Impact of substance abuse on the diagnosis, course, and treatment of mood disordersTreatment of depression in patients with opiate dependence
Section snippets
Relationships between opiates and mood
The classic effect of opiates in patients who are in pain is both to relieve pain and to relieve the dysphoria associated with pain. Among medical patients receiving analgesic doses, these changes are described as decreased anxiety, drowsiness, and a sense of tranquility (Jaffe and Martin 1990). Opiate-dependent individuals describe feelings of well-being that may be energizing or relaxing in quality. Opioid medications produce their pleasant effects by stimulating the brain reward system
Summary of findings
Depression is prevalent in opiate-dependent patients. Its etiology and relationship to opiate dependence is complex, but evidence suggests that depression in this population has adverse prognostic effects and also may be a factor in motivating patients to seek treatment for their drug problems. Depressive symptoms often improve after entry into treatment for opiate dependence, a finding which may represent a direct pharmacologic effect in the case of methadone or buprenorphine maintenance, an
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