Opioid Misuse and Mental Health Challenges

Addiction loves company.  

Just ask the eight million U.S. adults diagnosed with both substance use disorder and mental illness. It should come as no surprise that there is a correlation between the two diagnoses. Behavioral health conditions — such as anxiety or depression and opioid use — generally go hand in hand with one another.  

It’s not a big secret that opioid misuse and abuse is a problem across the nation. Nearly 71,000 Americans died as a result of drug overdose 2017 and more than 218,000 opioid-related deaths have occurred since the crisis began in 2011. Deaths involving prescription opioids have increased progressively since 2014.

Millions of Americans abusing substances are often troubled with depression, anxiety, and many other mental health challenges. When left undiagnosed and untreated, mental illness makes recovery even more challenging. 

The connection between opioid misuse and depression tends to be bi-directional, implying that if individuals experience one condition, the risk of the other considerably increases. While substance use disorders commonly co-occur with mental illness, correlation does not mean causation. 

Researchers propose several likelihoods for the co-occurrence of substance use and mental illness including:

  1. Common risk factors that can contribute to both mental illness and substance use, such as genetics and environmental factors (i.e. stress and transgenerational trauma).
  2. Mental illness contributing to drug use and substance use disorders, as many people often use drugs or alcohol as a form of self-medicating.
  3. Substance use and addiction can play a role in the development of mental illness. As a result of continued use of substances, changes or disruptions in the function of the brain’s primary circuits occur; impacting the ability to experience pleasure, decision-making ability and impulsivity or lack of self-control.

Research suggests that because of the changes in the brain’s reward, pleasure and hormone systems, an individual already predisposed or suffering from depression is more likely to experience increased opioid use to achieve the desired effect. 

Consequently, drug misuse and abuse lead to the display of symptoms associated with depression, such as feelings of helplessness and hopelessness, guilt, shame, and anguish. It must be recognized that adverse health elements can be reinforcing. For example, depression increases the likelihood that a person will use opioids and vice versa. Each of these factors increases the likelihood of opioid overdose death.

A few indicators of depression may include but are not limited to:

  • Decreased energy
  • Disruptions in sleep and/or appetite
  • Trouble with concentration/focus
  • Decreased interest in activities
  • Suicidal ideations and or plan

A few indicators of Opioid Misuse/Abuse may include but are not limited to:

  • Uncontrollable cravings
  • Weight loss
  • Social and familial isolation
  • New financial difficulties
  • Changes or disruptions in sleep and appetite patterns

Identification and treatment are critical for depression and opioid misuse and abuse. The most important step to getting help is to understand co-occurring diagnoses and how mental health challenges influence drug use and vice versa. To make a difference for people living with opioid misuse and mental health challenges, the ability, and knowledge to identify signs and symptoms of each are important. As well as having the courage to start a conversation about change.

Here are a few tips to start the conversation on mental health and drug misuse:

  • Approach the individual with empathy and compassion
  • Practice and use reflective listening to build rapport 
  • Explore the most appropriate and viable treatment options together

There are several options for the treatment of opioid use disorder. One common treatment is known as Medication-Assisted Treatment (MAT) uses medications, such as methadone or naltrexone, and combines the use with support programs to help with the journey of recovery. Several national organizations can also assist in locating drug treatment centers and suicide prevention for people coping with addiction and mental illness.

Call 1-800-662-HELP (4357) (toll-free) or go to findtreatment.samhsa.gov at any time to find drug treatment centers near you. However, if a person is experiencing a medical or mental health crisis, go to the emergency room or call 911. National Suicide Prevention Lifeline 1-800-273-TALK (1-800-273-8255) is also available for guidance.