Is There a Link Between Prescription Opioid Abuse and PTSD Severity?

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Prescription opioid abuse is the collective term for both the misuse of opioid medications by legitimate prescription recipients and any form of opioid medication use by people without a legitimate prescription. In the U.S., people participate in this form of prescription drug abuse fairly often. In a study published in May 2014 in The American Journal of Drug and Alcohol Abuse, a team of researchers affiliated with Dartmouth College investigated the connection between involvement in prescription opioid abuse and the relative severity of co-existing symptoms of the mental illness called post-traumatic stress disorder or PTSD.

Prescription Opioid Abuse

Doctors in the U.S. commonly prescribe opioid medications for purposes that include the relief of some types of short-term or persistent pain and the relief of certain coughs that don’t respond to more moderate treatment options. Unfortunately, substantial numbers of people target these medications for either recreational purposes or unapproved medical purposes. According to the results of a survey conducted in 2012 by the federal Substance Abuse and Mental Health Services Administration, roughly 1.9 percent of all American adults and teens abuse a prescription opioid in any calendar month. This rate of abuse makes opioid medications far and away the most commonly abused prescription substances in the U.S. Most prescription opioid abusers receive their medications for free from a relative or friend who acts as a willing supplier. In turn, most of the supplying relatives and friends get their medications from a single prescribing doctor. Other pathways for illicitly obtaining opioid medications include theft from a friend or relative, use of one’s own prescription(s) from one or several doctors and purchases from an unknown third party or a drug dealer.

PTSD

Post-traumatic stress disorder is so named because it appears in the aftermath (30 days or longer) of exposure to events that either have or appear to have the potential to produce lethal outcomes. Specific events associated with the condition include combat, terrorism exposure, sexual assaults, natural disasters and major collisions or other serious accidents. Any given person with PTSD likely has symptoms that fall into one of three categories: unwanted re-experiencing of a trauma-inducing event, a compelling urge to avoid anything related to a trauma-inducing event and an inability to fully step down from the heightened state of arousal associated with the body’s built-in “fight-or-flight” mechanism. Until 2013, the American Psychiatric Association grouped PTSD with a range of other conditions known together as anxiety disorders. The condition is now included in a related but distinct category of conditions called trauma- and stressor-related disorders.

Is There a Link?

In the study published in The American Journal of Drug and Alcohol Abuse, the Dartmouth College-affiliated researchers used information gathered in 2011 from 573 people receiving treatment for substance addiction to investigate the potential connection between prescription opioid abuse and the chances of developing a more severe or less severe form of post-traumatic stress disorder. Specific factors under consideration for each participant included basic demographic characteristics (racial/ethnic heritage, gender, age, etc.), level of involvement in the abuse of opioid medications or other substances, and the number of diagnosable PTSD symptoms.

The researchers concluded that the study participants involved in prescription opioid abuse had about a 42 percent higher chance of developing a severe form of PTSD. Even greater risks for severe PTSD were found in participants who combined prescription opioid abuse with the abuse of cocaine or sedative medications. When demographic factors were taken into consideration, the researchers concluded that, compared to men, women who abuse opioid medications have an almost 200 percent greater chance of developing PTSD. In terms of age, younger adults between the ages of 18 and 34 who abuse prescription opioids have substantially higher PTSD risks than older adults.

The study’s authors believe that their findings indicate a clear link between the abuse of opioid medications and the relative severity of any given case of post-traumatic stress disorder, especially among younger adults and women. However, they also note the general need for further research in this area, and the specific need to increase the accuracy of the terms used to diagnose PTSD in any future study participants. Even with this caution, they believe that doctors assessing patients involved in opioid medication abuse should also consider the possible presence of post-traumatic stress disorder when making their examinations.

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