Social Psychiatry and Psychiatric Epidemiology

, Volume 54, Issue 1, pp 131–134 | Cite as

Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011–2015

  • Madeline Foley
  • Laura M. Schwab-ReeseEmail author
Brief report



To assess the relationship between state-level depression and opioid overdose deaths between 2011 and 2015 in the United States.


We assessed the association between percent of state populations reporting depression diagnoses and number of opioid analgesic-related deaths using negative binomial generalized estimating equations.


A 1% point increase in state-level depression diagnoses was associated with a 26% (95% CI 1–58%) increase in opioid analgesic-related deaths.


Addressing depression in the provider–patient relationship may be important, as may be addressing the mental health provider shortage in the United States.


Depression Mental health Opioid Overdose 



This work was supported by the University of Colorado CU Science Discovery Program.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. 1.
    Seth P, Scholl L, Rudd RA, Bacon S (2018) Overdose deaths involving opioids, cocaine, and psychostimulants—United States, 2015–2016. MMWR Morb Mortal Wkly Rep 67:349–358CrossRefGoogle Scholar
  2. 2.
    Blau M (2017) STAT forecast: opioids could kill nearly 500,000 Americans in the next decade. Accessed 7 Jul 2017
  3. 3.
    Davis MA, Lin LA, Liu H, Sites BD (2017) Prescription opioid use among adults with mental health disorders in the United States. Am Board Fam Med 30(4):407–417CrossRefGoogle Scholar
  4. 4.
    Braden JB, Sullivan MD, Ray GT, Saunders K, Merrill J, Silverberg MJ, Rutter CM, Weisner C, Banta-Green C, Campbell C, Von Korff M (2009) Trends in long-term opioid therapy for noncancer pain among persons with a history of depression. Gen Hosp Psychiatry 31:564–570CrossRefGoogle Scholar
  5. 5.
    Quinn PD, Hur K, Chang Z, Scott EL, Krebs EE, Bair MJ, Rickert ME, Gibbons RD, Kroenke K, D’onofrio BM (2018) Association of mental health conditions and treatments with long-term opioid analgesic receipt among adolescents. JAMA Pediatr 172(5):423–430CrossRefGoogle Scholar
  6. 6.
    Volkow ND (2004) The reality of comorbidity: depression and drug abuse. Biol Psychiatry 56:714–717CrossRefGoogle Scholar
  7. 7.
    Scherrer JF, Salas J, Copeland LA, Stock EM, Ahmedani BK, Sullivan MD, Burroughs T, Schneider FD, Bucholz KK, Lustman PJ (2016) Prescription opioid duration, dose, and increased risk of depression in 3 large patient populations. Ann Fam Med 14:54–62CrossRefGoogle Scholar
  8. 8.
    Johnson EM, Lanier WA, Merrill RM, Crook J, Porucznik CA, Rolfs RT, Sauer B (2013) Unintentional prescription opioid-related overdose deaths: description of decedents by next of kin or best contact, Utah, 2008–2009. J Gen Intern Med 28:522–529CrossRefGoogle Scholar
  9. 9.
    Centers for Disease Control and Prevention (2017) CDC Wonder. Accessed 7 Jul 2017
  10. 10.
    Bachhuber MA, Saloner B, Cunningham CO, Barry CL (2014) Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999–2010. JAMA Intern Med 174:1668–1673CrossRefGoogle Scholar
  11. 11.
    Centers for Disease Control and Prevention (2017) Behavioral risk factor surveillance system. Accessed 1 Sept 2017
  12. 12.
    Centers for Disease Control and Prevention (2017) BRFSS prevalence and trends data. Accessed 5 Jun 2017
  13. 13.
    United States Census Bureau (2017) American factfinder. Accessed 7 Jul 2017
  14. 14.
    United States Census Bureau (2017) Guidance for data users. Accessed 18 Jun 2018
  15. 15.
    National Conference of State Legislatures (2017) State medical marijuana laws. Accessed 19 Sept 2017
  16. 16.
    Bureau of Labor Statistics (2017) Local area unemployment statistics. Accessed 16 Jun 2017
  17. 17.
    Yokell MA, Delgado MK, Zaller ND, Wang NE, McGowan SK, Green TC (2014) Presentation of prescription and nonprescription opioid overdoses to US emergency departments. JAMA Intern Med 174:2034–2037CrossRefGoogle Scholar
  18. 18.
    The Henry J Kaiser Family Foundation (2016) Mental health care health professional shortage areas (HPSAs). Accessed 7 Jul 2017

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Colorado, CU Science DiscoveryBoulderUSA
  2. 2.The Kempe Center for The Prevention and Treatment of Child Abuse and NeglectUniversity of ColoradoAuroraUSA
  3. 3.Department of Health and KinesiologyPurdue UniversityLafayetteUSA

Personalised recommendations