HOW DOES DEPRESSION AFFECT DRUG USE?

By Take The First Step , Dr. Michael Levy

Dear Dr. Levy: Is a person who is depressed more likely to turn to
using drugs than a person who is not depressed?

A: Researchers have looked at this issue, and clearly, there is a
relationship between psychiatric disorders, in particular depression,
and substance use. Depression is a risk factor for drug use.

Researchers found that young adults who experienced a major
depression within the past year of a study were twice as likely to
have initiated illicit drug use as compared to individuals who had
not experienced a major depression within the past year (12 percent
versus 5.8 percent).

However, I also want to say that the opposite relationship can also
occur - drug use can lead to depression, since using drugs can cause
so many problems for a person. Consequently, when a person is
depressed and also uses drugs, it can be difficult to figure out what
came first - the depression or the substance use.

The good news is that regardless of the specific relationship between
substance use and depression, if a person is going to be helped,
substance use must stop. If a person is no longer using drugs and
continues to feel depressed, the depression needs to be treated.

Dear Dr. Levy: I have heard that methadone is responsible for
causing many drug overdoses and death. Is this because of all the
take-home doses being given to people at methadone clinics?

A: You are right in that deaths from methadone overdoses rose 390
percent between 1999 and 2004, and there is concern that this trend
is continuing.

However, the supply of methadone on the streets is not primarily due
to take-home doses being given to individuals enrolled in methadone
treatment programs. Rather, it is due to the increasingly widespread
use of methadone for the treatment of chronic pain. It has been
documented that prescriptions for methadone rose by more than 700
percent from 2001 to 2006.

It should also be noted that the rate of methadone overdoses, while
rising, is still lower than the overdose rate for other narcotic
painkillers. This points to the widespread abuse and misuse of
prescription painkillers in general and not just the abuse and misuse
of methadone.

Send questions about addictions or related problems to: Take The
First Step, c/o Essex County Newspapers, 32 Dunham Road, Beverly, MA
01915; or send an e-mail to michael-levy@cabhealth.org. Questions
will be answered in confidence by a clinical team led by Dr. Michael
Levy, director of clinical treatment services at CAB Health &
Recovery Services in Peabody and author of "Take Control of Your
Drinking ... and You May Not Need to Quit."