US Army researchers have found that soldiers coming home from war suffer from chronic pain and use prescription opioids at far higher rates than civilians. In a survey of an infantry brigade that had recently returned from Afghanistan, 44% of soldiers reported having been in pain for at least three months and 15% had used opioids during the past month. By comparison, researchers estimate than 26% of civilians live with chronic pain and 4% use opioids.
“We were surprised by the percentages,” said Robin Toblin, a psychologist at the Walter Reed Institute of Research and lead author of the study published on Monday in the journal JAMA Internal Medicine.
The study suggested that despite the military’s efforts to improve pain management, a growing concern during the course of the recent wars, more needs to be done. It also raised but did not answer questions about whether opioids were being prescribed properly.
Opioid medications are strong painkillers prescribed for chronic pain, but those who take them can become addicted, accidentally overdose or develop other health problems. Reports indicate increasing use of opioid medications among US adults in general.
“Recently, rates of opioid use and misuse have ballooned, leading to significant numbers of overdose-related hospitalizations and deaths,” the study researchers, led by psychologist Robin wrote in the study.
A rapid rise in the use of prescription opioids such as oxycodone and hydrocodone has been a growing public health concern as the number of overdose deaths and rates of addiction skyrocket. More than 16,000 people a year die of overdoses, quadruple the number in 1999.
The drugs are effective for moderate and severe short-term pain. While they are often used for chronic pain, there is little evidence that the benefits outweigh the risks.
Chronic pain and use of opioids carry the risk of functional impairment of America’s fighting force.
The Army researchers surveyed 2,597 soldiers three months after their brigade returned from Afghanistan. A small number had been deployed to Iraq. Combat injuries were the biggest risk factor for chronic pain.
Among the 1,131 soldiers reporting chronic pain, nearly half described it as mild and nearly 14% said it was severe.
“This might imply that opioids are working to mitigate pain but it is also possible that soldiers are receiving or using these medications unnecessarily,” the researchers wrote. “This is cause for concern because opioids should be prescribed generally for moderate to severe pain and have high abuse and overdose potential.”
Among the soldiers who reported having chronic pain, 48 percent said they had had pain for a year or longer, 56 percent reported having pain almost every day and 51 percent reported moderate to severe pain. Also, 23 percent of this group reported using opioids in the past month.
In a commentary on the new findings, Dr. Wayne Jonas of the Samueli Institute in Alexandria, Virginia, and Dr. Eric Schoomaker of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, said the study’s findings show the worrisome impact of recent wars on the rates of pain and narcotic use among soldiers.
“The nation’s defense rests on the comprehensive fitness of its service member’s mind, body and spirit. Chronic pain and use of opioids carry the risk of functional impairment of America’s fighting force,” they wrote.
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