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Impact of adherence to antidepressants on long-term prescription opioid use cessation

  • Jeffrey F. Scherrer (a1), Joanne Salas (a1), Mark D. Sullivan (a2), Brian K. Ahmedani (a3), Laurel A. Copeland (a4), Kathleen K. Bucholz (a5), Thomas Burroughs (a6), F. David Schneider (a7) and Patrick J. Lustman (a8)...
Abstract
Background

Depression contributes to persistent opioid analgesic use (OAU). Treating depression may increase opioid cessation.

Aims

To determine if adherence to antidepressant medications (ADMs) v. non-adherence was associated with opioid cessation in patients with a new depression episode after >90 days of OAU.

Method

Patients with non-cancer, non-HIV pain (n = 2821), with a new episode of depression following >90 days of OAU, were eligible if they received ≥1 ADM prescription from 2002 to 2012. ADM adherence was defined as >80% of days covered. Opioid cessation was defined as ≥182 days without a prescription refill. Confounding was controlled by inverse probability of treatment weighting.

Results

In weighted data, the incidence rate of opioid cessation was significantly (P = 0.007) greater in patients who adhered v. did not adhered to taking antidepressants (57.2/1000 v. 45.0/1000 person-years). ADM adherence was significantly associated with opioid cessation (odds ratio (OR) = 1.24, 95% CI 1.05–1.46).

Conclusions

ADM adherence, compared with non-adherence, is associated with opioid cessation in non-cancer pain. Opioid taper and cessation may be more successful when depression is treated to remission.

Declaration of interest

None.

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Copyright
Corresponding author
Correspondence: Jeffrey F. Scherrer, Family and Community Medicine, Saint Louis University School of Medicine, 1402 N. Grand Blvd St. Louis, Missouri 63104, USA. Email: scherrjf@slu.edu
References
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Impact of adherence to antidepressants on long-term prescription opioid use cessation

  • Jeffrey F. Scherrer (a1), Joanne Salas (a1), Mark D. Sullivan (a2), Brian K. Ahmedani (a3), Laurel A. Copeland (a4), Kathleen K. Bucholz (a5), Thomas Burroughs (a6), F. David Schneider (a7) and Patrick J. Lustman (a8)...
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