The opioid epidemic is a public health problem associated with a host of negative outcomes. Although clinicians recognize covariation between opioid misuse with anxiety and depressive symptoms and disorders, research on this topic has only recently accumulated. Progress in this domain is impeded by the lack of systematic and integrative research to better understand and treat these co-occurring problems. This paper represents the first attempt to systematically review the empirical literature examining relations between opioid use and misuse, and anxiety and depression. In the first section, we define key terms and describe the article selection strategy. In the second section, we review the prevalence of anxiety and depressive symptoms among individuals who use and misuse prescription and illicit opioids. In the third section, we review the magnitude of associations between anxiety and depressive symptoms and disorders with opioid misuse, as well as highlight studies examining the longitudinal and temporal sequence of the relations between these variables. In the fourth section, we focus on experimental therapeutics, reviewing what is known about individual difference and transdiagnostic vulnerability factors for anxiety and depression that might contribute to opioid misuse and its symptoms. Finally, we discuss current knowledge gaps and present a heuristic model to guide future research.

阿片类药物流行是一个与许多负面后果相关的公共卫生问题。尽管临床医生认识到阿片类药物滥用与焦虑和抑郁症状和疾病之间存在协变，但有关这一主题的研究最近才积累起来。由于缺乏系统和综合的研究来更好地理解和处理这些同时发生的问题，该领域的进展受到阻碍。本文首次尝试系统地回顾研究阿片类药物使用和滥用以及焦虑和抑郁之间关系的实证文献。在第一部分中，我们定义关键术语并描述文章选择策略。在第二部分中，我们回顾了使用和滥用处方药和非法阿片类药物的个体中焦虑和抑郁症状的患病率。在第三部分中，我们回顾了焦虑和抑郁症状以及阿片类药物滥用障碍之间关联的程度，并重点研究了这些变量之间关系的纵向和时间序列。在第四部分中，我们重点关注实验疗法，回顾已知的个体差异以及可能导致阿片类药物滥用及其症状的焦虑和抑郁的跨诊断脆弱性因素。最后，我们讨论当前的知识差距并提出一个启发式模型来指导未来的研究。