Chronic Pain, Opioid Use Much Higher Among Soldiers

When compared with the general population, the rate of chronic pain and opioid use are much higher among soldiers, according to a study of 2,597 Army infantry members.

Conducted in 2011, after the aforementioned soldiers had been deployed from combat in Afghanistan or Iraq, a team including researchers from the Walter Reed Army Institute of Research and the Samueli Institute found that 44 percent reported experiencing chronic pain, while 15.1 percent indicated they had used opioids sometime in the previous month. According to the authors, the study is among the first to quantify the impact of recent wars on the prevalence of pain and the use of narcotics among soldiers.
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Among those reporting opioid use, 44.1 percent said they had experienced only mild or no pain in the past month. Those with chronic pain were more likely to be over the age of 30, to be married or have been married, to be injured in combat, to be in high-intensity combat, or to have experienced post-traumatic stress disorder or major depressive disorder, according to the researchers, who note that use of opioids was associated with sex, an age of 25 years or older, being married, rank, injury during combat, chronic pain, and pain severity.

The findings suggest “a large unmet need for the assessment, management, and treatment of chronic pain, and it is critical that the need be addressed,” says Robin Toblin, PhD, MPH, a clinical research psychologist at the Walter Reed Army Institute of Research, and co-author of the study.

“It is also key that clinicians follow the DoD/VA clinical practice guidelines for the management for opioid therapy for chronic pain,” says Toblin, “which recommend caution when prescribing opioids and suggest that other nonopioid options be considered whenever possible.

—Mark McGraw

Reference

Toblin R, Quartana P, et al. Chronic Pain and Opioid Use in US Soldiers After Combat Deployment. JAMA Intern Med. 2014.