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Leung J, Santo T, Colledge-Frisby S, Mekonen T, Thomson K, Degenhardt L, Connor JP, Hall W, Stjepanović D. OUP accepted manuscript. PAIN MEDICINE 2022; 23:1442-1456. [PMID: 35167694 PMCID: PMC9340651 DOI: 10.1093/pm/pnac029] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 12/01/2022]
Abstract
Objective To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms. Design We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods We searched PubMed, Embase, and PsycINFO for search terms related to opioids AND (depression OR bipolar OR anxiety OR post-traumatic stress disorder [PTSD]). Findings were summarized narratively, and random-effects meta-analyses were used to pool effect sizes. Results We identified 10,290 records and found 10 articles that met our inclusion criteria. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood outcome (adjusted effect size [aES] = 1.80 [95% confidence interval = 1.40–2.30]) and of an anxiety outcome (aES = 1.40 [1.20–1.80]) compared with those who did not use prescription opioids. Associations with depression were small and not significant after adjustment for potential confounders (aES = 1.18 [0.98–1.41]). However, some studies reported an increased risk of depressive symptoms after increased (aES = 1.58 [1.30–1.93]) or prolonged opioid use (aES = 1.49 [1.19–1.86]). Conclusions Mental health should be considered when opioids are prescribed because some patients could be vulnerable to adverse mental health outcomes.
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Affiliation(s)
- Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Thomas Santo
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | | | - Tesfa Mekonen
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Psychology, The University of Queensland, St Lucia, Australia
- Psychiatry Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kate Thomson
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- School of Medicine and Dentistry, Griffith Health, Griffith University, Southport, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jason P Connor
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Herston, Australia
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Daniel Stjepanović
- Correspondence to: Daniel Stjepanović, PhD, NCYSUR, The University of Queensland, 17 Upland Road, St Lucia, Brisbane, QLD 4072, Australia. Tel: +61 7 3443 2534; Fax: +61 7 334 69136; E-mail:
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