Recent Veterans’ Opioid Use Similar to U.S. Population

LITTLE ROCK, AR — Despite their issues with chronic pain, veterans who served in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) use opioids at about the same rate as the overall U.S. population.

That’s according to a first-of-its-kind study published recently in the journal Pain.1

“We found that use of opioids among OEF/OIF/OND veterans was characterized by use of moderate doses prescribed for fairly long periods of time,” explained lead author Teresa Hudson, PharmD, PhD, research scientist at the Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences. “However, chronic use among this group of veterans appeared to be lower than that of veterans who served in other time periods.”

For the study, researchers reviewed pharmacy claims data from the VHA in fiscal year 2012, determining that 23% of all OEF, OIF and OND veterans were prescribed an opioid in a given year. Most of the veterans, two-thirds, used the narcotics for a short period of time, but the remaining third took them chronically.

The percentage jumped to 35% among those with traumatic brain injury (TBI), according to the report.

Results indicated that most of the veterans received moderate doses ranging from 26 to 30 mg morphine equivalent dose daily, with median days of opioid use for all OEF/OIF/OND veterans being 30 to 40 days.

Those using opioids chronically tended to be young white men who were married and living in rural areas, study authors noted. Being diagnosed with post-traumatic stress disorder (PTSD) increased the likelihood of chronic painkiller use, with an odds ratio of 1.22, as did major depressive disorder (OR of 1.14) and tobacco use disorder (OR of 1.18).

Not surprisingly, pain also was a factor. Results noted that chronic use also was strongly associated with back pain (OR of 2.50) and that the likelihood of extending opioid prescriptions increased from OR of 3.76 for mild pain to OR of 8.49 for severe pain.

“Findings from this study suggest that opioid use patterns of OEF/OIF/and OND veterans are similar to those of the U.S. population and suggest that the opioid problem is not so much a VA problem, but rather, an American problem,” added study author Mark Edlund, MD, PhD, senior research scientist at RTI International.

  1. Hudson TJ, Painter JT, Martin BC, Austen MA, Williams JS, Fortney JC, Sullivan MD, Edlund MJ. Pharmacoepidemiologic analyses of opioid use among OEF/OIF/OND veterans. Pain. 2017 Mar 25. doi: 10.1097/j.pain.0000000000000874. [Epub ahead of print] PubMed PMID: 28195856.

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  1. Richard A. Lawhern, Ph.D. says:

    As far as this study goes, it seems to reflect common sense and decency. What is not said here is that thousands of veterans are being denied effective pain management and unilaterally being tapered down from higher doses of opioids by their VA providers. Some of those thousands have already committed suicide from being plunged into intractable agony. In some cases they have effectively been discharged without referral or support for opioid withdrawal. I commend to the authors, a few evenings of listening to “The Buchanan Report” on Internet talk radio. This venue regularly includes speakers who are dealing with the vile consequences of the VA having been directed by Congress to limit opioids under the restrictive and arbitrary policies of the US CDC March 2016 opioid prescribing guidelines.

    Pain is for the most part a symptom of underlying injury or disease rather than a disease unto itself — though there is some medical evidence that pain creates long term changes in the nervous system. It is very doubtful that the legal charter of the CDC even applies to public policy on pain treatment. Yet this guideline is ruining the lives of thousands of vets.

    It is time to repeal the CDC guidelines as biased, scientifically unsupported, and actively dangerous to the health and function of hundreds of thousands of pain patients, including Vets.

    Richard A. Lawhern, Ph.D.
    LTC USAF (COL select) Retired

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