Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-19T02:12:28.098Z Has data issue: false hasContentIssue false
  • English
  • Français

Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions

Published online by Cambridge University Press:  17 October 2011

S. S. Martins ,
M. C. Fenton ,
K. M. Keyes ,
C. Blanco ,
H. Zhu  and
C. L. Storr
S. S. Martins*
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
M. C. Fenton
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
K. M. Keyes
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
C. Blanco
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
H. Zhu
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
C. L. Storr
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
*
*Address for correspondence: S. S. Martins, Ph.D., Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 N. Broadway, 8th floor, Suite 896, Baltimore, MD 21205-1900, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Non-medical use of prescription opioids represents a national public health concern of growing importance. Mood and anxiety disorders are highly associated with non-medical prescription opioid use. The authors examined longitudinal associations between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders in a national sample, examining evidence for precipitation, self-medication and general shared vulnerability as pathways between disorders.

Method

Data were drawn from face-to-face surveys of 34 653 adult participants in waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models explored the temporal sequence and evidence for the hypothesized pathways.

Results

Baseline lifetime non-medical prescription opioid use was associated with incidence of any mood disorder, major depressive disorder (MDD), bipolar disorder, any anxiety disorder and generalized anxiety disorder (GAD in wave 2, adjusted for baseline demographics, other substance use, and co-morbid mood/anxiety disorders). Lifetime opioid disorder was not associated with any incident mood/anxiety disorders. All baseline lifetime mood disorders and GAD were associated with incident non-medical prescription opioid use at follow-up, adjusted for demographics, co-morbid mood/anxiety disorders, and other substance use. Baseline lifetime mood disorders, MDD, dysthymia and panic disorder were associated with incident opioid disorder due to non-medical prescription opioid use at follow-up, adjusted for the same covariates.

Conclusions

These results suggest that precipitation, self-medication as well as shared vulnerability are all viable pathways between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders.

Keywords

Anxiety disordersmood disordersnon-medical prescription opioid usetemporal sequence
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 6 , June 2012 , pp. 1261 - 1272
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. APA: Washington, DC.Google Scholar
Becker, WC, Sullivan, LE, Tetrault, JM, Desai, RA, Fiellin, DA (2008). Non-medical use, abuse and dependence on prescription opioids among US adults: psychiatric, medical and substance use correlates. Drug and Alcohol Dependence 94, 38–47.CrossRefGoogle ScholarPubMed
Blanco, C, Alderson, D, Ogburn, E, Grant, BF, Nunes, EV, Hatzenbuehler, ML, Sasin, DS (2007). Changes in the prevalence of non-medical prescription drug use and drug use disorders in the United States: 1991–1992 and 2001–2002. Drug and Alcohol Dependence 90, 252–260.Google Scholar
Boyd, CJ, McCabe, SE (2009). Coming to terms with nonmedical use of prescription medications. Substance Abuse Treatment, Prevention and Policy 3, 22.CrossRefGoogle Scholar
Brady, KT, Sinha, R (2005). Co-occurring mental and substance use disorders: the neurobiological effects of chronic stress. American Journal of Psychiatry 162, 1483–1493.CrossRefGoogle ScholarPubMed
Brands, B, Paglia-Boak, A, Sproule, BA, Leslie, K, Adlaf, EM (2010). Nonmedical use of opioid analgesics among Ontario students. Canadian Family Physician 56, 256–262.Google ScholarPubMed
Byrt, T (1996). How good is agreement? Epidemiology 7, 561.CrossRefGoogle ScholarPubMed
Canino, G, Bravo, M, Ramirez, R, Febo, VE, Rubio-Stipec, M, Fernandez, RL, Hasin, D (1999). The Spanish Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): reliability and concordance with clinical diagnoses in a Hispanic population. Journal of Studies on Alcohol 60, 790–799.Google Scholar
Compton, WM, Conway, KP, Stinson, FS, Colliver, JD, Grant, BF (2005 a). Prevalence and comorbidity of DSM-IV antisocial syndromes and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66, 677–685.CrossRefGoogle ScholarPubMed
Compton, WM, Thomas, YF, Conway, KP, Colliver, JD (2005 b). Developments in the epidemiology of drug use and drug use disorders. American Journal of Psychiatry 162, 1494–1502.CrossRefGoogle ScholarPubMed
Emrich, HM, Vogt, P, Herz, A (1982). Possible antidepressive effects of opioids: action of buprenorphine. Annals of the New York Academy of Sciences 398, 108–112.CrossRefGoogle ScholarPubMed
Fleiss, JL (1981). Statistical Methods for Rates and Proportions, 2nd edn. John Wiley and Sons: New York.Google Scholar
Grant, BF, Dawson, DA, Stinson, FS, Chou, PS, Kay, W, Pickering, R (2003). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 7–16.CrossRefGoogle Scholar
Grant, BF, Harford, TC, Dawson, DA, Chou, PS, Pickering, RP (1995). The Alcohol Use Disorder and Associated Disabilities Interview schedule (AUDADIS): reliability of alcohol and drug modules in a general population sample. Drug and Alcohol Dependence 39, 37–44.Google Scholar
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Huang, B (2005). Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Psychiatric Research 39, 1–9.Google Scholar
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Pickering, RP (2004 a). Prevalence, correlates, and disability of personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 65, 948–958.Google Scholar
Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Dufour, MC, Compton, W, Pickering, RP, Kaplan, K (2004 b). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 807–816.CrossRefGoogle ScholarPubMed
Grella, CE, Karno, MP, Warda, US, Niv, N, Moore, AA (2009). Gender and co-morbidity among individuals with opioid use disorders in the NESARC study. Addictive Behaviors 34, 498–504.CrossRefGoogle ScholarPubMed
Hasin, D, Carpenter, KM, McCloud, S, Smith, M, Grant, BF (1997). The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a clinical sample. Drug and Alcohol Dependence 44, 133–141.CrossRefGoogle Scholar
Hasin, DS, Goodwin, RD, Stinson, FS, Grant, BF (2005). Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry 62, 1097–1106.CrossRefGoogle ScholarPubMed
Hatzenbuehler, ML, Keyes, KM, Narrow, WE, Grant, BF, Hasin, DS (2008). Racial/ethnic disparities in service utilization for individuals with co-occurring mental health and substance use disorders in the general population: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 69, 1112–1121.Google Scholar
Haydon, E, Rehm, J, Fischer, B, Monga, N, Adlaf, E (2005). Prescription drug abuse in Canada and the diversion of prescription drugs into the illicit drug market. Canadian Journal of Public Health 96, 459–461.Google Scholar
Huang, B, Dawson, DA, Stinson, FS, Hasin, DS, Ruan, WJ, Saha, TD, Smith, SM, Goldstein, RB, Grant, BF (2006). Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 67, 1062–1073.Google Scholar
Kendler, KS, Prescott, CA, Myers, J, Neale, MC (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929–937.CrossRefGoogle ScholarPubMed
Krueger, RF, McGue, M, Iacono, WG (2001). The higher-order structure of common DSM mental disorders: internalization, externalization, and their connections to personality. Personality and Individual Differences 30, 1234–1259.Google Scholar
Kuehn, BM (2007). Prescription drug abuse rises globally. JAMA 297, 1306.Google Scholar
Lyons, M, Hitsman, B, Xian, H, Panizzon, MS, Jerskey, BA, Santangelo, S, Grant, MD, Rende, R, Eisen, S, Eaves, L, Tsuang, MT (2008). A twin study of smoking, nicotine dependence, and major depression in men. Nicotine and Tobacco Research 10, 97–108.CrossRefGoogle ScholarPubMed
Martins, SS, Keyes, KM, Storr, CL, Zhu, H, Chilcoat, HD (2009 a). Pathways between nonmedical opioid use/dependence and psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 103, 16–24.Google Scholar
Martins, SS, Storr, CL, Zhu, H, Chilcoat, HD (2009 b). Correlates of extramedical use of Oxycontin® and other analgesic opioids among the US general population. Drug and Alcohol Dependence 99, 58–67.Google Scholar
McCabe, SE, Cranford, JA, Boyd, CJ, Teter, CJ (2007). Motives, diversion and routes of administration associated with nonmedical use of prescription opioids. Addictive Behaviors 32, 562–575.Google Scholar
Monheit, B (2010). Prescription drug misuse. Australian Family Physician 39, 541–546.Google Scholar
Robinson, J, Sareen, J, Cox, BJ, Bolton, JM (2011). Role of self-medication in the development of comorbid anxiety and substance use disorders. Archives of General Psychiatry 68, 800–806.Google Scholar
Saitoh, A, Kimura, Y, Suzuki, T, Kawai, K, Nagase, H, Kamei, J (2004). Potential anxiolytic and antidepressant-like activities of SNC80, a selective δ-opioid agonist, in behavioral models in rodents. Journal of Pharmacological Sciences 95, 374–380.CrossRefGoogle ScholarPubMed
Schepis, TS, Hakes, JK (2011). Non-medical prescription use increases the risk for the onset and recurrence of psychopathology: results from the National Epidemiological Survey on Alcohol and Related Conditions. Addiction. Published online: 1 June 2011. doi:10.1111/j.1360-0443.2011.03520.x.Google Scholar
Substance Abuse and Mental Health Services Administration Office of Applied Studies (2005). Results from the 2004 National Survey on Drug Use and Health: National Findings. DHHS publication no. SMA 05–4062, NSDUH series H-28. SAMHSA: Rockville, MD.Google Scholar
Substance Abuse and Mental Health Services Administration Office of Applied Studies (2006). Results from the 2005 National Survey on Drug Use and Health: National Health Findings. DHHS publication no. SMA 07–4293, NSDUH series H-32. SAMHSA: Rockville, MD.Google Scholar
Substance Abuse and Mental Health Services Administration (2009). Results from the 2008 National Survey on Drug Use and Health: National Findings. HHS publication no. SMA 09–4434, NSDUH series H-36. SAMHSA: Rockville, MD.Google Scholar
Substance Abuse and Mental Health Services Administration (2010). TEDS Report: Substance Abuse Treatment Admissions Involving Abuse of Pain Relievers: 1998 and 2008. SAMHSA: Rockville, MD.Google Scholar
Sullivan, ED, Edlund, MJ, Steffick, D, Unützer, J (2005). Regular use of prescribed opioids: association with common psychiatric disorders. Pain 119, 95–103.Google Scholar
Szklo, M, Javier-Nieto, F (2004). Quality assurance control. In Epidemiology: Beyond the Basics (ed. Sklo, M. and Javier Nieto, F.), p. 377. Jones and Bartlett Publishers: Sudbury, MA.Google Scholar
Tetrault, JM, Desai, RA, Becker, WC, Fiellin, DA, Concato, J, Sullivan, LE (2008). Gender and non-medical use of prescription opioids: results from a national US survey. Addiction 103, 258–268.Google Scholar
Walwyn, WM, Miotto, KA, Evans, CJ (2010). Opioid pharmaceuticals and addiction: the issues, and research directions seeking solutions. Drug and Alcohol Dependence 108, 156–165.Google Scholar
Weber, MM, Emrich, HM (1988). Current and historical concepts of opiate treatment in psychiatric disorders. International Clinical Psychopharmacology 3, 255–266.CrossRefGoogle ScholarPubMed
Young, SE, Smolen, A, Corley, RP, Krauter, KS, DeFries, JC, Crowley, TJ, Hewitt, JK (2002). Dopamine transporter polymorphism associated with externalizing behavior problems in children. American Journal of Medical Genetics 114, 144–149.Google Scholar