Research reportFactors associated with the development of depression in chronic non-cancer pain patients following the onset of opioid treatment for pain

- We examined associations with depression post opioid use in people with chronic pain.
- Participants were a national sample prescribed opioids for chronic non-cancer pain.
- Six in 10 reported lifetime depression, of which 48% had onset post-opioid medication.
- Pain self-efficacy, support and medication concerns related to post-opioid depression.
- Monitoring mood dysfunction is important when starting opioids.
- Psychological treatments that address self-efficacy may be useful.

Background and aimsPharmaceutical opioid prescription rates are increasing globally, however knowledge of their long-term effects on mental health, in particular depression remains limited. This study aimed to identify factors associated with the onset of depression post-opioid use that differ to factors associated with depression post-pain.MethodParticipants (N=1 418) were a national sample prescribed opioids for chronic non-cancer pain. Age at onset of depression, pain and commencement of opioid medications were collected via structured interview.ResultsSix in 10 (61%) reported lifetime depression; of those, almost half developed depression after pain and after they started opioid medications (48%). Variables associated with post-opioid depression included lower pain self-efficacy and poorer social support, younger onset of opioid use, and difficulties and concerns with opioid medications.ConclusionsThe findings highlight the importance of monitoring for the emergence of mood dysfunction, particularly for those starting opioids for pain at a younger age, and consideration of psychological treatments that address self-efficacy that appears to be associated with post-opioid depression.