Relationship between Religious Support and Major Depressive Episode for Adult Non-Medical Prescription Opioid Users and Non-Users

Background and Purpose: An estimated 2.1 million people in the US had an opioid use disorder, and in 2017, the US Department of Health and Human Services declared the opioid epidemic a public health emergency. Non-medical prescription opioid use (NMPOU) is linked with poor mental health outcomes. Previous research has shown that religious support is protective for mental health. This study fills the gap in knowledge about how to assist NMPOU users in decreasing or preventing their depression symptoms by incorporating religious support. This study addresses the following research questions: (1) How does NMPOU status impact the relationship between religious support and major depressive episode (MDE)? and (2) What factors contribute to increasing MDE for NMPOU people?

Methods: Data from the 2016 National Survey on Drug Use and Health were analyzed for 42,625 adults age 18 years and older. Weighted binary logistic regression analysis was conducted using STATA 15 to examine the odds of NMPOU and religious support with having a MDE, all within the past year. Religious support was measured by 1) the importance of one’s religious beliefs, 2) degree that one’s religious beliefs influence their decisions, 3) the importance that one’s friends share their religious beliefs, and 4) the number of religious services one attended in the past year. Subgroup analyses were conducted with NMPOU users compared to non-users.

Results: NMPOU was associated with increased odds of having a past-year MDE (OR = 2.99, 95% CI: 2.47, 3.62). The importance of one’s religious beliefs (OR = 0.78, 95% CI: 0.64, 0.93) and sharing one’s religious beliefs with friends (OR = 0.67, 95% CI: 0.58, 0.78) were associated with lower odds of having a past-year MDE. Sub-group analysis found the importance of one’s religious beliefs and sharing one’s religious beliefs with friends remained associate with lower odds for non-users (OR = 0.78, 95% CI: 0.64, 0.94) and (OR = 0.66, 95% CI: 0.56, 0.78), respectively. However, the association of religious support and MDE among NMPOU users was not statistically observed.

Conclusions and Implications: Results indicated that NMPOU was a risk factor for having an MDE among US adults. Religious support from friends and believing religious beliefs are essential in life were protective against MDE among non-users. However, NMPOU status appeared to negate the protective influence of religious support on MDE. Further research is needed to explore protective factors that can effectively address the association between opioid misuse and mental health and be incorporated into social work interventions targeting the opioid epidemic.