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Post by Steven Nguyen on May 19, 2017 13:02:45 GMT -4
Studies have shown that patients with acute and chronic pain conditions who also had mood disorders such as depression were more likely to transition to long-term opioid use. Usually, patients with acute pain conditions end their need for opioids once their pain is resolved. However, patients with mood disorders are not discontinuing opioid therapy as do most others, resulting in long-term opioid use. The mood-altering effect of opioids, often producing euphoria and decreased anxiety, could be a significant driving factor for patients to not give up their prescription opioids. If depression continues to be widely under-diagnosed and untreated, the vicious cycle of depressed patients not weaning off their opioids and opioids exacerbating depression will not get any better.
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Post by Wardah Khalid on May 19, 2017 15:54:23 GMT -4
This article focuses on the important link between opioid use and depression. Without treatment for depression, a patient's need for a feeling of elevated mood will continue the cycle of chronic opioid use and depression. What this article does not go in depth about is the fact that long-term opioid use will in turn disrupt patients' pleasure centers in the brain. It is more difficult for users to feel enjoyment in normal every day activities, because as tolerance to the drug leads to a need for higher dosages, that tolerance also leads to the need for more opioid use to feel pleasure. Thus, treating the underlying depression is the most important step in preventing addiction. This would most likely be overlooked in a primary care setting, so I feel that it is important to understand that pain, opioid use, and depression are all interlinked. Also, society still has a long way to go in addressing the stigma around mental health. There are still many people that do not believe that depression requires therapy and/or antidepressant medication, and if the depression is not treated, then people will continue to seek substitutes like opioids.
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Post by Sara Massey on May 19, 2017 17:34:53 GMT -4
Before reading this article, I was unaware that people with depression would be abusing opioids, but the more I think about it, it makes perfect sense. Opioids have similar characteristics with antidepressants, and so in theory they would have similar effects, which would motivate patients struggling with depression to either start using, or increase their dosage of opioids. This article also emphasized on the fact that depression is a widely misunderstood mental illness. It is obvious that more awareness should be raised on depression, so that people suffering from it would not feel like they have to use drugs inappropriately.
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Post by Jared Lambert on May 19, 2017 19:29:07 GMT -4
This article was definitely an enlightening read, and applicable, as I have already been exposed to both opioid addiction and clinical depression within the first week working at the clinic. Depression, as we all know, is a very complex disease that can present itself and effect people in a wide array of clinical manifestations. One of the effects being a decreased tolerance for and increased sensitivity to pain. With depression being one of the most commonly diagnosed diseases in the U.S. its correlation with opioid abuse is a predictable, but no less serious consequence. The rise of opioid abuse is absolutely a problem that needs to be addressed. From the recent regulatory changes of opioid prescriptions it is heartening to see that steps to decrease its incidence are being implemented.
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Post by Brume Okrokoto on May 22, 2017 16:44:52 GMT -4
This article has many astonishing revelations. But one that's most interesting to me is the idea that people with depression have more difficulty in the recovering process from surgery. So, not only is depression a cause for physical pain, it also tamper with the normal physiological processes of the human body. I find this idea really intriguing and worthy of further research. But overall, I feel this article shines a light on some of the most overlooked aspects of the effects of depression on human behavior. For instance, depressed people are not just moody and down all the time, they are also in a state of alarm, they are agitated and restless.
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Post by Nyimasatta Jawo on May 24, 2017 9:13:27 GMT -4
The connection between depression and opioid abuse can be understood as opioids can put an individual in a euphoric mood. Due to its effects people with depression who have not been diagnosed with depression but notice it's effects after use might think that is their treatment of choice without knowing that other options are available for them. The article makes a good point about the lack of diagnosis of depression because that's the main reason I think most individuals end up being addicted to opioids. These people might be more in tune with the pain they feel and if opioids help with that pain they are unaware of their depression symptoms.
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Post by Rashonda Carlisle on May 24, 2017 14:54:35 GMT -4
This article outlines the sad truth of how mental illness is perceived. As stated, it is easier to admit to chronic pain than to state that you have depression. It is more acceptable to hurt than to be sad. I am not surprised that the majority of people who stay on stronger pain medication have an underlying mental disease. These medications have become easier to obtain, and adding that to the fact that people are ashamed to admit to their disease, they will seek help in the ways that are easy and nonjudgmental. The slight euphoric feeling, or the increased sleep can become addictive to people who are at a constant state of despair. It also shows how important it is for physicians to screen patients that they are prescribing these type of medications to. We surely do not want to underestimate a patient's pain, however, if there seems to be something more than just the physical aspect of the pain then the physician needs to dig deeper. Listening and observing is just as important as X-rays and Lab exams, and can even make the patient comfortable enough to express the real issue at hand.
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Post by ljones on May 25, 2017 0:03:36 GMT -4
Pain is one of the most common sign associated with many conditions. The link between depression and pain is not surprising. Depression is generally thought of as having emotional complaints; however, many patients do indicate that they experience physical complaints such as GI problems, headaches/ migraines and sometimes minor aches and pains. Pain can act as a diagnostic factor in depression as patients who suffer with chronic pain after being diagnosed and treated for depression are more likely to have a recurrence. It is expected, as pain increases depressive feelings, higher dosage of medication for the depression may be sought hence as depression magnifies pain, the same effect is employed resulting in the increase use of opioids. It is interesting that Buprenorphine has antidepressant properties and long term use of partial opioid agonist such as Suboxone can have depressive effects.
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Post by AlanaWharton on May 25, 2017 23:22:20 GMT -4
This article was an eye-opener, I never knew there was a relationship between depression and pain nor that depression could prolong a patient's recovery post surgery. The opioid use and abuse is understandable since opioids: block pain signals thereby reducing the pain they feel, have antidepressant, euphoric and sedative side effects. It would seem like taking the opioids help them "feel normal" or at least not depressed for awhile. What I found to be worrisome is the fact that opioid use can cause depression resulting in a vicious cycle that delays recovery. And what's even more worrisome is the fact that people are not getting the necessary help because they either refuse to disclose their correct symptoms for fear of being stigmatized or there is no mental healthcare specialist in their area.
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Post by Aishat Zurakat MS3 on May 26, 2017 1:05:44 GMT -4
After reading this article, I can relate it with my experience at PACT Atlanta. About 80% of the patients with opioid dependence had depression at one time or are currently depressed. Most of them where depressed a that time. Therefore, i agree that the effect of opioids can feel as mood-elevating as an antidepressant.It is true that it is easier to explain not being able to get out of bed because of a bad back than crushing sadness. Pain is considered normal but depression is considered a sign of weakness. This topic should be looked into deeper and would make a good research.
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Post by Fiyinfoluwa D Aderibigbe (FDA) on May 26, 2017 2:23:12 GMT -4
Doctors constantly have to weigh the pros and cons of a drug against its side effects. While also trying to maintain the oaths of beneficence and non-maleficence. It’s no mean feat but its the bedrock of the entire medical profession. Diagnosing depression is the relatively easy part, treatment however is quite complex due to the challenging and variability of its symptoms. It also doesn’t help matters that's its intertwined with a lot of other conditions and predispositions. The nature of the mechanism of actions of the drugs used in treating these conditions in relation to their site of actions has also been barely understood over the years. Then there is the likely hood that one can easily get addicted and or dependent on these drugs. It’s not gloom though gradual progress is being made with studies and researches, in the due time all this will pay off.
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Post by Opeyemi Owa on May 29, 2017 8:27:25 GMT -4
This article makes a valid point, and provides answers and It's never a sad thing to finally have answers. From my experience at a pain management clinic during my Family Med clerkship i can testify that more often than not, pain and depression go hand in hand feeding off each other. This article is a step in the right direction, We would be remissed if we didn't take the depression screening done at these clinics more seriously, maybe even going as far as instilling a law that requires patients on opioids to be seen frequently by a psychiatrist. I think the results would do a lot more that decrease the rate of opiod abuse.
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Post by Jocelyn Anyanwu on May 30, 2017 5:13:13 GMT -4
It is a sad thing to hear in the news about any overdose. Abuse of opioids is on the rise especially in the “Triangle” in the Atlanta area where the young ones are dying from opioid overdose. According to the article, not all chronic pain sufferers are on pain medication, and not all patient on prescription pain medications (Opioids) gets addicted to the medication. It is sad to know that depression has a hand in getting people addicted to prescription medication because of the need to” numb” the pain. With depression comes the state of heightened sensitivity which triggers to pain also, and to combat the pain prescription opioids serves as a mood elevator and an anti-depressant, so addiction is greater in depressed people. According to the article, misuse and addiction of pain medications are higher in adolescents with history of depression. Knowing that the emotional pain and the depression is a reason to abuse pain killers in the depressed patient makes it even more dangerous as it can be used to commit suicide in a patient with suicidal tendency. The vicious cycle created by the opioids on depressed patients who depend on the medications to treat “pain” exacerbated depression. It is noted that addicts magnify their “pain” symptoms to gain more pain killers rather than focus on the root cause which is the depression. This is a great topic as physicians should recognize the signs of addiction while at the same time try to differentiate the real pain and addiction. Noted also is the budget cuts to Medicaid and the programs and services to addiction treatment and mental issues. Hopefully, some decisions could be made to reverse the budget cuts to one of the fundamental services to humankind which is their health care.
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Post by jordanv on May 30, 2017 21:54:06 GMT -4
I hadn’t thought about depression being a cause for starting the use of opioids. I had thought about depression stemming from the use but not the other way around. There definitely is a shortage of providers in rural areas and especially mental health providers. It’s sad that the new health care bill cuts funding to these areas and will only exacerbate the problem. It doesn’t even make fiscal sense. If Medicare doesn’t cover mental health problems it will harder for the people with mental health issues become productive members of society. It will also cost more long term in health care, paying for treatment for mental health issues will cost less that continued ER visits.
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Post by Nazia Rahman on Jun 4, 2017 16:29:59 GMT -4
It`s not surprising to learn correlation between depression and chronic opioid use. This article emphasized on how chronic opioid exposure for a long duration of time could eventually affect the mood showing depressive symptoms. But it is a two way street. People who are in chronic pain may be depressed and using opioid relieves pain for a short period of time. They may take increased amounts of the medication to get the desired effect and numb their symptoms. For instance: when the patient in the article mentioned " it`s easier to explain not being able to get out of bed because of a bad back than crushing sadness" summarizes the importance of mental health. Therefore it is important for us as health care providers to monitor the usage of medication by the patient and ensure the risks of substance overdose.
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