The findings, which appear in the July issue of the Journal of the American Board of Family Medicine, show that nearly 19 percent of the 38.6 million American adults with mental health disorders use prescription opioids, which are designed to relieve acute pain, compared with only 5 percent of those without.
Adults with depression and anxiety receive 51 percent of the 115 million opioid prescriptions distributed each year in the U.S., the study found.
The higher rate of use of opioids among those with the two most common types of mental illness in the country holds true across all levels of pain and across different types of pain, including that stemming from cancer and arthritis, the study found.
“Independent of pain and independent of medical conditions, having a mental health disorder is strongly associated with getting an opioid prescription, which is really, really concerning,” Dr. Brian Sites, the anesthesiologist, said in an interview in his office at Dartmouth-Hitchcock Medical Center last week.
The finding “suggests that there may be additional patient- and provider-related factors specific to those with mental illness that increase the likelihood of receiving prescription opioids,” the study authors wrote.
Being able to identify a subset of the population that might be more likely to use opioids regardless of their pain levels could help providers and policy makers address opioid use, the authors wrote.
Sites, who called the results “absolutely breathtaking,” said managing pain for patients he sees before, during and after surgery can be complicated when those patients have mental health disorders.
“I realize how complicated it is to deal with some of these issues from a pain standpoint for an operation,” said Sites, who had recently been in an operating room and was wearing scrubs during the interview. “I figure maybe there are issues kind of on a larger scale as well.”