Does the Long-Term Use of Oral Opioids for Chronic Noncancer Pain (CNCP) Increase Depressive Symptoms in Department of Defense Retiree Population? - Abstract
The optimal medical therapy for patients with chronic noncancer pain (CNCP) continues to be a challenging prospect. The use of oral opioids for the treatment of CNCP continues to be controversial because the true extent of their long-term efficacy, safety and effect on mental and physical functional status remains unclear. Recent
studies have shown a correlation between long term opioid use and depression.
Retrospective chart reviews of retired Department of Defense patients, without a diagnosis of depression, were randomly selected from files maintained in the Chronic Pain Clinic located at Wilford Hall Medical Center. Changes in patients’ depressive symptoms were assessed based on changes in patients’ reported Beck Depression Inventory (BDI) score from each of their clinic visit throughout the course of their therapy.
A statistically significant increase in BDI scores was discovered in patients on high dose opioids (>50mg oral morphine equivalents per day) when compared to low dose opioid group (<50mg oral morphine equivalents per day). No significant changes were found in pain scores over the course of therapy.
This finding suggests that long term opioid therapy could increase a patient’s depressive symptoms and those patients on such therapy should continue to be monitored closely for depression.