Study links opioid use to mental health

Mentally ill at least half of opioid users

Staff photo by DAMIEN FISHER John Broderick, former Chief Justice of the New Hampshire Supreme Court, speaks about a new study unveiled Monday showing the links between mental illness and opioid use. He spoke at an event at Dartmouth-Hitchcock in Nashua, with U.S. Rep. Annie Kuster and Dartmouth-Hitchcock’s Dr. Brian Sites, the co-authors of the study.

NASHUA – A new study published this week by Dartmouth-Hitchcock doctors links mental illness to the opioid addiction crisis, showing that more than half of all people obtaining opioid prescriptions have some form of mental health illness.

“Adults with mental health disorders were more than twice as likely to receive an opioid prescription,” said Dr. Brian Sites, an anesthesiologist at Dartmouth-Hitchcock and one of the study’s co-authors.

“Despite representing only 16 percent of the adult population, adults with mental health disorders receive more than half of all opioid prescriptions distributed each year in the United States.”

Sites, during a press conference in Nashua on Monday, said the state’s devastating opioid abuse epidemic has largely been fueled by the overprescription of the drugs. Prior studies have already shown that the vast majority of people dealing with heroin and opioid addictions started with legal prescriptions to deal with some form of pain, he said.

“It all starts with a well-intentioned prescription,” Sites said.

His study, published in the Journal

of the American Board of Family

Medicine and written by doctors with Dartmouth-Hitchcock and the University of Michigan, finds that of the 38.6 million Americans diagnosed with mental health disorders, such as depression, anxiety or mood disorders, more than 7 million (18 percent) are being prescribed opioids each year. In comparison, only 5 percent of adults without mental disorders are likely to use prescription opioids.

“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,” Sites said.

Sites also said because pain is a subjective phenomenon, “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.”

Former New Hampshire Supreme Court Chief Justice John Broderick, who has dealt with substance abuse issues within his own family, said people dealing with mental health problems often use drugs and alcohol to self-medicate.

“There’s a mental health problem in this country that we need to confront in a different way,” Broderick said.

Too many people with mental illnesses stay in the shadows, ashamed of their conditions, he

said, and that results in people misusing drugs or alcohol – and winding up in legal trouble.

“Jails and prisons are the largest providers of mental health services in the United States,” Broderick said.

U.S. Rep. Annie Kuster, D-N.H., said Sites’ study shows the need to continue funding health care for vulnerable people through Medicaid and the Medicaid expansion brought by the Affordable Care Act.

“People want to get treatment, they don’t want to be addicted to opioids,” Kuster said.

Kuster used the study’s release to campaign against the health care laws put forward by Republicans in the U.S. House and Senate that would cut Medicaid, phase out the Medicaid expansion, and allow states to waive essential benefits such as mental health and substance abuse treatment.

“Republicans should abandon repeal (of the Affordable Care Act) and come together to do the hard work to fix our system,” Kuster said.

Annette Escalante, with Nashua-based Harbor Homes, said her organization is already starting to merge mental health treatment with drug and alcohol recovery instead of keeping the treatments separate.

While this is proving to be effective, such dual treatment may not happen with health insurance through Medicaid and the Medicaid expansion, Escalante said. That will send recovery treatment backward, she continued, to a status quo that doesn’t work.

“We can’t keep doing what we have been doing for years and expect different outcomes,” she said.

Damien Fisher can be reached at 594-1245, dfisher@nashuatelegraph.com or @Telegraph_DF.