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Increased Risk of Depression Recurrence After Initiation of Prescription Opioids in Noncancer Pain Patients

      We read with interest the article by Scherrer and colleagues
      • Scherrer J.F.
      • Salas J.
      • Copeland L.A.
      • Stock E.M.
      • Schneider F.D.
      • Sullivan M.
      • Bucholz K.K.
      • Burroughs T.
      • Lustman P.J.
      Increased risk of depression recurrence after initiation of prescription opioids in noncancer pain patients.
      published in The Journal of Pain. The authors conducted a retrospective study using data from Veterans Health Administration (VA; n = 5,400), and Baylor Scott & White Health (n = 842). They reported that patients exposed to an opioid compared with those unexposed had a significantly greater risk of depression recurrence in both patient populations. They conclude that their results suggest opioid use doubles the risk of depression recurrence even after controlling for pain, psychiatric disorders, and opioid misuse.
      • Scherrer J.F.
      • Salas J.
      • Copeland L.A.
      • Stock E.M.
      • Schneider F.D.
      • Sullivan M.
      • Bucholz K.K.
      • Burroughs T.
      • Lustman P.J.
      Increased risk of depression recurrence after initiation of prescription opioids in noncancer pain patients.
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      References

      1. ICD9data.com: Depressive disorder, not elsewhere classified [Internet]. Available at: http://www.icd9data.com/2015/Volume1/290-319/300-316/311/default.htm. Accessed February 22, 2016.

      2. GAO. U.S. Government Accountability Office. VA Health Care: Improvements Needed to the Monitoring of Antidepressant Use for Major Depressive Disorder and the Accuracy of Suicide Data. Available at: http://gao.gov/products/GAO-15-648T. Accessed February 22, 2016.

        • Scherrer J.F.
        • Salas J.
        • Copeland L.A.
        • Stock E.M.
        • Schneider F.D.
        • Sullivan M.
        • Bucholz K.K.
        • Burroughs T.
        • Lustman P.J.
        Increased risk of depression recurrence after initiation of prescription opioids in noncancer pain patients.
        J Pain. 2016; 17: 473-482
        • Wasan A.D.
        • Michna E.
        • Edwards R.R.
        • Katz J.N.
        • Nedeljkovic S.S.
        • Dolman A.J.
        • Janfaza D.
        • Isaac Z.
        • Jamison R.N.
        Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain.
        Anesthesiology. 2015; 123: 861-872

      Linked Article

      • Increased Risk of Depression Recurrence After Initiation of Prescription Opioids in Noncancer Pain Patients
        The Journal of PainVol. 17Issue 4
        • Preview
          Several studies have shown that chronic opioid analgesic use is associated with increased risk of new-onset depression. It is not known if patients with remitted depression are at increased risk of relapse after exposure to opioid analgesics. A retrospective cohort design using patient data from the Veterans Health Administration (VHA; n = 5,400), and Baylor Scott & White Health (BSWH; n = 842) was performed with an observation period in the VHA from 2002 to 2012 and in the BSWH from 2003 to 2012.
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      • Response to Ruan et al. Letter to the Editor: Increased Risk of Depression Recurrence After Initiation of Prescription Opioids in Noncancer Pain Patients
        The Journal of PainVol. 17Issue 8
        • Preview
          We appreciate the thoughtful comments of Ruan et al,1 regarding the definition of depression used in our recent study on the association between opioid use and depression recurrence.2 The authors argue that using International Classification of Diseases, Ninth Revision (ICD-9) code 311 is not an appropriate measure for major depression. Selecting an ICD-9 code for depression is multifactorial and partly influenced by whether patients were treated in specialty mental health care or primary care. We do not have enough information to distinguish between major depressive episode and the less specific clinical features of sadness and depressed mood related to ICD-9 code 311.
        • Full-Text
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