Mental illnesses as a potential risk factor for non-medical use of prescription opioids: a narrative review

Abstract

This review summarises the available evidence on mental illnesses as a potential risk factor for non-medical use of prescription opioids (NUPO) and discusses how these findings may be applicable to clinicians in the Australian healthcare setting. A literature search of PubMed and Embase was conducted in November 2019 to identify articles on NUPO and mental illnesses; articles were considered relevant if they examined associations between NUPO and mental illnesses. A narrative synthesis was used to summarise the findings. The evidence synthesised from this review shows that mental illness may be a risk factor for NUPO. Although there is limited literature in Australia, strong associations between mental illness and NUPO were identified among various study cohorts, including people receiving treatment for risky substance use, chronic pain patients and community-based samples. Pharmacists can be involved in potential strategies to reduce NUPO-related harm, particularly for individuals who are more likely to engage in NUPO. Understanding potential risk factors for NUPO, such as the diagnosis of a mental illness, may inform safer and more effective opioid dispensing and prescribing by clinicians.