Study links mental health disorders with greater opioid use

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A spike in the number of patients coming in with infected heart valves has surgeons speaking up — because even if the expensive and involved surgery is successful, most of these patients will still die young.
Wochit

Adults with mental health disorders are consuming more than half of all painkillers prescribed in the United States, according to a new study. 

While adults suffering from depression, anxiety and mood disorders represent just 16 percent of the nation’s population, they received 51 percent of all opioid prescriptions.

Researchers at the University of Michigan and Dartmouth-Hitchcock Medical Center said that rethinking pain management among this group is “critical” to combat a growing national opioid addiction epidemic — one that has hit Tennessee particularly hard.

Tennessee leads the nation in the number of opioid prescriptions per person and has a five-year overdose death toll that has climbed to 6,036 people.

“When we got the results, we were completely shocked at the large discrepancy in prescribing,” said Dr. Brian Sites, an anesthesiologist at the Dartmouth-Hitchcock Medical Center and a co-author of the study published in the Journal of the American Board of Family Medicine.

“The sheer magnitude suggests the possibility of over-prescribing,” Sites said. “There’s just no way all these prescriptions are needed.”

But the leader of Tennessee’s Department of Mental Health and Substance Abuse Services cautioned against drawing sweeping conclusions or tailoring public policies around the conclusions of one study. 

“If the study bears out with further research, our department will be the first to say we want to develop ways in which we can serve that population,” said Marie Williams, the department’s commissioner. 

“If it doesn’t, we don’t want to further stigmatize a group that is already stigmatized.”

Opioids were the number one substance abused in 2016 by individuals with mental illness who were receiving services from the Department of Mental Health and Substance Abuse Services, with alcohol a close second.

Williams noted the study did not focus on individuals known to be abusing opioids. The study defined opioid users as anyone who had two or more prescriptions per year. It also did not include people living in institutions such as mental health facilities or jails. 

Addiction treatment experts say they have long seen a correlation between mental health disorders and substance abuse, but the study is a first to put a number on those cases.

“The large number using opioids — that’s more than would have been anticipated,” said Dr. Karen Rhea, chief medical officer for Centerstone, which treats more than 65,000 people in Tennessee at its behavioral health centers.

Rhea said chronic physical pain among people with depression and anxiety is a real problem, not a phantom one, she said. 

An internal analysis of Centerstone patient data found that chronic pain was a risk factor for attempted or completed suicide, Rhea said. 

The cause and effect may differ among individuals, she said. People with back pain or those who suffered debilitating injuries may be at risk for depression, while individuals who suffer anxiety can experience so-called somatic disorders, which are symptoms of physical pain exacerbated by intense anxiety about that pain. 

Sites, the study researcher, said while more research is needed, one key to solving it is clear. 

“This isn’t a drug cartel problem,” he said. “This is a physician prescribing problem. We know where it starts.”

The majority of physicians would agree with the study’s conclusion that improving pain management is critical to reducing opioid dependency among all populations, said Nita Shumaker, a Chattanooga pediatrician and president of the Tennessee Medical Association said

But Shumaker said physicians need more tools to help patients with chronic pain and those at risk for addiction.

Although mandatory training is now required for medical professionals who prescribe opioids, Shumaker said the group would be working in the coming year to provide education to both doctors and their patients to help them manage “complex medical conditions while managing pain with alternative treatment models.”

Meanwhile, there are efforts underway in Tennessee aimed specifically at people with “dual diagnoses” — those with mental health illness and addiction.

Centerstone in February launched an anxiety recovery program aimed at educating patients with chronic anxiety about how it interacts with physical pain, Rhea said.

And the Department of Mental Health and Substance Abuse Services has launched an initiative with the Tennessee Hospital Association to create a protocol for emergency rooms that identify people with anxiety or depression and treat them for those conditions, rather than prescribing opioids.

Reach Anita Wadhwani at awadhwani@tennessean.com, 615-259-8092 or on Twitter @AnitaWadhwani.

Need help for addiction or mental health care? Call Tennessee REDLINE: 800-889-9789

 

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYParting with pain — and pills | 1:28

Medical professionals want to change how patients think about pain
Holly Fletcher, Kyleah Starling

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYEver wondered about how to treat pain – without pills | 2:00

Changing how pain is recognized and treated — by patients, providers and insurance companies — is vital to efforts to tackle health care costs and reform, opioid dependency and, particularly in Tennessee, wellness.
Holly Fletcher, The Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYShe started her addiction in her teens and lost all of her 20’s to drugs | 3:03

She started her addiction in her teens and lost all of her 20’s to drugs
Larry McCormack / USA Today Network – Tennessee

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYA temporary home for Tennessee women battling addiction | 1:56

The “cabin” in White Pine, Tennessee serves as a temporary home for both pregnant and non-pregnant women battling addiction. Most have multiple felonies.
Lacy Atkins / The Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYWendell Taylor was addicted to pain killers | 1:46

Wendell Taylor was addicted to pain killers. Now he is turning his life around.
Larry McCormack / USA Today Network – Tennessee

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYDonna Marsh is in chronic pain but believes opioids help | 1:39

Donna Marsh is in chronic pain but believes opioids help with her pain. She has now become an advocate for those that depend on the drugs to ease their pain.
Larry McCormack / USA Today Network – Tennessee

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYOpioid-addicted parents lose their children | 0:59

In 2014, there were 864 Tennessee children whose parents had their rights terminated. Experts say the state’s opioid addiction epidemic is a key driver.

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYA Mother’s Nightmare | 2:20

Judy Jenkins talks about her daughter Lydia Dale Huebner, who died of an accidental drug overdose.
Lacy Atkins / Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYIUDs for inmates seen as a tool to combat opioid crisis | 1:32

Female inmates speak out about addiction and listen to a presentation about babies born addicted to drugs. The number of babies born addicted to drugs, particularly opioids, climbed in Tennessee to 1039 in 2015 – up from 936 in 2013.
Lacy Atkins / The Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYJudge Slone attempts to stop the opioid crisis | 2:04

Judge Duane Slone observed the arc of the opioid crisis first-hand since painkiller-addiction began taking ahold of lives in the rural northeast Tennessee counties he serves.
Lacy Atkins / The Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYExpert compares current opioid crisis to past tobacco crisis | 1:19

Dr. David Edwards, Clinical Chief of Chronic Pain Service at Vanderbilt University Medical Center, weighs in on the opioid crisis, comparing it to the tobacco crisis and an overflowing tub.
Karen Kraft, Anita Wadhwani / The Tennessean

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CLOSEWATCH: THOSE AFFECTED BY OPIOID EPIDEMIC TELL THEIR STORYThe opioid epidemic’s grip on Tennessee | 2:34

There were more opioid prescriptions than people in Tennessee in 2015. More people died of opioid overdoses than vehicle accidents, homicide or suicides in 2012. Between 2010-2015, opioid abuse claimed the lives of 6,039 Tennesseans.

  • Parting with pain  and pills  Study links mental health disorders with greater opioid use 107b9 35553607001 5389982195001 5389962124001 vs
  • Ever wondered about how to treat pain - without pills  Study links mental health disorders with greater opioid use 107b9 35553607001 5389765632001 5389742780001 vs
  • She started her addiction in her teens and lost all of her 20's to drugs  Study links mental health disorders with greater opioid use 107b9 35553607001 5372017105001 5372003225001 vs
  • A temporary home for Tennessee women battling addiction  Study links mental health disorders with greater opioid use 107b9 35553607001 5377894183001 5377856292001 vs
  • Wendell Taylor was addicted to pain killers  Study links mental health disorders with greater opioid use 107b9 35553607001 5372018677001 5372014685001 vs
  • Donna Marsh is in chronic pain but believes opioids help  Study links mental health disorders with greater opioid use 107b9 35553607001 5372021627001 5372014700001 vs
  • Opioid-addicted parents lose their children  Study links mental health disorders with greater opioid use 107b9 35553607001 5222323635001 5222302238001 vs
  • A Mother's Nightmare  Study links mental health disorders with greater opioid use 107b9 35553607001 5253724455001 5253722661001 vs
  • IUDs for inmates seen as a tool to combat opioid crisis  Study links mental health disorders with greater opioid use 107b9 35553607001 5303429975001 5303389675001 vs
  • Judge Slone attempts to stop the opioid crisis  Study links mental health disorders with greater opioid use 385cf 35553607001 5300416430001 5300390044001 vs
  • Expert compares current opioid crisis to past tobacco crisis  Study links mental health disorders with greater opioid use 385cf 35553607001 5251173692001 5251155813001 vs
  • The opioid epidemic's grip on Tennessee  Study links mental health disorders with greater opioid use 385cf 35553607001 5367109197001 5367085219001 vs

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CLOSEVIDEOS: OPIOID CRISISOpioid epidemic increases number of endocarditis cases | 2:01

A spike in the number of patients coming in with infected heart valves has surgeons speaking up — because even if the expensive and involved surgery is successful, most of these patients will still die young.
Wochit

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CLOSEVIDEOS: OPIOID CRISISOB-GYN talks about treating pregnant, opioid addicted women | 1:51

OB-GYN Dr. Jennifer Maddron talks about her approach to treating pregnant women struggling with opioid addiction.
Calvin Mattheis/Knoxville News Sentinel

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CLOSEVIDEOS: OPIOID CRISISDoctor on helping pregnant women fight pill addiction | 1:48

Dr. Geogy Thomas of Dayspring Family Health discusses the process in helping pregnant women with pain medicine addiction.
Saul Young/News Sentinel

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CLOSEVIDEOS: OPIOID CRISISOpioid overdose drug spikes 600 percent in price as ODs increase | 1:03

The price of Evzio, a device intended to prevent death during an opioid overdose, has been increasing as the opioid epidemic spreads. Matt Hoffman reports.
Buzz60

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CLOSEVIDEOS: OPIOID CRISISJudge Slone attempts to stop the opioid crisis | 2:04

Judge Duane Slone observed the arc of the opioid crisis first-hand since painkiller-addiction began taking ahold of lives in the rural northeast Tennessee counties he serves.
Lacy Atkins / The Tennessean

Study links mental health disorders with greater opioid use a1ad8 35553607001 5303429975001 5303389675001 vsx

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CLOSEVIDEOS: OPIOID CRISISIUDs for inmates seen as a tool to combat opioid crisis | 1:32

Female inmates speak out about addiction and listen to a presentation about babies born addicted to drugs. The number of babies born addicted to drugs, particularly opioids, climbed in Tennessee to 1039 in 2015 – up from 936 in 2013.
Lacy Atkins / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISA Mother’s Nightmare | 2:20

Judy Jenkins talks about her daughter Lydia Dale Huebner, who died of an accidental drug overdose.
Lacy Atkins / Tennessean

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CLOSEVIDEOS: OPIOID CRISISExpert compares current opioid crisis to past tobacco crisis | 1:19

Dr. David Edwards, Clinical Chief of Chronic Pain Service at Vanderbilt University Medical Center, weighs in on the opioid crisis, comparing it to the tobacco crisis and an overflowing tub.
Karen Kraft, Anita Wadhwani / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISOpioid-addicted parents lose their children | 0:59

In 2014, there were 864 Tennessee children whose parents had their rights terminated. Experts say the state’s opioid addiction epidemic is a key driver.

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CLOSEVIDEOS: OPIOID CRISISSurgeon General Dr. Vivek Murthy speaking about opioids | 1:37

Surgeon General Dr. Vivek Murthy, spoke at Meharry about opioids addiction and treatments as part of the “Turn the Tide Rx.”
Larry McCormack / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISMedical schools tackle opioid painkiller abuse | 1:49

Medical schools are expanding their training to help future doctors fight opioid abuse. New training programs at many schools teach students to prescribe opioid painkillers only as a last resort, and to evaluate patients for signs of drug abuse. (Ju
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CLOSEVIDEOS: OPIOID CRISISDrug czar: Funding needed to end drug epidemic | 6:21

Michael Botticelli, director of the White House Office of National Drug Control Policy, on the responsibility that doctors and pharmaceutical companies must take to end the opioid epidemic in the U.S.

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CLOSEVIDEOS: OPIOID CRISISWhy federal officials push for opiate abuse, treatment funding | 1:05

Federal officials chided Congress for not funding Obama’s $1.1B budget allocation for opioid treatment and education resources. Tennessee would be eligible for $24M over two years to help battle the epidemic.
Karen Kraft / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISBill Haslam on opioids | 0:45

Governor Bill Haslam talks about how to combat Tennessee’s opioid epidemic after a town hall meeting with the U.S. Secretary of Agriculture, Tom Vilsack and Virginia Governor Terry McAuliffe at the Southwest Virginia Higher Education Center.
Saul Young / USA Today Network

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CLOSEVIDEOS: OPIOID CRISISNashville Storytellers: Betty Mason | 16:52

Betty Mason, whose 19-year-old daughter died from a heroin overdose in May. “Through hell and back,” focuses on our storytellers’ personal anecdotes about addiction and recovery. (8/15/16)
Karen Kraft / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISNashville Storytellers: Trina Frierson | 12:59

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Karen Kraft / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISNashville Storytellers: Brad Schmitt | 23:26

Brad Schmitt, a recovering addict for six years and the Nashville Insiders columnist for The Tennessean. “Through hell and back,” will focus on our storytellers’ personal anecdotes about addiction and recovery. (8/15/16)
Karen Kraft / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISNashville Storytellers: Dr. Jessica Young | 14:51

Dr. Jessica Young, an assistant professor of Obstetrics and Gynecology at Vanderbilt University, runs Vanderbilt’s Drug Dependency Clinic for pregnant women. “Through hell and back:” Personal anecdotes about addiction and recovery. (8/15/16)
Karen Kraft / The Tennessean

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CLOSEVIDEOS: OPIOID CRISISBroken Road to Recovery: Opioid Crisis | 7:37

DC Digital Reporters Matthew Leonard, Sarah Taddeo and Gary Craig discuss their investigative package on the opioid crisis.

  • Opioid epidemic increases number of endocarditis cases  Study links mental health disorders with greater opioid use 1d3c4 35553607001 5441675191001 5441623357001 vs
  • Doctor on helping pregnant women fight pill addiction  Study links mental health disorders with greater opioid use 2974f 35553607001 5398080997001 5398072957001 vs
  • Opioid overdose drug spikes 600 percent in price as ODs increase  Study links mental health disorders with greater opioid use 2974f 29906170001 5321748236001 5321650766001 vs
  • Judge Slone attempts to stop the opioid crisis  Study links mental health disorders with greater opioid use 385cf 35553607001 5300416430001 5300390044001 vs
  • IUDs for inmates seen as a tool to combat opioid crisis  Study links mental health disorders with greater opioid use 107b9 35553607001 5303429975001 5303389675001 vs
  • A Mother's Nightmare  Study links mental health disorders with greater opioid use 107b9 35553607001 5253724455001 5253722661001 vs
  • Expert compares current opioid crisis to past tobacco crisis  Study links mental health disorders with greater opioid use 385cf 35553607001 5251173692001 5251155813001 vs
  • Opioid-addicted parents lose their children  Study links mental health disorders with greater opioid use 107b9 35553607001 5222323635001 5222302238001 vs
  • Surgeon General Dr. Vivek Murthy speaking about opioids  Study links mental health disorders with greater opioid use 783a0 35553607001 4974516916001 4974482056001 vs
  • Medical schools tackle opioid painkiller abuse  Study links mental health disorders with greater opioid use 783a0 29906170001 5000419219001 5000350181001 vs
  • Why federal officials push for opiate abuse, treatment funding  Study links mental health disorders with greater opioid use 783a0 35553607001 5023523924001 Pills LRG
  • Bill Haslam on opioids  Study links mental health disorders with greater opioid use 783a0 35553607001 5014294942001 5014274704001 vs
  • Born Hurting: Tennessee's struggle with addicted mothers and babies born drug-dependent  Study links mental health disorders with greater opioid use 783a0 35553607001 3620212465001 video still for video 3620141977001
  • Nashville Storytellers: Betty Mason  Study links mental health disorders with greater opioid use 783a0 35553607001 5087832086001 5087796256001 vs
  • Nashville Storytellers: Trina Frierson  Study links mental health disorders with greater opioid use 783a0 35553607001 5088875579001 5088828637001 vs
  • Nashville Storytellers: Brad Schmitt  Study links mental health disorders with greater opioid use 04760 35553607001 5089046807001 5089025210001 vs
  • Nashville Storytellers: Dr. Jessica Young  Study links mental health disorders with greater opioid use 04760 35553607001 5088873154001 5088856038001 vs
  • Broken Road to Recovery: Opioid Crisis  Study links mental health disorders with greater opioid use 04760 36517057001 5071006573001 5070989164001 vs