Prescription opioid use and 12-month depression trajectories

Authors

• Jeffrey F Scherrer
• Joanne Salas
• Aniketh Naidu
• Scott Secrest
• Lauren Wilson
• Celeste Pappas, Henry Ford HealthFollow
• Patrick J Lustman
• Brian Ahmedani, Henry Ford HealthFollow
• Ryan W Carpenter
• Lisa R. Miller-Matero, Henry Ford HealthFollow
• Mark D Sullivan

Recommended Citation

Scherrer JF, Salas J, Naidu A, Secrest S, Wilson L, Pappas C, Lustman PJ, Ahmedani B, Carpenter RW, Miller-Matero LR, Sullivan MD. Prescription opioid use and 12-month depression trajectories. Psychiatry Res. 2026;361:117096.

Document Type

Article

Publication Date

3-18-2026

Publication Title

Psychiatry research

Keywords

Cohort; Depression; Epidemiology; Opioid; Pain; Prospective; Trajectory

Abstract

INTRODUCTION: Retrospective cohort studies indicate prescription opioids increase risk for depression. No prospective cohort studies have modeled prescription opioid use and depression trajectories. We determined whether daily vs. non-daily prescription opioid use was associated with more severe and worsening depression.

METHODS: Participants with a new period of prescription opioid use were recruited from two health care systems. Those who enrolled were invited to complete twelve-monthly surveys over a year follow-up. Depression was measured with the PHQ-9, and opioid use was self-reported. From the 760 participants with 3 or more monthly surveys, we computed PHQ-9 latent growth trajectories. A 3-class solution best fit the data and revealed a severe-increasing depression trajectory, a moderate-stable, and a low-decreasing trajectory.

RESULTS: Participants were 53.6 ± 11.7 years of age, 68.5% were female and 70.5% identified as white race. Daily vs. non-daily opioid use was not significantly associated with depression trajectories. Higher emotional support (OR=0.92:95%CI:0.89-0.94) and ability to participate in social roles (OR=0.96; 95%CI:0.93-0.99) protected against, while pain related functional impairment (OR=1.39; 95%CI: 1.11-1.74), more pain sites (OR=1.20; 95%CI: 1.10-1.31) and smoking (OR=2.38; 95%CI:1.27-4.47) increased the likelihood of severe-increasing depression compared to low-decreasing depression.

CONCLUSIONS: The lack of an independent link between daily opioid use and worsening or more severe depression in this sample suggests that increased rates of depression in daily opioid-exposed patients may be a result of high risk patients receiving daily opioids rather than a direct effect of the opioid exposure. Screening for factors related to depression should improve safer opioid prescribing.

PubMed ID

41924766

Volume

361

First Page

117096

Last Page

117096