A maintenance program with opioid agonists (methadone, buprenorphine, LAAM) is an effective treatment for people who are dependent on opioids in terms of retention in treatment and reduced use of opioids. Depression is however still prevalent and negatively impacts on treatment outcomes. Treatment with antidepressant drugs has therefore been proposed. These adjunct drug treatments include tricyclic antidepressants (doxepin, desipramine, and imipramine) and selective serotonin reuptake inhibitors (SSRIsfluoxetine, sertraline). (Swierzewski, 2001)
A current study’s lead author quoted a startling statistics that “the use of prescription opioid analgesics has quintupled recently and that more than 200 million prescriptions were issued to patients in 2009 in the US.”
Given the magnitude of their use, their link to depression could constitute a “public health problem,” he said. (NIMH, 2016)
It wouldn’t be the first time the drugs have been linked to health problems of epidemic proportions. (Swierzewski, 2001). Prescription drug abuse has been called the fastest-growing drug problem in the US by the Centers for Disease Control and Prevention (CDC), as the number of deaths from opioid painkillers like hydrocodone and oxycodone rose nearly four-fold between 1999 and 2009. (Swierzewski, 2001)
Men are still more likely to die from prescription painkiller overdoses (NIMH, 2016), but women are quickly catching up. Nearly 50,000 such deaths occurred among women between 1999 and 2010, and the statistics revealed by the CDC give a sombre view of this growing problem
- More than 6,600 women, or 18 women every day, died from a prescription painkiller overdose in 2010
- There were four times more deaths among women from prescription painkiller overdose than for cocaine and heroin deaths combined in 2010.
- In 2010, there were more than 200,000 emergency department visits for opioid misuse or abuse among women — about one every three minutes.
The problem, once primarily seen in inner cities, is now even spanning to rural areas, hitting people of all ethnic backgrounds and income levels.
Opioids like morphine, codeine, oxycodone, hydrocodone and fentanyl are one of the most commonly abused drug classes. These drugs are not only addictive, they can lead to slowed breathing and death if too much is taken, and the risks are compounded if you add alcohol to the equation. (Swierzewski, 2001). Hydrocodone, a prescription opiate, is synthetic heroin. It’s indistinguishable from any other heroin as far as your brain and body is concerned. So, if you’re hooked on hydrocodone, you are in fact a good-old-fashioned heroin addict. (Pani P., Vacca R., Trogu E., Amato L. and Daroli M., 2010)
Worse, pain-killing drugs like fentanyl are actually 100 times more potent than natural opioids like morphine, making the addictive potential and side effects associated with prescription drug use much higher. At the root of the problem, of course, is the fact that so many Americans are struggling with pain. (Keggler S., Stone M., Holland M., 2017). Chronic pain affects 100 million Americans – that’s more than the number impacted by diabetes, heart disease and cancer combined.Yet, many physicians simply do not know how to help their patients manage, or eliminate, chronic pain without the use of these risky drugs. (NIMH, 2016)