The Connection Between Mental Health And Opioid Addiction

Overuse of opioids is a huge public health issue. The opioid epidemic is the deadliest drug epidemic in US history, and people with mental illnesses are the hardest hit.

12/21/20224 min read

Overuse of opioids is a huge public health issue. The opioid epidemic is the deadliest drug epidemic in US history, and people with mental illnesses are the hardest hit. Anxiety and depression account for more than half of all opioid prescriptions written in the United States.

Anxiety disorder affects one-third of those with opioid use disorder (OUD), and major depressive disorder affects nearly a quarter of those with OUD, with lifetime prevalence rates of psychiatric diagnoses up to double that. We'll go over how to recognize the indicators of comorbid diseases and what to do if someone has both an OUD and a mental health diagnosis in this article.

What Are Opioids and How Do They Work?

Prescription pain relievers such as morphine, codeine, methadone, oxycodone, hydrocodone, fentanyl, hydromorphone, and buprenorphine are examples of opioids. Opioids include illegal substances like heroin and fentanyl analogs like carfentanil (illegally produced, extraordinarily strong, and hazardous). Opioids connect to opioid receptors in the brain and peripheral nervous system, decreasing pain and producing drowsiness, constipation, and breathing slowing.

They're also highly addictive since they produce a brief pleasure and a sense of relief from bad emotions or anxiety, which encourages users to use them again. Furthermore, if opioids are used on a daily or near-daily basis, quitting them might result in unpleasant withdrawal symptoms.

What Is an Opioid Addiction?

Opioid Use Disorder is a clinical term that describes what happens when people become addicted to opioids. Because opioid use can cause and exacerbate sadness and anxiety, OUD is linked to poor mental health. OUD can also be accelerated by certain diagnoses.

As a result, in someone who suffers from both, it's critical to address both the psychiatric disease and the OUD head-on. It will be far more difficult to recover from either if that does not happen.

What Causes Opioid Addiction?

While using opioids, if someone feels euphoria or respite from unpleasant emotions, they may increase their use. The psychological and neurological alterations generated by opioids are at the root of increasing frequency of use and the development of addicted behavior.

When someone begins to take drugs on a regular or near-daily basis, other brain changes such as tolerance and withdrawal begin to occur. Tolerance occurs when the opioid receptors in the brain become less responsive, requiring the user to take more and more to have the same benefit. When a person stops using, they experience a number of unpleasant symptoms, including anxiety and low mood. People begin to experience extreme cravings and a loss of control over their use at the same time.

Furthermore, any opioid usage is linked to a high chance of acquiring an OUD in the future. According to statistics, 5% of people who misuse prescription opioids progress to heroin, and 10% of those who take opioids for chronic pain acquire an OUD. Adolescents and young adults are especially at risk because they are more inclined than adults to experiment with drugs. Adolescents get their first opioids from friends or relatives in the vast majority of cases.

The Signs and Symptoms of an Opioid Addiction

OUD is a clinical diagnosis that requires patients to meet two of 11 criteria in the past year. This includes the following:

  • Spending a lot of time taking the drug, looking for it, or recovering from it

  • Using despite the negative social and physical effects

  • Cravings for the substance are quite strong.

  • Attempts to minimize or eliminate the use of

  • Withdrawal symptoms and tolerance

Symptoms of an Opioid Addiction
  • Poor academic or professional performance

  • Isolating oneself from friends and family

  • Visiting the doctor

  • Pain symptoms that are exaggerated

  • To hide injection marks, I hid my arms with long sleeves.

  • Read our article on the Early Signs of Opioid Addiction to discover more about the signs of opioid addiction and abuse.

Intoxication Symptoms
  • Slowing down your thoughts

  • Pupils that are little

  • Coordination issues

  • I'm falling asleep

Opioid Withdrawal Symptoms
  • Irritability

  • Sweating

  • Shills

  • Vomiting

  • Diarrhea

  • pupils that are dilated

Mental Health and Opioid Use Disorder

People with OUD are more likely to develop psychiatric problems, and vice versa. Major depressive illness, post-traumatic stress disorder (PTSD), and anxiety disorders such as generalized anxiety disorder, social phobia, panic disorder, and obsessive-compulsive disorder are among the related disorders.

Suicidal thoughts and behaviors are also common in people with OUD. According to one study, 39% of patients who had just overdosed expressed a desire to die, and up to a third of overdose deaths may be due to suicide. The relationship between OUD and mental health issues can be attributed to a variety of factors. Overuse of opioids, for example, produces anxiety and depression via a number of pathways, including:

  • Having been exposed to adversity, tragedy, and violence

  • Having difficulty finishing school or succeeding at job

  • Disappointment or financial hardship as a result

  • Long-term usage has neurobiological repercussions that lead to a worsening of tolerance, repeated withdrawal cycles, and a deteriorating loss of control.

  • People who use or misuse opioids are also more likely to develop OUD if they have psychiatric problems such depression, anxiety, or post-traumatic stress disorder. Self-medication, especially if they are not receiving therapy for their anxiety or depression, can lead to this.

In the short term, opioids can help with irritability, depression, problems sleeping, loss of interest with life, anxiousness, and nightmares, all of which are common in these diseases. Furthermore, these sets of illnesses may share genetic, neurological, medical (e.g. chronic pain), and environmental foundations.

Treatments for Opioid Addiction and Mental Illness
The key to recovering from OUD and avoiding overdose is to seek therapy for both the OUD and the underlying mental health issue from the beginning. The most effective treatment for opioid use disorder is a combination of drugs and therapy, such as buprenorphine, naltrexone, or methadone. Residential or intense outpatient treatment, as well as attendance at 12-step meetings, may be beneficial adjuncts.

Depression, anxiety, and PTSD are all addressed differently, and each has its own set of evidence-based therapy options. Several therapy approaches, however, deserve to be mentioned because they are effective across diagnoses:

  • Cognitive behavior therapy, which focuses on recognizing and replacing maladaptive thinking, is useful for mood, anxiety, chronic pain, and post-traumatic stress disorder (PTSD).

  • For PTSD and phobias, exposure therapy is useful.

  • People with comorbid illnesses may benefit from dialectical behavior therapy, which focuses on improving mindfulness and emotion regulation for suicidal and self-harm behavior as well as substance use.

  • Selective serotonin reuptake inhibitors, as well as their cousins tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors, are used to treat depression, anxiety, and post-traumatic stress disorder (PTSD).

If the symptoms of the mental health condition do not improve after therapy for the opioid use disorder, your doctor may consider a trial of one of these antidepressant drugs. People who abuse opiates are also likely to abuse benzodiazepines, especially if they suffer from anxiety. However, combining opioids and benzodiazepines can be fatal since benzodiazepines exacerbate opioid-induced respiratory depression. Benzodiazepines, too, have an addiction risk and should be avoided wherever feasible.