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Long-term Use of Opiates May Increase the Risk of Depression

Opioid analgesics also known as prescription narcotic painkillers, have been used to treat pain for many years. With the amount of controversy surrounding these medications has grown, so has the research studying them. One team of investigators led by a Saint Louis University researcher has discovered a link between long-term use of opiate based narcotic painkillers and the increase in the risk of developing severe depression.

The study was published in the Journal of General Internal Medicine. The study analyzed medical records of 50,000 veterans who has no prior issues with opiates, pain, or depression who were prescribed opioid painkillers for injuries. According to the research, patients who has been using opioids for 180 days or longer were at a 53 percent increased risk of suffering from depression. Those who remained on opioids for 90-180 days were at a 25 percent risk compared to patients who never took opioids for longer than 89 days.

“These findings suggest that the longer one is exposed to opioid analgesics, the greater is their risk of developing depression,” said Jeffrey Scherrer, Ph.D. associate professor of family and community medicine at Saint Louis University and principle investigator of the study. “Opioids have long been known to allay pain and suffering, but reports of adverse effects are abundant and continue to emerge.”

According to researchers, there is no definite reason why opioids increase depression in patients who are prescribed them. Many factors may attribute to the depression. When a patient is taking opioids for a long period of time, their brain's “reward system” is overstimulated. The over stimulation raises the threshold in which the patient is able to feel pleasure. Natural means of pleasure such as food and sexual activity no longer peak the systems reward center.

Long-term use of opioids will change the way the brain works. With an over abundance of noradrenaline in the brain, feelings of anxiety, aches and pains are frequent. These side-effects can last a prolonged period of time depending on genetics, length of use, and amount used. The body may be deficient in adrenal, testosterone, vitamin D and glucose dysregulation.

With over 200 million prescriptions issued to patients in 2009 and recent studies indicating that the use of opiate painkillers has quintupled, we have a major public health issue. Americans need to understand that if they are prescribed these medications for an injury and are using them even as prescribed for a prolonged period of time, they may be facing a future battle with depression.

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