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

Abstract

Purpose: To assess the relationship between state-level depression and opioid overdose deaths between 2011 and 2015 in the United States. Methods: 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. Results: A 1% point increase in state-level depression diagnoses was associated with a 26% (95% CI 1–58%) increase in opioid analgesic-related deaths. Conclusions: Addressing depression in the provider–patient relationship may be important, as may be addressing the mental health provider shortage in the United States.