Patients With Mental Health Disorders Receive More Opioids

Patients With Mental Health Disorders Receive More Pescription Opioidsstevepb / Pixabay

People with anxiety and depression are disproportionately prescribed painkillers. That’s what new research from the Dartmouth-Hitchcock Medical Center suggests, adding a complex layer to the opioid epidemic ravaging the United States and encouraging calls from New Hampshire’s congressional delegation to not move forward with the repeal of the Affordable Care Act.

The findings, which appear in the July issue of the Journal of the American Board of Family Medicine, show that nearly 19 percent of the 38.6 million American adults with mental health disorders use prescription opioids compared to only 5 percent of those without a disorder. Adults with depression and anxiety receive 51 percent of the 115 million opioid prescriptions distributed each year in the U.S., the study found.

“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,” said Brian Sites, an anesthesiologist at Dartmouth-Hitchcock and one of the co-authors of the study.

prescription opioids

Image Credit: Dartmouth-Hitchcock

Opioid prescribing in the U.S. quadrupled between 1999 and 2015, and during that time more than 183,000 people died from overdoses related to prescription opioids, according to the Centers for Disease Control and Prevention.

Sites also notes that because pain is subjective, “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.”

The study does not give a specific reason why people with mental disorders are more frequently prescribed opiates. The study encourages more research on this population to understand opiate addiction.

Those patients may have some form of physical pain, but their mental condition may cause them to feel that pain more acutely or be less able to cope with it, leading to increased requests for something to dull the pain. As a result, doctors trying to be empathetic to their patients’ complaints may tend to overprescribe opioid painkillers, Stiles said.

Research also shows that patients are more likely to take opioids when there aren’t specialists nearby. A study published earlier this year found that the number of seniors in rural America who take at least three prescribed psychotropic drugs ? including opioids and antidepressants ? tripled over a nine-year period. The study found that many of these prescriptions were given without a proper diagnosis.

Being able to identify a subset of the population that could be more likely to use opioids could help providers and policymakers address opioid use. It “suggests that there may be additional patient- and provider-related factors specific to those with mental illness that increase the likelihood of receiving prescription opioids,” the authors wrote.

U.S. Rep. Annie Kuster, D-N.H., was present for a press conference about the study on Monday. She said repealing Obamacare could be disastrous for New Hampshire’s opioid epidemic.

“This is critically important in New Hampshire, as we have gone from second in the nation in deaths from the opioid crisis and heroin to first for fentanyl,” she said. “That’s not what we want to be known as first in the nation for.”

The U.S. Congress is currently in a heated healthcare battle. The Senate is working on legislation to repeal the healthcare law, but a vote on the bill has been delayed due to opposition from Republicans. New Hampshire Democratic Sens. Jeanne Shaheen and Maggie Hassan have both stated their opposition to the healthcare overhaul and have sent many press releases condemning “Trumpcare.”

“This new study is yet another reminder that, to combat the devastating opioid crisis, we must make mental health treatment affordable and accessible,” Shaheen said in a statement.

Hassan said she opposes proposed cuts to Medicaid that would affect coverage of mental health and substance abuse services.

“As we work to combat the horrific substance misuse crisis that is devastating our communities and taking a major toll on our economy in New Hampshire, this study highlights how dangerous Trumpcare, which includes massive cuts to Medicaid, would be for our state,” Hassan said in a statement. “We need a comprehensive, holistic approach to combating this epidemic that addresses the underlying causes of addiction, including mental health issues.”

To address the overprescription problem within the mental health community, Sites has suggested physicians need more access to alternative medicine besides opioids, including acupuncture, massage therapy, physical therapy, and non-opioid pharmaceuticals.

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About the Author

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Carter Dougherty, InsideSources.com

1 Comment on "Patients With Mental Health Disorders Receive More Opioids"

  1. A Simple Way with Symbols

    In the West we like to make things complicated, and you can read about the complicated way that we have ended up using the Reiki symbols in my article ‘Simplicity and Sandwiches’ which was published in our February 2002 Newsletter and which can be found on our web site. The way that most of us now use symbols is a world away from the simple approach that Usui used. So how can we work with symbols in a way that echoes more the way that Usui taught his students?
    Well firstly, Usui taught symbols to a very small number of people, just in the last few years of his life. The vast majority of his students were taught in a very different way. Most of his students were given meditations to use so that they could, over a long period of time, become more and more familiar with the three energies taught at second-degree level, for example. Once they were thoroughly familiar with the energies, once they had *become* the energies again and again, then they were given a shortcut – a trigger – to connect them to those energies. The triggers that they used were ancient Shinto mantras called kotodama, or jumon, not symbols.

    In the West we do it backwards by comparison: we are given a trigger (a symbol) to connect us to an energy that we are not familiar with, and with which we may never become familiar, depending on how we have been taught to use the symbols. Usui had his students become the three energies again and again and again, and when they were ingrained, when they were innate, only then would you be given a way of connecting to the energies that were already within you.

    The energies were also viewed somewhat differently. The first energy was not seen as some sort of ‘Power’ energy, in the way that the first symbol is seen as the ‘Power’ symbol in the West. The first energy was simply earth energy, energy of the physical body, a physical healing energy. The second energy was seen as heavenly energy and the third energy was said to produce ‘oneness’. Usui’s students learned to get to grips with these energies through meditation, so how can we learn to experience earth energy and celestial energy? Well we can do this by using the symbols.

    Try this solitary exercise: sit comfortably in a chair with your eyes closed and your hands resting in your lap palms uppermost. In your mind’s eye, visualise the first symbol up in the air above you, and say its name silently to yourself three times. Now imagine that cascades of energy are flooding down onto you from that symbol, cascading into your head, your torso, your hands; endless cascades of energy or light keep on flooding into your body. Do this for several minutes. How does that feel? What impressions do you get of the energy? Where was your attention focused? What were your thoughts?

    Now repeat this exercise using the second symbol, again visualising it up in the air above you, saying its name three times, and drawing down endless cascades of energy into your body. How does this feel by comparison? What impressions do you get of the second energy? Where is your attention focused? What is going on in your head?

    If you have a Reiki friend to hand, you can do this exercise together: one person sits comfortably in a chair and the other stands behind. The person standing up is going to send energy from the first or second symbol in quite an intense way. What they do is this: ‘charge’ your hands with the energy of the first symbol, say, by drawing the symbol over your palm, saying the name three times, and press your hands together to ‘transfer the effect across’ to he other hand. Now in your mind’s eye draw out the first symbol up in the air above you and say the name three times. Move your hands so that they are hovering alongside the recipient’s temples, and imagine that you are drawing down cascades of energy from the symbol above you, which flood into your crown, through your arms and out of your hands into the recipient. Keep on visualising. How does the energy feel as it comes through your hands? What impressions do you get in your body? How does it feel for the recipient? What adjectives can they use to describe the essence of the energy that they have received?

    Now repeat this exercise using the second symbol.

    How does this differ from the first energy?
    Having carried out this exercise countless times and with many, many students, I can generalise about the sort of impression that most people tend to get from the two symbols, the two energies. Maybe you will notice some, though not all, of these experiences.

    The first energy seems thick, dark, heavy, dense, solid, maybe oppressive or claustrophobic sometimes, hot, fierce, coarse, penetrating, with pressure and slow pulsation, your focus is on your physical body. The second energy seems soft, light, gentle, ethereal, like soft fluffy clouds or marshmallows, cool, blue, expansive, exhilarating, and uplifting.

    What you have experienced is the essence of earth energy and the essence of heavenly energy, and these are two energies that you have available to you when treating others. These energies are the essence of Usui’s system at second-degree level. The first energy focuses on the physical body, and the second focuses on thoughts and emotions. They are so different, so distinctive. Try using them on their own, just one energy, just one focus, without mixing symbols together. Keep things simple and uncluttered by focusing like a laser beam on one thing at a time, and see what happens. And with time, and with familiarity with the two energies, try producing those energies directly, using intent, and see what happens.

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