Various studies including the selected studies have revealed that the use of opioid as a prescription can cause depression among patients. In these qualitative studies, the researchers have also revealed that long term use of opioids as prescription or cases of overdose are the major causes of depression and anxiety among patients given opioid as prescription. There are however, research gaps that have been identified after an analysis of these studies. The first research gap is that research studies have not focused on whether controlled substance agreement (CSA) can give better outcomes. Elrashdi et al (2018) have thus revealed that a study is needed to determine if depression, anxiety and other psychological factors related to chronic opioid therapy (COT) at the time of controlled substance agreement (CSA) may lead to improved management and better outcomes. In other words, studies should examine if there can be better management if anxiety and depression are recorgnised.
Secondly, there is a research gap in assessing how depression resulting from opioid prescription relate with symptoms of other psychological issues and the way they influence each other. Gros et al (2013) has made this observation and also claimed that there was a need to conduct similar studies using a larger population, in their study that also revealed the existence of mood and anxiety disorders among patients under prescribed opioid. The small size of the sampled population also made it difficult for the researcher to go further and examine the existence of other psychological illnesses one at a time among people under opioid prescription. The mental issues that attracted interests were panic disorder, generalized anxiety disorder and major depressive disorder. As such, there is a need to conduct a study that will examine each of these mental disorders one at a time which will therefore mean that there is a need for a study with a much bigger sample size. A similar observation was also made by Barry et al., (2010) who also observed the cause of depression was also caused by a lack of addiction referral options. Therefore, a study should be conducted to also evaluate if there would be better outcomes if chronic opioid prescription would be managed using such methods as addiction referrals.
Another research gap that has been sighted has been in the area of examining the existence of previous mental disorders and the role that they can play. Sullivan et al (2006) have made a study that focused more on the constant use that leads to addition and hence depression, but studies have not focused on the psychological state of the patient before the use of opioids and how that can contribute to depression. For instance, the studies do not examine if there are different occurrences if patients prescribed on opioids had other mental conditions and illnesses prior to the prescription. The studies have also not assessed if such prior mental illnesses like stress can lead to depression after a patient is put on opioids.
Finally, there is a gap on the inclusion of age and examination of how depression resulting from opioid prescription is emerging dependent on age. While Chalana et al (2017) considered age in the study, there is still a gap in this area off research where hardly no study has examined the way in which age plays a role in the rise of depression among patients after being put under opioid prescription. In other words, it is important to understand the trends of emerging depression and anxiety after opioid prescription with regard to age.
Strengths and weaknesses in existing studies
Sullivan, M. D., Edlund, M. J., Zhang, L., Unützer, J., & Wells, K. B. (2006). Association Between Mental Health Disorders, Problem Drug Use, and Regular Prescription Opioid Use. Archives of Internal Medicine, 166(19), 2087. doi:10.1001/archinte.166.19.2087 Retrieved from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/411106
Chalana, H., Kundal, T., & Singh Malhari, A. (2017). Depression as a Risk Factor for Relapse After Inpatient Opioid Detoxification: 1-Year Follow-Up Study. International Journal of High Risk Behaviors and Addiction, In Press(In Press). doi:10.5812/ijhrba.59543
Gros, D. F., Milanak, M. E., Brady, K. T., & Back, S. E. (2013). Frequency and Severity of Comorbid Mood and Anxiety Disorders in Prescription Opioid Dependence. The American Journal on Addictions, 22(3), 261-265. doi:10.1111/j.1521-0391.2012.12008.x
Barry, D. T., Irwin, K. S., Jones, E. S., Becker, W. C., Tetrault, J. M., Sullivan, L. E., … Fiellin, D. A. (2010). Opioids, Chronic Pain, and Addiction in Primary Care. The Journal of Pain, 11(12), 1442-1450. doi:10.1016/j.jpain.2010.04.002
Elrashidi, Y., M. , Philpot, M. L., Ramar, P., Leasure, B. W., and Ebbert, O. J., (2018). Depression and Anxiety Among Patients on Chronic Opioid Therapy,Health Services Research and Managerial Epidemiology, (5) pp. 1-7
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