Opioid Drugs for Mental Anguish: Basic Research and Clinical Trials

The prescription opioid crisis of overdosing and overprescribing has reached epic proportions, according to the North American media. Just last week, we learned that 91% of patients who survive opioid overdose are prescribed more opioids! The CDC calls it an epidemic, and notes there's been “a 200% increase in the rate of overdose deaths involving opioid pain relievers and heroin.” A recent paper in the Annual Review of Public Health labels it a “public health crisis” and proposes “interventions to address the epidemic of opioid addiction” (Kolodny et al., 2015).In the midst of this public and professional outcry, why on earth would anyone recommend opioid drugs as a treatment for severe depression and suicidal ideation??Let's revisit the questions posed in my previous post: Does the pain of mental anguish rely on the same neural machinery as physical pain?     Can we treat these dreaded ailments with the same medications? The opioid-for-depression proponents would answer both of those questions in the affirmative,1 with some qualifications. First off, the actual medication in question (and its dose) is different from the typically abused opiate / opioid drug. As far as I can tell, no one is clamoring for narcotic analgesics like OxyContin and Vicodin to be used as antidepressants.In his 2008 paper on the Psychotherapeutic Benefits of Opioid Agonist Therapy, Dr. Peter L. Tenore reviewred the history of the Opium Cure and declared, “Opioids ha...

Source: The Neurocritic - January 7, 2016 Category: Neuroscience Authors: The Neurocritic Source Type: blogs