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Chronic pain and opioid use much higher among soldiers


 

FROM JAMA

Rates of chronic pain and opioid use are significantly higher among soldiers, compared with the general population, a survey of 2,597 Army infantry soldiers showed.

The survey, conducted in 2011 after the soldiers had been deployed from combat in Afghanistan or Iraq, found that 44% of the soldiers reported experiencing chronic pain and 15.1% declared that they had used opioids sometime in the past month.

The survey also found that among those reporting opioid use, 44.1%% said they had experienced only mild or no pain in the past month, while among those with chronic pain, only 23.2% had received opioids in the past month, according to a research letter published online June 30 (JAMA 2014 [doi:10.1001/jamainternmed.2014.2726]).

Those with chronic pain were more likely to be aged over 30 years, to be married or have been married, to be injured during combat, to be in higher-intensity combat, or to have experienced posttraumatic stress disorder or major depressive disorder. Use of opioids was associated with "sex, age 25 years or older, being married, rank, injury during combat, chronic pain, and pain severity," wrote Robin L. Toblin, Ph.D., and colleagues.

"These findings suggest a large unmet need for assessment, management, and treatment of chronic pain and related opioid use and misuse in military personnel after combat deployments," said Dr. Toblin of the center for military psychiatry and neuroscience at the Walter Reed Army Institute of Research in Silver Spring, Md.

An accompanying editorial contrasted the figures for chronic pain and opioid use in the military with those in the general population – 26% and 4%, respectively (JAMA 2014 June 30 [doi:10.1001/jamainternmed.2014.2114]).

"While chronic pain and opioid use have been a long-standing concern of the military leadership, this study is among the first to quantify the impact of recent wars on the prevalence of pain and narcotic use among soldiers," wrote Dr. Wayne B. Jonas of the Samueli Institute in Alexandria, Va., and the Uniformed Services University of the Health Sciences in Bethesda, Md., and Dr. Eric B. Schoomaker, also of the Samueli Institute.

No conflicts of interest were declared.

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