Written by: Hailey Davis and Kendall Chandler
As undergraduates, we recognize the importance of speaking out on important issues that affect our communities, especially those with long-lasting consequences. We would like to spread awareness about this intricate connection, as most individuals struggling with both conditions often do not receive appropriate treatment for either. In the ongoing opioid crisis, addiction is the main focus. However, there is another issue that deserves more attention: the relationship between opioid use and mental health disorders. These conditions are often related, and they affect individuals in many ways. Instead of treating these conditions separately, we must understand their connection to develop more effective treatment options.
Mental health struggles are widespread, according to the World Health Organization (WHO), 1 in 8 people experience mental health disorders. The understanding of this connection is crucial, considering how opioids can impact and alter brain chemistry. When opioids enter the brain, they trigger the release of dopamine, a neurotransmitter involved in mood regulation, motivation, social bonding, pleasure, and reward. Initially, opioids create feelings of euphoria and a sense of well-being, but continued use can eventually lessen the brain’s ability to produce dopamine on its own. As a result, the brain becomes dependent on opioids. An individual may experience emotional instability, decreased mood, and a loss of motivation, which can affect their relationships. Opioids also affect the brain’s ability to naturally produce oxytocin, which is responsible for trust and bonding. When oxytocin levels are disrupted, a person’s ability to form and maintain relationships decreases. This can lead to social isolation and difficulties in regulating emotions. Their day-to-day function can also become affected, showing that the opioid epidemic does not affect one person; it has a ripple effect on families and the community.
Drug abuse has caused widespread deaths throughout the United States. In Pennsylvania, opioids contributed to 82% of the 4,721 overdose deaths statewide, and these numbers should be compelling enough to want to act. The statistics from our area highlight the importance of these issues. Neighboring counties such as Allegheny County recorded 46.9 overdose deaths per 100,000 people, Westmoreland County had 36.4, and Fayette County had 44.3, with the top two suspected drugs being opioids/fentanyl. These numbers are high, and they will continue to increase if we do not properly address how to overcome these battles. For example, in 2024, it was reported that 87% of the overdose deaths in Allegheny County were due to opioids, which shows just how severe the epidemic is. A crucial first step in combating these issues would be to make it more acceptable for people to open up and talk about their struggles and seek help before it is a moment of crisis.
However, a significant barrier to this is the stigma around Opioid Use Disorder (OUD). Individuals dealing with both OUD and mental health disorders often face judgment instead of empathy, which discourages them from seeking help. According to the National Institute of Mental Health (NIMH), approximately 62% of individuals with OUD also experience a co-occurring mental illness. Although many people suffer from both conditions, only 24% receive treatment for both conditions. Recently, in Pennsylvania, it was discovered that courts were denying medication to people suffering from OUD. This poses a dangerous risk because when these life-saving medications are not available, people with OUD will experience severe withdrawal symptoms and are at an increased risk of relapsing. After further investigation, it was found that many people in Pennsylvania courts were also being denied their prescribed methadone and buprenorphine medications. This led to a situation where these individuals had to choose between their health and incarceration or dismissal from their treatment programs. This is a violation of the Americans with Disabilities Act (ADA) regarding individuals with OUD while they were under court supervision. As a result of this violation, courts were ordered to pay up to $100,000 to those affected and to train judges and employees on ADA requirements related to OUD medications. The U.S. Department of Justice’s agreement with Pennsylvania courts marks a significant shift in how OUD is approached, offering those with OUD the opportunity for rehabilitation instead of incarceration. By focusing on treatment and rehabilitation, we can better address the complex relationship between addiction and mental health, providing the necessary resources for those to heal.
Even though the situation may seem overwhelming, it is important to remember that recovery is possible. Support groups and treatment programs are available to assist people through their recovery journey, reminding them that they do not have to face their challenges alone. In Allegheny County, UPMC has an outpatient addiction medicine program that provides customized treatment plans for addiction without overnight hospital stays. They also offer medication-assisted therapy for substance use disorders, helping individuals safely detox without going through intense withdrawal symptoms. In Westmoreland County, Independence Health System offers Assertive Community Treatment (ACT), which provides flexible treatment and support to individuals living with severe mental illness. Every step towards recovery, no matter how big or small, is a sign of strength. Nobody is alone in this, and help is always available. Reaching out is the first step in the healing journey.