Biography
Biography: Norman S Miller
Abstract
The psychiatric symptoms, particularly depression and anxiety, associated with chronic use of opioid medications as a result of
overprescribing are common and debilitating. Opioid medications are classifi ed as depressants and induce serious depression and
anxiety, particularly with chronic and persistent use. Th e Diagnostic and Statistical Manual of Mental Disorders, fi ft h edition (DSM-
5) provides diagnoses for these opioid-induced conditions. Substance-induced disorders, particularly for depression and anxiety,
include intoxication and withdrawal, substance/medication-induced depressive disorder and substance/medication-induced anxiety
disorder. Importantly, DSM-5 criteria indicate that diagnoses for major depressive disorder and anxiety disorder cannot be made if
there is a substance, such as opioid medications, responsible for the condition. Oft en the way to distinguish between a substanceinduced
disorder and an independent major depressive or anxiety disorder is to discontinue the opioid medications. Given that
opioids are not effi cacious for long-term prescribing, discontinuation of the medication is the treatment of choice.