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



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.

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

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Correspondence to Laura M. Schwab-Reese.

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Foley, M., Schwab-Reese, L.M. Associations of state-level rates of depression and fatal opioid overdose in the United States, 2011–2015. Soc Psychiatry Psychiatr Epidemiol 54, 131–134 (2019).

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  • Depression
  • Mental health
  • Opioid
  • Overdose