The United States is in the midst of an opioid epidemic, most commonly caused by abused prescription opioids and opiates (synthetic man-made opioids), which you can now even buy online from sites like pilldoctor.co.uk. A close cousin to heroin, a number of heroin addicts have also died of opioid overdoses because these prescription painkillers are so much more potent and difficult to control (from an addict's perspective and experience) that it's relatively easy to overdose. However, death and addiction aren't the only potential side effects of opioids. Depression is another common side effect, which in some cases can lead to increased suicidal thoughts and self-harm.
It’s estimated that in 2018, around 2.4 million people in the US abuse prescription painkillers, and the most commonly described is opioids—even though studies have shown that over the counter painkillers like Ibuprofen are more effective at managing pain without the side effects of addiction and depression. Untreated depression is an extremely dangerous mental illness. If a person did not have depression prior to taking prescription opioids, it might have been undiagnosed and the addiction exacerbated it.
Opioid abuse and depression are closely related bi-directionally, which means that if a person has one they’re more likely to have the other. This is exceptionally worrying because opioids have been prescribed for treatments and patients who, arguably, weren’t good candidates. Due to the highly addictive nature of opioids, they are best prescribed for those who need short-term pain management (such as recovering from a surgery) and are not prone to drug addiction. Many times, opioid addiction treatment also includes the treatment of tertiary conditions such as depression, bipolar disorders, and anxiety.
Although generally considered a bi-directional relationship, there’s some research that considers the idea that opioids can put a person at a higher risk of depression even if they weren’t previously depressed. There’s a study at St. Louis University where researchers discovered that of 100,000 patients who were prescribed opioids, 10 percent developed depression after taking opioids for just one month. The reason for being prescribed opioids ranged drastically and included back pain, arthritis, and migraines. None of these ten percent had previously been diagnosed with depression.
Some opioid/opiate users either reach out to heroin when they find it too difficult or expensive to sustain their addiction once their prescription runs out. It’s estimated that heroin addiction has doubled in the past decade, and many experts agree it’s due to the opioid epidemic. Addiction to heroin has been strongly linked to feeling despair, guilt, and hopelessness. Researchers have found that 48 percent of heroin users are depressed. Heroin users are also at a higher risk of suicide than other drug users, with around 35 percent of heroin users considering suicide at some point during their addiction journey.
If a person is struggling with depression as well as heroin or opioid use, it’s important to treat both of the conditions. Some researchers believe depression can be caused when there are changes in the brain due to opioid use. Opioids and heroin change how the pleasure and reward system works in the brain, as well as hormones. Since opioids give users a constant feeling of pleasure and rewards, this can shift the opposite feeling—depression and sadness—and perhaps lead to a constant extreme shift from high pleasure to severe depression.
There’s also some research that shows a person with depression doesn’t have as much success with opioids. This can make them use more of the drug to achieve the effect they’re chasing. Part of prescribing opioids is supposed to include screening for depression, but it’s possible that this isn’t always the case or that the screenings aren’t thorough enough.
The signs of depression can also vary greatly person to person. It can include irritability, losing interest in activities, changes in appetite or sleeping patterns, lethargy, difficulty concentrating, and feeling suicidal. At the same time, the signs of an opioid addiction can also vary. It might be taking opioids longer or in larger amounts than what's prescribed, trying but failing to cut back on use, and spending a lot of time and resources getting and recovering from opioid use. Craving the drug, or it interfering with other parts of a person's life, is also a common sign of addiction. When research opioid treatment options, it's important to find a source that treats both depression and the addiction.
