Opioid Overdoses, Depression Linked

Schwab Reese and Madeline Foley, a student at Riverdale Country School, analyzed data from the Centers for Disease Control and Prevention on opioid-related deaths from 2011 to 2015. Rates of opioid-related deaths were generally stable from 2011 to 2013, but increased substantially in the two following years.

Data on depression was collected by a telephone survey of more than 400,000 people across the country. About 19 percent of respondents reported a depression diagnoses in 2015 – up from 17.5 percent in 2011.

“We know from prior literature that people who are depressed are more likely to be prescribed opioids, but also that people who are prescribed opioids are more likely to become depressed,” said Schwab Reese. “We need to recognize that this is probably a bidirectional relationship.”

The solution, said Schwab Reese, is twofold. Doctors should screen for depression and discuss the risk with patients before prescribing opioids. Because nearly two-thirds of opioid overdoses involve prescription medications, doctors could play a significant role in preventing opioid misuse and depression.

Second, Americans need better access to mental health care.

More than 40 million Americans have a mental health condition, and more than half of them don’t receive treatment. In West Virginia, the state with the highest number of opioid-related deaths in 2015, nearly a million people live in areas with a shortage of mental health care providers. The U.S. would need an additional 3,000 providers to meet American’s mental health needs, according to another study.

“We can’t say this person had depression and that led to an overdose – this was a population-level analysis,” said Schwab Reese. “To me, that means we need a population-level response.”

The work aligns with Purdue’s Giant Leaps celebration, acknowledging the university’s global advancements made in health, longevity and quality of life as part of Purdue’s 150th anniversary. This is one of the four themes of the yearlong celebration’s Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues.

Contacts and sources:
Writer: Kayla Zacharias
Laura Schwab Reese
Purdue University

Citation: Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011–2015.
Madeline Foley, Laura M. Schwab-Reese. Social Psychiatry and Psychiatric Epidemiology, 2018; DOI: 10.1007/s00127-018-1594-y