RESTON, VA — While use and misuse of opioids by active-duty servicemembers has been examined in several studies, much less is known about use of painkillers by their spouses.
A study in Military Medicine estimated the number of military spouses who received high-risk or long-term opioid prescriptions between 2010 and 2014. Authors from the Naval Health Research Center and ABT Associates also addressed how the MHS can help prevent risky prescribing in order to improve military force readiness.1
Researchers used data from the Millennium Cohort Family Study, a nationwide survey of 9,872 spouses of servicemembers with two to five years of military service and added information from the military’s Pharmacy Data Transaction Service about prescriptions for controlled drugs dispensed to the spouses.
“Our objectives were to estimate the prevalence of opioid prescribing indicative of long-term use (≥60-day supply or at least one extended-release opioid prescription in any three-month period) and, separately, high-risk use (daily dosage of ≥90 morphine mg equivalent or total dosage of ≥8,190 morphine mg equivalent, or prescriptions from more than three pharmacies, or concurrent prescriptions),” the authors explained.
Researchers also gathered information on the spouses’ physical health, sociodemographic characteristics, substance use behaviors, perceived social support and stresses associated with military stress, among others.
The spouses were predominantly female (86%), had not served in the military themselves (79%), and were spouses of enlisted (91%) active duty (86%) servicemembers, according to the study.
Results indicated that almost half (47.6%) of spouses obtained at least one opioid prescription during the two-year observation window, and 8.5% had received opioid prescriptions that posed risk to their health.
The authors pointed out that about 7% of the spouses met the criteria for receipt of high-risk opioid prescriptions, 3% obtained opioids from three or more pharmacies during a three-month period, and 4% of those who received any opioids received both long-term and high-risk prescriptions.
Associated with increased odds of obtaining high-risk prescriptions included adverse childhood experiences, physical pain and lack of social support, according to the research.
The authors noted that about 48% of military spouses had used MHS insurance to fill at least one opioid prescription during the two-year observation period, adding that DoD has taken measures to minimize high-risk opioid prescribing. Those included:
Passing prescribing guidelines in 2017,
Establishing the controlled drug management analysis reporting tool and
Establishing a pain management education and training program.
“These efforts should continue to expand as reducing the numbers of service members and spouses at risk for adverse events may be effective in reducing opioid misuse and improve the overall health and safety of military spouses and thus, the readiness of the U.S. Armed Forces,” the authors advised.
- McDonald DC, Radakrishnan S, Sparks AC, et al. High-risk and Long-term Opioid Prescribing to Military Spouses in the Millennium Cohort Family Study [published online ahead of print, 2020 Jul 22]. Mil Med. 2020;usaa146. doi:10.1093/milmed/usaa146