New Research Shows Americans with Mental Illness use Opioids at Alarming Levels

More than half of all opioid medications distributed each year in the United States are prescribed to adults with mental illness — patients diagnosed with depression and anxiety — according to new research by Dartmouth-Hitchcock and the University of Michigan.

The study, published in the July issue of the Journal of the American Board of Family Medicine, is among the first to show the extent to which the population of Americans with mental illness use opioids.

In the setting of the U.S. opioid crisis, the authors warn this connection between mental illness and opioid prescribing is particularly concerning because mental illness is also a prominent risk factor for overdose and other adverse opioid-related outcomes.

“Adults with mental health disorders were more than twice as likely to receive an opioid prescription,” said Dr. Brian Sites, an anesthesiologist at Dartmouth-Hitchcock. This higher opioid use among those with mental illness persists across all key characteristics including cancer status and various levels of self-reported pain.

“Despite representing only 16 percent of the adult population, adults with mental health disorders receive more than half of all opioid prescriptions distributed each year in the United States,” said Matthew Davis of the University of Michigan, co-author of the study.

The study found among the 38.6 million Americans diagnosed with mental health disorders more than seven million (or 18 percent) are being prescribed opioids each year. In comparison, only 5 percent of adults without mental disorders are likely to use prescription opioids.

“Because of the vulnerable nature of patients with mental illness, such as their susceptibility for opioid dependency and abuse, this finding warrants urgent attention to determine if the risks associated with such prescribing are balanced with therapeutic benefits,” Sites warns. Sites noted because pain is a subjective phenomenon, “the presence of mental illness may influence the complex dynamic between patient, provider and health system that results in the decision to write an opioid prescription.”