Patterns of major depression and nonmedical use of prescription opioids in the United States

Abstract

Introduction Recent epidemiologic studies have shown that nonmedical use of prescription opioids (NMUPO) and major depression frequently co-occur. Comorbid forms of drug use and mental illness such as NMUPO and depression pose a greater disease burden than either condition alone. However, sociodemographic and substance use differences between individuals with either NMUPO or depression and those with comorbid conditions have not yet been fully investigated. Methods Data came from the 2011 and 2012 National Survey on Drug Use and Health (NSDUH). Adolescents and adults were examined independently because of differences in screening for major depressive episodes (MDE). Weighted multinomial logistic regression investigated differences between persons with either past-year NMUPO (4.0%) or MDE (5.5%) and those with comorbid NMUPO and MDE (0.6%), compared to persons with neither condition. Results Females were more likely than males to report either MDE-alone and comorbid NMUPO and MDE, whereas adult men were marginally more likely to report NMUPO-alone (not significant among adolescents). Polydrug use and alcohol use disorders were more pronounced among those with comorbid NMUPO and MDE than persons with either NMUPO-alone or MDE-alone. Persons with independent and comorbid NMUPO and MDE were more likely to report lower income and unemployment versus employment. Conclusions This study found that independent and comorbid NMUPO and MDE were disproportionately clustered with burdens of lower socioeconomic position, suggesting that a population-based approach to address NMUPO would target these social determinants of health, whereas a highrisk approach to prevention should be tailored to females experiencing MDE symptoms and polydrug users.

Sex differences in prescription opioid use

“…However, consistent with the findings of the recent literature examined, we found that women were more likely to report use of prescription opioids compared to men. In accordance with findings from LeResche et al, and Fink et al, we also found that women were more likely to report chronic health conditions including pain (17) and depression (14). …”

“…In the 2011–2012 cohort, (n= 113,665) analyzed using multinomial logistic regression for past year misuse of prescription opioids, misuse of prescription opioids and major depressive episodes (MDE) were prevalent among women but not for men (14). Additionally, poly-drug use was found to be more prevalent among those with comorbid misuse of prescription opioids and MDE than persons with prescription opioid misuse alone or MDE alone.…”

Exploring trends of nonmedical use of prescription drugs and polydrug abuse in the Twittersphere using unsupervised machine learning

“…Primarily, in this study, the central theme that emerged was that polydrug abuse is predominantly associated with Twitter prescription drug abuse discussions and could be indicative of larger behavioral trends of users abusing multiple prescription drugs and also combining use with other illicit substances. These results could form the basis for future indepth studies examining the unique health and substance abuse consequences associated highly prevalent polydrug uses (including potentially linkages to mental health issues and behavior among young adults and adolescents already identified in the literature) (Fink et al, 2015;Kelly, Wells, Pawson, LeClair, & Parsons, 2014;Mackesy-Amiti, Donenberg, Ouellet, 2015).…”

Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States

“…56 This study found association between low income and 12-month MDD, consistent with other studies conducted within the last 3 years. 1,57,58 While this association could be due to depression-impaired functioning leading to lower income, the increases in depression and suicide that have accompanied growing income inequality suggest that the relationship of low income to MDD is due to stress from inadequate financial resources for life necessities or pessimism about improved future prospects. 1 If so, while treatment can benefit those with MDD, prevention may require change in larger societal processes.…”