Across the country, there's been a greater understanding of treating pain. The prescription of opioid pain relievers--drugs like codeine, vicodin or morphine--has nearly doubled since 1994. But at the same time, prescription opioid abuse, overdose and death has also increased dramatically. The same trends are true for veterans of the Iraq and Afghanistan wars. Today, due to medical advances and improvements in combat protective gear, higher numbers of veterans of these wars are surviving injuries. But once home, they continue to suffer both pain and mental health problems. They are often prescribed opioid pain relievers.
But little has been known about mental health disorders and the prescribing of opioids to veterans. Researchers at the San Francisco Veterans Affairs Medical Center and UCSF set out to address this question and found that veterans with mental health problems were more likely to be prescribed opioid drugs than veterans without mental health issues.
The study, published Tuesday in the Journal of the American Medical Association, reviewed information from more than 140,000 Iraq and Afghanistan war veterans who were diagnosed with pain. Veterans without mental health problems were prescribed opioids much less frequently--about 6.5 percent of them received these prescriptions. That rate went up to 11.7 percent in veterans with a mental health diagnosis. And the rate was highest--17.8 percent--for veterans with Post-Traumatic Stress Disorder (PTSD).
The study also showed that all veterans that were prescribed opioids had a higher risk of misusing their prescription opioid by either over-dosing, having drug-related accidents, hurting oneself, or other things that would cause them to end up in the Emergency Room. That risk was the greatest among those with PTSD.
Lead author Karen Seal is a physician at the San Francisco Veterans Affairs Medical Center and a professor at UCSF. She says the study results are troubling. "The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society."