Opioids and Depression: How are they Connected?

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Opioids and depression are closely interlinked. Significant numbers of those diagnosed with addictions like opioid use disorder also have co-occurring mental health conditions like depression. Those with mental health disorders are also at heightened risk of substance abuse. Understanding this connection is paramount for individuals navigating addiction and their loved ones.

Do Opioids Cause Depression?

The connection between opioids and depression operates in a bidirectional manner, meaning that experiencing one condition increases the risk of developing the other condition. Opioid abuse is characterized by the non-medical use of prescription opioids or their extended use in higher doses than prescribed by a doctor. This behavior has been associated with increased rates of depression, anxiety, and bipolar disorders.

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Additionally, some research suggests that any usage of prescription opioids may increase the likelihood of developing depression. A study at St. Louis University revealed that, among over 100,000 patients prescribed opioids, 10% developed depression after using the medications for more than a month. Opioids were originally prescribed to treat conditions such as back pain, headaches, and arthritis. Study participants had not been diagnosed with major depressive disorder prior to the initiation of treatment.

Opioids and Depression Statistics

Here’s a snapshot of the extent of opioid abuse and episodes of depression in the United States:

  • Over 16 million people worldwide are opioid-dependent, with over 6 million U.S. adults reporting opioid use in 2022, according to the most current data from NSDUH 2022 (National Survey on Drug Use and Health).
  • From 2013 to 2019, synthetic opioid death rates in the United States increased by a staggering 1040%, according to WHO (World Health Organization).
  • Reports from SAMHSA (Substance Abuse and Mental Health Services Administration) indicate that the percentage of individuals with a past-year prescription pain reliever use disorder decreased from 0.7% in 2015 to 0.5% in 2019, affecting 1.1 million people.
  • A 2020 study found that one in ten participants who were prescribed opioids for more than one month developed episodes of depression.
  • Long-term opioid use has been shown to increase the risk of depression, with a study highlighting the connection between depression and chronic pain associated with opioid use.
  • The opioid epidemic in the United States has garnered significant attention in recent years. A crucial aspect of this issue is its intersection with mental health, particularly depression. A study conducted with data from NHANES (National Health and Nutrition Examination Survey) illuminates the prevalence and trends of opioid use among individuals with depression. The study identifies that those with depression constitute a substantial portion of prescription opioid users, with a prevalence rate of 13% in the examined population of 6006 adults. Despite the overall prevalence of opioid use in the general U.S. population being reported at 6.8%, the study found that the prevalence of opioid use among people with depression remained relatively steady over the study period, indicating a consistent trend.
A man deeply distressed after learning the opioids and depression are linked

Why do Opioids Cause Depression?

The link between opioids and depression is complex and multifaceted. Opioids act on the CNS (central nervous system) by binding to specific receptors in the brain, altering the perception of pain. However, these substances can also affect neurotransmitter levels, especially those related to mood regulation.

  • Neurotransmitter imbalance: Opioids can disrupt the balance of neurotransmitters like serotonin and norepinephrine, which play crucial roles in mood regulation. An imbalance in these neurotransmitters is often associated with depressive symptoms.
  • Hormonal changes: Opioid use may influence hormonal systems, including the stress hormone cortisol. Dysregulation of cortisol levels can contribute to mood disturbances, including depression.
  • Withdrawal symptoms: Abrupt discontinuation of opioids or a rapid reduction in dosage can lead to withdrawal symptoms, which may include depression. This highlights the importance of gradual tapering under medical supervision.
  • Chronic pain and emotional toll: Living with chronic pain conditions, for which opioids are often prescribed, can take a significant emotional toll. The challenges associated with managing pain on a daily basis may contribute to the development or exacerbation of depressive symptoms.

Understanding the potential mechanisms behind the link between opioids and depression is essential for healthcare providers to develop tailored treatment plans that address both pain management and mental health. If you suspect that opioids are affecting your mood, discussing these concerns with your healthcare provider is crucial for a comprehensive and individualized approach to your well-being.

What do I Do if Opioids Are Making Me Depressed?

If you find that opioids are contributing to feelings of depression, you should address the issue promptly. Opioids can have various effects on mood and mental well-being. If you suspect that opioids are impacting your mental health, consider the following steps:

Consult your healthcare provider

The first and most important step is communicating openly with your healthcare provider. Share your concerns about the potential link between opioid use and depression. They can evaluate your overall health, assess your medication regimen, and make necessary adjustments to address any adverse effects on your mental well-being.

Monitor and document your symptoms

Keep a journal of your mood, emotions, and any other symptoms you may be experiencing. Note the timing and intensity of these feelings in relation to your opioid use. This information can be valuable for your healthcare provider in determining the most appropriate course of action.

Explore alternative pain management strategies

Discuss with your healthcare provider the possibility of alternative pain management strategies that may be effective for your specific condition. This could include physical therapy, non-opioid medications, or other interventions that can help alleviate pain without negatively impacting your mental health.

Mental health support

If you are struggling with depression, consider seeking support from a mental health professional. A therapist or counselor can provide coping strategies, emotional support, and guidance on managing the emotional aspects of dealing with chronic pain or the challenges associated with opioid use.

Gradual tapering

In some cases, your healthcare provider may recommend a gradual tapering of opioid medication to minimize withdrawal symptoms and allow for a smoother transition to alternative pain management methods. This should be done under close medical supervision to ensure your safety.

Engage in healthy lifestyle habits

Focus on maintaining a healthy lifestyle by incorporating regular exercise, a balanced diet, and sufficient sleep into your routine. These lifestyle factors can positively impact both physical and mental well-being.

Build a support system

Share your concerns with friends and family members who can offer emotional support during this challenging time. Having a strong support system can make a significant difference in coping with the complexities of managing chronic pain and associated mental health issues.

Remember, it’s essential to collaborate closely with your healthcare provider to tailor a plan that addresses both your pain management needs and mental health concerns. Never make changes to your medication regimen without consulting a medical professional, as abrupt discontinuation of opioids can have serious consequences.

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Get Treatment for Opioid Addiction at California Detox

Opioid addiction can be extremely disruptive, but it is also treatable. When opioid addiction co-occurs with mental health conditions like major depressive disorder, the optimum treatment pathway involves integrated and coordinated treatment of both conditions. We can help you achieve this at California Detox.

Begin your recovery with supervised opioid detoxification at our luxury facility in Laguna Beach, California. Access FDA-approved medications to mitigate cravings and withdrawal symptoms while addressing the issue of opioid dependence. After a week or so of detox, you can move into an ongoing inpatient treatment program at our beachside rehab center.

Dual diagnosis treatment allows you to tackle your addiction and mental health condition simultaneously. Individualized treatment plans blend the following interventions:

When you are ready to move beyond opioid addiction and depression, call 949.694.8305 to begin your recovery right away.


Yes, opioids can contribute to anxiety and depression. Opioids affect the central nervous system, and their long-term use may disrupt the balance of neurotransmitters in the brain, potentially leading to mood disturbances such as anxiety and depression.
Prolonged use of opioids has been associated with an increased risk of worsening depression. The impact of opioids on the brain’s reward system and neurotransmitter function may exacerbate existing depressive symptoms or contribute to the development of depression over time. It’s crucial for individuals using opioids to be aware of these potential mental health effects and seek appropriate medical guidance.


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