendations for misuse involving prescription versus non-prescription opioids
Bedene, A., Dahan, A., Rosendaal, F. R., & van Dorp, E. L. A. (2022) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2022.2114898 · Cited by 38 · see citing works
Obesity and Incident Prescription Opioid Use in the U.S., 2000–2015
Stokes, A., Lundberg, D. J., Hempstead, K., Berry, K. M., Baker, J. F., & Preston, S. H. (2020) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2019.12.018 · Cited by 36 · see citing works
Associations of mental health and family background with opioid analgesic therapy: a nationwide Swedish register-based study
Quinn, P. D., Rickert, M. E., Franck, J., Sariaslan, A., Boersma, K., Lichtenstein, P., Larsson, H., & D'Onofrio, B. M. (2019) · Pain · doi:10.1097/j.pain.0000000000001643 · Cited by 34 · see citing works
Astrocytes & Astrocyte derived Extracellular Vesicles in Morphine Induced Amyloidopathy: Implications for Cognitive Deficits in Opiate Abusers
Sil, S., Singh, S., Chemparathy, D. T., Chivero, E. T., Gordon, L., & Buch, S. J. (2021) · Aging and Disease · doi:10.14336/ad.2021.0406 · Cited by 32 · see citing works
Management of Opioid-Tolerant Patients with Acute Pain: Approaching the Challenges
Macintyre, P., Roberts, L. J., & Huxtable, C. (2019) · Drugs · doi:10.1007/s40265-019-01236-4 · Cited by 32 · see citing works
Baseline Risk Factors for Prolonged Opioid Use Following Spine Surgery: Systematic Review and Meta-Analysis
Mohan, S., Lynch, C. P., Cha, E. D. K., Jacob, K. C., Patel, M. R., Geoghegan, C. E., Prabhu, M. C., Vanjani, N. N., Pawlowski, H., & Singh, K. (2021) · World Neurosurgery · doi:10.1016/j.wneu.2021.12.086 · Cited by 32 · see citing works
Depression and Long-Term Prescription Opioid Use and Opioid Use Disorder: Implications for Pain Management in Cancer
Bates, N. E., Bello, J. K., Osazuwa‐Peters, N., Sullivan, M. D., & Scherrer, J. F. (2022) · Current Treatment Options in Oncology · doi:10.1007/s11864-022-00954-4 · Cited by 32 · see citing works
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Comparison of Opioids Prescribed for Patients at Risk for Opioid Misuse Before and After Publication of the Centers for Disease Control and Prevention’s Opioid Prescribing Guidelines
Scherrer, J. F., Tucker, J. L., Salas, J., Zhang, Z., & Grucza, R. A. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.27481 · Cited by 31 · see citing works
Developments of Microextraction (Extraction) Procedures for Sample Preparation of Antidepressants in Biological and Water Samples, a Review
Ghorbani, M., Mohammadi, P., Keshavarzi, M., Ziroohi, A., Mohammadi, M., Aghamohammadhasan, M., & Pakseresht, M. (2021) · Critical Reviews in Analytical Chemistry · doi:10.1080/10408347.2021.2018648 · Cited by 31 · see citing works
Psycho-Social Correlates of Opioid Use Disorder among the US Adult Population: Evidence from the National Survey on Drug Use and Health, 2015–2018
Haider, M. R., Brown, M. J., Gupta, R. D., Karim, S., Olatosi, B., & Li, X. (2020) · Substance Use & Misuse · doi:10.1080/10826084.2020.1788086 · Cited by 30 · see citing works
Association of co-occurring opioid or other substance use disorders with increased healthcare utilization in patients with depression
Vekaria, V., Bose, B., Murphy, S. M., Avery, J., Alexopoulos, G. S., & Pathak, J. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01372-0 · Cited by 30 · see citing works
Association Between Preoperative Depression and Readmission Rate Following Primary Total Joint Arthroplasty: A Systematic Review and Meta-Analysis
Kim, H., & Kim, C. (2021) · The Journal of Arthroplasty · doi:10.1016/j.arth.2021.06.020 · Cited by 29 · see citing works
Are medical comorbidities contributing to the use of opioid analgesics in patients with knee osteoarthritis?
King, L. K., Marshall, D. A., Jones, C., Woodhouse, L. J., Ravi, B., Faris, P., HAWKER, G. A., HAWKER, G. A., Marshall, D. A., Bohm, É., et al. (2020) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2020.04.012 · Cited by 28 · see citing works
Genome-wide association analysis of opioid use disorder: A novel approach using clinical data
Song, W., Kossowsky, J., Torous, J. B., Chen, C., Huang, H., Mukamal, K. J., Berde, C. B., Bates, D. W., & Wright, A. T. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108276 · Cited by 26 · see citing works
Are Patient-Reported Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Influenced by Preoperative Mental Health?
Goh, G. S.-H., Liow, M. H. L., Yue, W.-M., Tan, S. B., & Chen, J. L.-T. (2020) · Global Spine Journal · doi:10.1177/2192568220912712 · Cited by 27 · see citing works
Characteristics associated with transition from opioid initiation to chronic opioid use among opioid-naïve older adults
Musich, S. A., Wang, S. S., Slindee, L. B., Kraemer, S., & Yeh, C. S. (2018) · Geriatric Nursing · doi:10.1016/j.gerinurse.2018.10.003 · Cited by 24 · see citing works
Anxiety sensitivity and opioid misuse and dependence among trauma-exposed adults with chronic pain
Zvolensky, M. J., Rogers, A. H., Shepherd, J. M., Vujanovic, A. A., & Bakhshaie, J. (2020) · Journal of Behavioral Medicine · doi:10.1007/s10865-020-00142-5 · Cited by 24 · see citing works
Prevalence and Trends of Opioid Use in Patients With Depression in the United States
Tumenta, T., Ugwendum, D. F., Chobufo, M. D., Mungu, E. B., Исааковна, К. И., & Olupona, T. (2021) · Cureus · doi:10.7759/cureus.15309 · Cited by 21 · see citing works
Opioid use disorders, psychiatric comorbidities, and risk for suicide attempts among veterans seeking pain care
Ashrafioun, L., Zerbo, K., Bishop, T., & Britton, P. C. (2019) · Psychological Medicine · doi:10.1017/s0033291719002307 · Cited by 18 · see citing works
Perspective Chapter: Interdisciplinary Pain Rehabilitation Programs – Evidence and Clinical Real-World Results
Gerdle, B. U. C., Fischer, M. R., & Ringqvist, Å. (2022) · Pharmaceutical science. · doi:10.5772/intechopen.102411 · Cited by 20 · see citing works
Opioid Pain Medication Prescription for Chronic Pain in Primary Care Centers: The Roles of Pain Acceptance, Pain Intensity, Depressive Symptoms, Pain Catastrophizing, Sex, and Age
Ramírez‐Maestre, C., Reyes-Pérez, Á., Esteve, R., López-Martínez, A. E., Bernardes, S. F., & Jensen, M. P. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176428 · Cited by 20 · see citing works
Towards a Comprehensive Theory of Non-Cancer Acute and Chronic Pain Management: The Critical Role of Reactive Oxygen and Nitrogen Species in Pain, and Opioid Dependence, Addiction, Hyperalgesia, and Tolerance
Tobore, T. O. (2021) · Advances in Redox Research · doi:10.1016/j.arres.2021.100003 · Cited by 20 · see citing works
Psychological Capital and Its Factors as Mediators Between Interpersonal Sensitivity and Depressive Symptoms Among Chinese Undergraduates
Liu, X., Wang, Z., Zhang, C., Xu, J., Shen, Z., Peng, L., Mi, Y., & Liu, X. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s452993 · Cited by 27 · see citing works
The Penrose Effect and its acceleration by the war on drugs: a crisis of untranslated neuroscience and untreated addiction and mental illness
Grecco, G. G., & Chambers, R. A. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0661-9 · Cited by 18 · see citing works
Adverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only
Aquino, J. P. D., Sofuoglu, M., Stefanovics, E. A., & Rosenheck, R. A. (2019) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2019.1607363 · Cited by 18 · see citing works
Interest in reducing methamphetamine and opioid use among syringe services program participants in Washington State
McMahan, V., Kingston, S., Newman, A., Stekler, J. D., Glick, S. N., & Banta‐Green, C. J. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108243 · Cited by 18 · see citing works
Meta-analysis of retrospective studies suggests that the pre-operative opioid use is associated with an increased risk of adverse outcomes in total hip and or knee arthroplasty
Chen, L., Wang, Q., Li, D., Chen, C., Li, Q., & Kang, P. (2021) · International Orthopaedics · doi:10.1007/s00264-021-04968-9 · Cited by 18 · see citing works
Clinical Perspective on Opioids in the Context of Suicide Risk
Nestadt, P. S., & Bohnert, A. S. B. (2020) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20200003 · Cited by 17 · see citing works
Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse
Hudak, J., Bernat, E. M., Fix, S. T., Prince, K. C., Froeliger, B., & Garland, E. L. (2022) · Biological Psychiatry · doi:10.1016/j.biopsych.2022.01.019 · Cited by 16 · see citing works
Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors
Weyandt, L. L., Guðmundsdóttir, B. G., Shepard, E., Brick, L. A. D., Buchanan, A. L., Clarkin, C. M., Francis, A. R., & Marraccini, M. E. (2021) · Pharmacy · doi:10.3390/pharmacy9020106 · Cited by 15 · see citing works
Health-related quality of life in hospitalized older patients with versus without prolonged use of opioid analgesics, benzodiazepines, and z-hypnotics: a cross-sectional study
Cheng, S., Siddiqui, T. G., Gossop, M., Stavem, K., Kristoffersen, E. S., & Lundqvist, C. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01838-8 · Cited by 15 · see citing works
Effect of preoperative long-term opioid therapy on patient outcomes after total knee arthroplasty: an analysis of multicentre population-based administrative data
Goplen, C. M., Kang, S. H., Randell, J. R., Jones, C., Voaklander, D. C., Churchill, T. A., & Beaupré, L. A. (2021) · Canadian Journal of Surgery · doi:10.1503/cjs.007319 · Cited by 15 · see citing works
The association of prescription opioid use with suicide attempts: An analysis of statewide medical claims data
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
The Influence of Expectancies on Pain and Function Over Time After Total Knee Arthroplasty
Carrière, J. S., Martel, M. O., Loggia, M. L., Campbell, C. M., Smith, M. T., Haythornthwaite, J. A., & Edwards, R. R. (2022) · Pain Medicine · doi:10.1093/pm/pnac067 · Cited by 14 · see citing works
Injuries That Happen at Work Lead to More Opioid Prescriptions and Higher Opioid Costs
Asfaw, A., Quay, B., Bushnell, T., & Pana‐Cryan, R. (2022) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002709 · Cited by 14 · see citing works
Independent and joint contributions of physical disability and chronic pain to incident opioid use disorder and opioid overdose among Medicaid patients
Hoffman, K. L., Milazzo, F., Williams, N., Samples, H., Olfson, M., Diaz, I. M., Doan, L., Cerdá, M., Crystal, S., & Rudolph, K. E. (2023) · Psychological Medicine · doi:10.1017/s003329172300332x · Cited by 14 · see citing works
Opioid Exposure Negatively Affects Antidepressant Response to Venlafaxine in Older Adults with Chronic Low Back Pain and Depression
Stahl, S. T., Jung, C., Weiner, D. K., Peciña, M., & Karp, J. F. (2019) · Pain Medicine · doi:10.1093/pm/pnz279 · Cited by 14 · see citing works
Mind-body approaches targeting the psychological aspects of opioid use problems in patients with chronic pain: evidence and opportunities
Martel, M. O., Bruneau, A., & Edwards, R. R. (2021) · Translational research · doi:10.1016/j.trsl.2021.02.013 · Cited by 14 · see citing works
Understanding the Risks of Long-Term Opioid Therapy for Chronic Pain
Sullivan, M. D., & Ballantyne, J. C. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220592 · Cited by 13 · see citing works
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Low-dose ketamine infusion to facilitate opioid tapering in chronic non-cancer pain with opioid-use disorder: a historical cohort study
Elyn, A., Roussin, A., Lestrade, C., Franchitto, N., Jullian, B., & Cantagrel, N. (2024) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2023-105035 · Cited by 12 · see citing works
Depressed Symptomatology in Systemic Lupus Erythematosus Patients
Kellahan, S. R., Huang, X., Lew, D., Xian, H., Eisen, S. A., & Kim, A. H. J. (2021) · Arthritis Care & Research · doi:10.1002/acr.24833 · Cited by 12 · see citing works
Long-Term Opioid Therapy Among Patients With Systemic Lupus Erythematosus in the Community: A Lupus Midwest Network (LUMEN) Study
Figueroa‐Parra, G., Jeffery, M. M., Dabit, J. Y., Chevet, B., Valenzuela-Almada, M. O., Hocaoǧlu, M., Osei‐Onomah, S., Kurani, S. S., Vallejo, S., Achenbach, S. J., et al. (2022) · The Journal of Rheumatology · doi:10.3899/jrheum.220822 · Cited by 11 · see citing works
Gene × environment effects and mediation involving adverse childhood events, mood and anxiety disorders, and substance dependence
Kranzler, H., Davis, C., Feinn, R., Jinwala, Z., Khan, Y., Oikonomou, A., Silva-Lopez, D., Burton, I., Dixon, M., Milone, J., et al. (2024) · Nature Human Behaviour · doi:10.1038/s41562-024-01885-w · Cited by 10 · see citing works
Trends in potentially inappropriate opioid prescribing and associated risk factors among Korean noncancer patients prescribed non-injectable opioid analgesics
Noh, Y., Heo, K.-N., Yu, Y.-M., Lee, J.-Y., & Ah, Y.-M. (2022) · Therapeutic Advances in Drug Safety · doi:10.1177/20420986221091001 · Cited by 12 · see citing works
Trends in Celecoxib Prescribing: A Single Institution 16-Month Review
Cerda, I. H., Jung, H. S., Guerrero, M. C., Díez-Tafur, R., Yong, R. J., Robinson, C. L., & Hasoon, J. J. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14082823 · Cited by 10 · see citing works
Opioids Use and Abuse: Prescription Practice, Attitude, and Beliefs among Doctors of Karachi
Majid, Z., Tanveer, M., Asghar, S. A., Tahir, F., Minhaj, A., Khan, H. A., Sialvi, T., Mahmood, S. H., Qadar, L. T., & Imtiaz, F. (2019) · Cureus · doi:10.7759/cureus.5253 · Cited by 10 · see citing works
Long-term opioid therapy and mental health comorbidity in patients with chronic pain
Vogt, S., Pfau, G., Vielhaber, S., Haghikia, A., Hachenberg, T., & Brinkers, M. (2023) · Pain Medicine · doi:10.1093/pm/pnad004 · Cited by 9 · see citing works
Male gender, smoking, younger age, and preoperative pain found to increase postoperative opioid requirements in 592 elective colorectal resections
Karlsdottir, B. R., Zhou, P., Wahba, J., Mott, S. L., Goffredo, P., Hrabe, J. E., Hassan, I., Kapadia, M. R., & Gribovskaja‐Rupp, I. (2022) · International Journal of Colorectal Disease · doi:10.1007/s00384-022-04208-5 · Cited by 9 · see citing works
Self-reported cannabis use is not associated with greater opioid use in elective hand surgery patients
Bowers, N. L., Hao, K. A., Trivedi, S. M., Satteson, E., King, J. J., Wright, T. W., & Matthias, R. C. (2022) · European Journal of Orthopaedic Surgery & Traumatology · doi:10.1007/s00590-022-03321-z · Cited by 9 · see citing works
STRategies to Improve Pain and Enjoy life (STRIPE): results of a pragmatic randomized trial of pain coping skills training and opioid medication taper guidance for patients on long-term opioid therapy
Wartko, P. D., Krakauer, C. A., Turner, J. A., Cook, A. J., Boudreau, D. M., & Sullivan, M. D. (2023) · Pain · doi:10.1097/j.pain.0000000000002982 · Cited by 9 · see citing works
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The contribution of pain catastrophizing, depression and anxiety symptoms among patients with persistent pain and opioid misuse behaviours
Baranoff, J. A., Clubb, B. S., Coates, J. M., Elphinston, R. A., Loveday, B., & Connor, J. P. (2023) · Journal of Behavioral Medicine · doi:10.1007/s10865-023-00452-4 · Cited by 9 · see citing works
Pain intensity, physical function, and depressive symptoms associated with discontinuing long‐term opioid therapy in older adults with Alzheimer's disease and related dementias
Wei, Y. J., Winterstein, A. G., Schmidt, S. O., Fillingim, R. B., Daniels, M. J., Solberg, L. M., & DeKosky, S. T. (2023) · Alzheimer s & Dementia · doi:10.1002/alz.13489 · Cited by 8 · see citing works
Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder
Schellekens, A., Veldman, S. E., Suranto, E. S. D., van Rijswijk, S. M., van der Wal, S. E. I., Schene, A. H., & Beek, M. H. C. T. V. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10163727 · Cited by 9 · see citing works
Depression and Buprenorphine Treatment in Patients with Non-cancer Pain and Prescription Opioid Dependence without Comorbid Substance Use Disorders
Scherrer, J. F., Salas, J., Grucza, R. A., Sullivan, M. D., Lustman, P. J., Copeland, L. A., & Ballantyne, J. C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.089 · Cited by 9 · see citing works
Self-citation
Prescribing Patterns and Use of Risk-Reduction Tools After Implementing an Opioid-Prescribing Protocol
Breeden, M. A., Jacobs, C. K., Witthaus, M., Salas, J., Everard, K. M., Penton, E., & Scherrer, J. F. (2020) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2020.01.190247 · Cited by 8 · see citing works
Opioids for acute and chronic pain when receiving psychiatric medications
Janakiram, C., Okunev, I., Tranby, E. P., Fontelo, P. A., Iafolla, T., & Dye, B. A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286179 · Cited by 8 · see citing works
The Efficacy of Ketamine for Acute and Chronic Pain in Patients with Cancer: A Systematic Review of Randomized Controlled Trials
Azari, L., Hemati, H., Tavasolian, R., Shahdab, S., Tomlinson, S. M., Babilonia, M. B., Huang, J. J., Tometich, D. B., Turner, K. L., Anaraki, K. S., et al. (2024) · Healthcare · doi:10.3390/healthcare12161560 · Cited by 8 · see citing works
Motivations for Prescription Drug Misuse Related to Mental Health Problems in Adults
Drazdowski, T. K., Schulte, M. T., Wolitzky-Taylor, K. B., Schaper, H., & Chapman, J. E. (2021) · Substance Use & Misuse · doi:10.1080/10826084.2021.2012687 · Cited by 8 · see citing works
Impact of Opioid Dose Reductions on Patient-Reported Mental Health and Suicide-Related Behavior and Relationship to Patient Choice in Tapering Decisions
Yarborough, B. J. H., Stumbo, S. P., Schneider, J. L., Ahmedani, B. K., Daida, Y. G., Hooker, S. A., Negriff, S. L., Rossom, R. C., & Lapham, G. T. (2023) · Journal of Pain · doi:10.1016/j.jpain.2023.11.002 · Cited by 8 · see citing works
Age Differences in Non-Medical Prescription Opioid Use and Psychological Distress
Chan, K., Moller, M., Marsack‐Topolewski, C. N., Winston, P., Jennings, R., & Prifti, A. (2020) · Substance Use & Misuse · doi:10.1080/10826084.2020.1765808 · Cited by 8 · see citing works
Short- and long-term opioid use in survivors of subarachnoid hemorrhage
Mahta, A., Anderson, M. N., Azher, A. I., Mahmoud, L. N., Dakay, K. B., Abdulrazeq, H., Abud, A. M., Moody, S., Reznik, M. E., Yaghi, S. R., et al. (2021) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2021.106770 · Cited by 8 · see citing works
Associations between Elevated Depressive Symptoms and Substance Use, Prescription Opioid Misuse, Overdose History, Pain, and General Health among Community Pharmacy Patients Prescribed Opioids
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Association Between Psychiatric Symptoms and Craving in Drug Withdrawal
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Depression and Prescription Opioid Misuse Among Chronic Opioid Therapy Recipi- ents With No History of Substance Abuse
(2016)

Authors: Sullivan, M. D.
Affiliations: University of Washington (US)
Corresponding author: Sullivan, Mark D.
ORCID: Sullivan, Mark D.
Venue: The Clinical Journal of Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-09
Volume: 34
Issue: 9
Pages: 878-884
ISSN: 0749-8047 (ISSN-L)
DOI: 10.1097/ajp.0000000000000603
OpenAlex: W2792478259
Cited by: 196
References: 75
Citations by year: 2026: 9 · 2025: 21 · 2024: 29 · 2023: 29 · 2022: 33 · 2021: 29 · 2020: 28 · 2019: 17 · 2018: 1
FWCI: 3.40
Type: journal article
Language: en
Open access: closed
Locations: Clinical Journal of Pain (publishedVersion)
PubMed (publishedVersion)
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: depression, long-term opioid therapy, chronic pain, prescription opioid abuse, opioid use disorder, nonmedical opioid use, opioid dose escalation, insomnia, treatment-resistant depression, confounding by indication
MeSH terms: Analgesics, Opioid, Depression, Depressive Disorder, Humans, Opioid-Related Disorders, Behavior, Addictive

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Depression Effects on Long-term Prescription Opioid Use, Abuse, and Addiction

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