Misuse of Prescribed Pain Medication in a Military Population—A Self-Reported Survey to Assess a Correlation With Age, Deployment, Combat Illnesses, or Injury?

Abstract

Opioid misuse is a growing epidemic among the civilian and military communities. Five hundred prospective, anonymous surveys were collected in the emergency department waiting room of a military tertiary care hospital over 3 weeks. Demographics, medical and military characteristics were investigated for association with opioid use. Univariate logistic models were used to characterize the probability of misuse in relation to the demographic, medical, and military-specific variables. Traumatic brain injury (TBI) and posttraumatic stress disorder were investigated within different age cohorts with adjustment for deployment. The opioid misuse rate disclosed by the subject was 31%. Subjects with TBI were less likely to misuse opioids. We found a trend among younger cohorts to have a higher likelihood for misusing opioids when diagnosed with TBI or posttraumatic stress disorder with history of deployment in the past 5 years. The most common form of misuse was using a previously prescribed medication for a new pain. Traumatic brain injury and/or enrollment in post-deployment recovery programs maybe protective against opioid misuse. Chronic opioid use among young soldiers maybe viewed as a weakness that could influence opioid misuse. Younger cohorts of active duty service members could be at higher risk for misuse. Efforts to enhance close monitoring of misuse should address these at-risk populations.

Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.

“…Socioeconomic status has also been shown to be a risk factor for chronic opioid use (Schoenfeld et al 2017 ). Enlisted (Bennett et al 2013 ) and younger service members (Ramirez et al 2017 ) are much more likely to misuse opioids than officers and older service members. This was corroborated in our findings as well, which identified belonging to an enlisted family was a significant predictor of receiving a new opioid prescription 1 year or later after surgery.…”

Scoping Review of Opioid Use After Traumatic Brain Injury

“…38 Another survey conducted with community-based veterans reported increased opioid misuse among younger veterans with TBI and especially among those with TBI and PTSD. 40 In examining the role of TBI in illicit opioid use, a study found that more than half of a population of heroin users had a history of TBI and that a greater number of TBIs were associated with an early onset of heroin use. 34 Veterans with TBI were found to have a 3-fold increased risk of opioid overdose even when accounting for co-occurring psychiatric diagnoses.…”

Association Between Predeployment Optimism and Onset of Postdeployment Pain in US Army Soldiers

“… 6 Chronic pain in veterans is associated with other significant problems, such as functional disability, vocational limitations, family discord, greater health care use, traumatic brain injury, and psychiatric comorbidities, including posttraumatic stress disorder (PTSD), major depressive disorder, and substance abuse that includes opioid misuse. 5 , 8 , 9 , 10 , 11 , 12 , 13 …”

“…6 Chronic pain in veterans is associated with other significant problems, such as functional disability, vocational limitations, family discord, greater health care use, traumatic brain injury, and psychiatric comorbidities, including posttraumatic stress disorder (PTSD), major depressive disorder, and substance abuse that includes opioid misuse. 5,[8][9][10][11][12][13] Determining who might be at risk for chronic pain after deployment is essential. Previous studies have shown that in soldiers deployed to Afghanistan and Iraq the following characteristics are associated with postdeployment pain: older age (>30 years), 6 being married or previously married, 6 exposure to combat 6,14 (especially injury during combat 6 ), duty involving heavy physical labor, 6 and PTSD and other psychiatric conditions.…”

“…Such pain is frequently reported as lasting longer than 1 year, with more than half experiencing pain almost every day, if not constantly . Chronic pain in veterans is associated with other significant problems, such as functional disability, vocational limitations, family discord, greater health care use, traumatic brain injury, and psychiatric comorbidities, including posttraumatic stress disorder (PTSD), major depressive disorder, and substance abuse that includes opioid misuse …”