A Fatal Blow? Depression and Opioids

photo of a woman with a tear running down her cheek

New research from Purdue University finds that there is a stark relationship between depression and increased rates of opioid deaths, especially in areas with shortages of mental health providers and high rates of underinsurance.

Deaths attributable to overdoses of prescription narcotics "have really skyrocketed" during the last few years across much of the nation, reported Laura Schwab-Reese, a Purdue University researcher, in a recent webcast. "It's pretty bad, and we are seeing that it's getting quite a bit worse."

Overdose deaths among clinically depressed patients are most common in underserved jurisdictions.

Her research found that "for every additional percentage of the population that reported depression, there was a 26 percent increase in the number of opioid overdose deaths."

Poor access to mental health services, she said, is implicated by the study, adding that suicide is increasing at the same time that opioid-related deaths are increasing. Read more about opioids and suicide HRSA Exit Disclaimer.

Map of the US showing mental health provider shortage of each state, with inset photo of Purdue University researcher Laura Schwab-Reese

From 1999-2017, almost 400,000 people died from an overdose involving any opioid, including prescription narcotics and illicit opioids, according to the CDC. Two out of three drug deaths now involve an opioid – an increase of almost six times since 1999 -- as the drugs have been increasingly prescribed for general pain control outside of cancer settings, contrary to CDC guidelines. Depression is but one possible side effect

The impact of Fentanyl, a highly concentrated synthetic pain reliever 50 to 100 times more potent than morphine, has been especially dramatic – because very little is required to reach a lethal dose and a large quantity of the antidote Narcan is needed to reverse its effects, Schwab-Reese said.

At the same time, Americans generally -- and young people in particular -- aren't receiving necessary mental health services, making it more likely that they'll turn to substances. Estimates suggest that 44 percent of the nation's mental health needs are going unmet – while two-thirds of adolescents at risk go untreated.

That lack of care is clearly and broadly linked to drug overdoses and fatalities - and plainly intertwined with opioids. Depression, for instance, is both a risk factor and a consequence of opioid abuse.

View the webcast.

Date Last Reviewed:  March 2019