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Prescription opioid use among adults with mental health disorders in the United States

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TLDR
The 16% of Americans who have mental health disorders receive over half of all opioids prescribed in the United States, and improving pain management among this population is critical to reduce national dependency on opioids.
Abstract
Background: The extent to which adults with mental health disorders in the United States receive opioids has not been adequately reported. Methods: We performed a cross-sectional study of a nationally representative sample of the noninstitutionalized U.S. adult population from the Medical Expenditure Panel Survey. We examined the relationship between mental health (mood and anxiety) disorders and prescription opioid use (defined as receiving at least 2 prescriptions in a calendar year). Results: We estimate that among the 38.6 million Americans with mental health disorders, 18.7% (7.2 million of 38.6 million) use prescription opioids. Adults with mental health conditions receive 51.4% (60 million of 115 million prescriptions) of the total opioid prescriptions distributed in the United States each year. Compared with adults without mental health disorders, adults with mental health disorders were significantly more likely to use opioids (18.7% vs 5.0%; P Conclusions: The 16% of Americans who have mental health disorders receive over half of all opioids prescribed in the United States. Improving pain management among this population is critical to reduce national dependency on opioids.

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Life Expectancy and Mortality Rates in the United States, 1959-2017

TL;DR: US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014, with the largest relative increases occurring in the Ohio Valley and New England.
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Compositional and contextual factors associated with drug overdose deaths in the United States.

TL;DR: Analysis of compositional and contextual factors associated with drug overdose deaths rates in the US reveals a consistently strong association between compositional mental health factors and census tract-level death rates from drug overdose.
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Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis.

TL;DR: Evidence from high-quality studies showed that opioid use was associated with statistically significant but small improvements in pain and physical functioning, and increased risk of vomiting compared with placebo, and Comparisons of opioids with nonopioid alternatives suggested that the benefit for pain and functioning may be similar.
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TL;DR: The factors that triggered the opioids crisis and its further evolution are analyzed, along with the interventions to manage and prevent opioid use disorder (OUD), which are fundamental for curtailing the opioid crisis.
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Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism.

TL;DR: The findings suggest that ketamine's acute antidepressant effect requires opioid system activation, and the dissociative effects of ketamine are not mediated by the opioid system, and they do not appear sufficient without the opioid effect to produce the acute antidepressant effects ofketamine in adults with treatment-resistant depression.
References
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Journal ArticleDOI

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TL;DR: The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
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CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016

TL;DR: This guideline is intended to improve communication about benefits and risks of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy.
Journal ArticleDOI

Depression and pain comorbidity: a literature review.

TL;DR: A model that incorporates assessment and treatment of depression and pain simultaneously is necessary for improved outcomes.
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