Higher prevalence of chronic pain, opioid use reported by soldiers returning from combat

Soldiers returning from combat in Afghanistan or Iraq reported a higher prevalence of chronic pain and opioid use compared with estimates in the general civilian population, according to a research letter published in JAMA Internal Medicine.

In 2011, researchers collected confidential surveys from 2,597 soldiers 3 months after returning from Afghanistan or Iraq. Researchers assessed past-month pain frequency and severity and past-month frequency of opioids and other pain medication use. Standardized scales assessed injuries during combat, combat intensity, posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and alcohol misuse. Researchers defined chronic pain by soldiers reporting pain duration of at least 3 months.

Overall, 45.4% of soldiers reported injuries during combat. Of the 15.1% of soldiers who reported past-month opioid use, researchers found 5.6% reported no past-month pain, 38.5% reported mild pain, 37.7% reported moderate pain and 18.2% reported severe pain. Forty-four percent of soldiers reported chronic pain, with 48.3% reporting duration of 1 year or longer, 55.6% reporting nearly daily or constant frequency of pain and 51.2% reporting severity of moderate to severe pain. According to study results, 23.2% of soldiers reported past-month opioid use and 57.9% reported few or several days use.

Study results showed chronic pain was significantly associated with age 30 years or older, being married or having been married previously, injury during combat, combat intensity, PTSD and MDD, while opioid use was associated with sex, age 25 years or older, being married, rank, injury during combat, chronic pain and pain severity.

“These results are notable because this is an operational unit of young soldiers surveyed at their workplace and are likely, in part, related to deployment effects, including injuries, combat exposure, and mental health conditions,” the researchers wrote. “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 deploys.”

For more information:

Toblin RL. JAMA Intern Med. 2014;doi:10.1001/jamainternmed.2014.2726.

Disclosure: The researchers have no relevant financial disclosures.

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