Opiates and Anti-Depressants: The Vicious Cycle

A prescription medication epidemic was recognized around the turn of the century, but nobody could fathom the lasting effects it would have on our society at that time. The rate of addiction soared and so did the subsequent rate of overdose, but instead of these rates returning to cyclical norms, here we are nearly two decades later realizing the lasting effects of overprescribing opiates.  

Quick Facts:

  • According to Fortune magazine, an estimated 254 million opioid prescriptions were filled in 2010, enough to medicate every adult in the U. S. for a month on a round-the-clock basis. In that same year, pharmaceutical companies generated revenues of $11 billion from opioid sales alone.

  • OxyContin, a powerful opioid drug, was touted as a non-addictive drug suitable for treating most any type of pain symptom. In 2010, Purdue Pharma generated $3.1 billion dollars off OxyContin sales. That being so, the company was eventually found guilty of misleading the public and ordered to pay penalties fines along the lines of $635 million dollars.

  • 78 Americans die everyday from opioid overdose. More people died from drug overdose in 2014 than any year on record. Over 60% of overdose cases involve an opioid.

Beyond the evident challenges that our large-scale opiate dependency presents, we need to turn our attention to some of the residual effects as well. New research indicates a link between opiate use and depression. Most noteworthy, people who have never suffered from depression are now reporting symptoms and are being prescribed additional medications to alleviate what is essentially an unwanted side-effect.  What the likelihood of an additional antidepressant prescription does is create a cycle of lifetime medication.

So what begins as legitimate physical pain and trauma likely turns into an opioid addiction which results in a trial and error phase of prescription anti-depressants that is also a high-risk precursor for dependency.  And what is worse is that antidepressants probably do not even work for opioid abusers.  A study by the NIH recognized that the lifetime prevalence of depression in subjects with opioid dependence is higher than in the general population (44‐54% versus 16%) and represents a risk factor for morbidity and mortality. As a result it conducted a study investigating the 'use of medication to treat depression in people with opioid dependence' which concluded the following in 2010:

There is low evidence, at the present, supporting the clinical use of antidepressants for the treatment of depressed opioid addicts in treatment with opioid agonists. There is a need of larger randomised studies investigating relevant outcomes, safety issues and reporting data to allow comparison of results.
- The National Institute of Health

The concomitant problems of addiction and / or depression plus the need for additional medications when dealing with opioids should be plenty of motivation to start shifting our treatment focus in pain management and mental health.   Right now we are managing symptoms instead of addressing and modulating the underlying sources of the problems.  There are treatments like TMS Therapy that effectively treat this epidemic without relying on prescription medications:

 

**As of July 2016, there are over 650 physicians providing NeuroStar TMS Therapy, and more than 25,000 patients have been successfully treated**