Examining the Link Between Mental Health and Opioid Abuse

By Sheila Pakdaman via Multibriefs

For more than 5,000 years, people have been using opioid-based medications around the globe. It isn't exactly news that we, as a nation, are facing an opium problem. The New York Times calls it "America's 50-state epidemic," meaning it's not just effecting a region, it's affecting the places we least expect as well.

According to public health officials, this is the worst drug crisis in American history, topping the cocaine epidemic in the 1980s. As the stories are investigated by journalists, a common thread comes to light: mental health.

Could there be a correlation between anxiety, depression, bipolar disorder and other psychological disorders and suspected drug use? And if there is, why isn't widely reported?

A simple Google search with the keywords "opium," "mental health" and "heroin" gives a plethora of links pointing to a mind-body connection between the abuse and mental state of the user. However, the evidence indicates that the drug use actually may cause the mental health issues.

While drug abuse can lead to chemical changes in the brain, it begs the question of what really causes the drug abuse to begin with? An individual suffering from mental illness may be inclined to abuse drugs. He/she may turn to drugs to ease and alleviate the symptoms of a possibly undiagnosed or mismanaged mental disorder.

If we look at the most common mental disorder globally — depression — and relate its effects on life to that of a heroin-dependent user we see some starling similarities.

Major Depressive Disorder (MDD) side effects on lifestyle:

• Increased aches and pains, which occur in about two out of three people with depression
• Chronic fatigue
• Decreased interest in activities enjoyed
• Decreased appetite
• Insomnia, lack of deep sleep or oversleeping

Heroin dependence side effects on lifestyle:

• Strong desire to use opioids
• Inability to control or reduce use
• Trouble meeting social or work obligations
• Having legal problems due to drug use
• Spending large amounts of time to obtain opiates
• Development of tolerance (meaning the need to use larger amounts over time)
• Having withdrawal symptoms after stopping or reducing use (such as depressed mood, upset stomach, insomnia and muscle aches)

The similar and coincidental symptoms bring to light the two being concurrent and not necessary a cause and effect.

And then, there are the different classifications of opioids based on the receptors they effect: clinical prescription drugs such as morphine, and street drugs such as heroin. Per the National Institute of Drug Abuse (NIDA), nearly 35,000 deaths were accounted for opioid overdose in 2015. About 16,000 were due to morphine, with 15,000 due to heroin — with the ratio being much higher for males than females.

However, per the Substance Abuse and Mental Health Services Administration (SAMSHA), in 2015 twice as many females (8.5 percent), suffered from MDD than males (4.7 percent), suggesting an inverse relationship.

There is much to be discovered in terms of understanding mental health disorders and drug abuse and dependency. We can only continue to look at the signs, focus on the epidemic and find ways to overcome the barriers to preventing further incidence of dependency.

Sheila Pakdaman is a published researcher in the fields of neurochemistry, communicable diseases and drug dependency. She received her B.S. in biopsychology from the University of California, Santa Barbara Psychology and Brain Sciences, and her M.S. in global medicine from the Keck School of Medicine at University of Southern California. Sheila currently lectures at University of California, Los Angeles Extension in the Alcohol and Drug Counseling Program, educating aspiring drug counselors. She aims to continue her research and education in the neurosciences and earn an M.D./Ph.D. in the near future