Opioids, Depression and the Principle of Balance

2016 January 20
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A study published in the Annals of Family Medicine by Jeffrey Scherrer et al. points out an incidence of new onset depression of 9-12% with medical opioid use, the incidence rising with duration of use. The risk is seen in those who use it more than 30 days.

There has been significant publicity for this as well as other risks. Would not the following be a balanced approach?

  • to be aware of the possibility of depression with prolonged use and to look for it and treat it if it happens,
  • to avoid using opioids as first line treatment for non-cancer pain, and nevertheless,
  • to use opioids when it is indicated instead of condemning the person to pain when nothing else helps.

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