Do Depression and Anxiety Drive Chronic Opioid Use?

Chronic pain not associated with cancer is common (5%–35%) in primary care patients, is disabling, and is increasingly treated with opioid drugs. To investigate whether mental disorders increase the risk for opioid use, researchers used prospective population-based data about 6439 respondents to telephone surveys in 1998 and 2001. Structured interviews were used to diagnose four mental disorders (depression, dysthymia, panic disorder, and generalized anxiety disorder [GAD]); problem alcohol use and drug use were identified with common assessment tools.

After adjustment for 1998 demographic and clinical factors (e.g., pain severity), presence of a mental disorder in 1998 (13% of respondents) doubled the risk for opioid use in 2001. Each disor…