March 6th, 2012
05:21 PM ET

Veterans with PTSD more likely to be be prescribed painkillers

As veterans return from Iraq and Afghanistan, they continue to experience pain at home. And those who are diagnosed with mental health issues, including PTSD, are most likely to be prescribed opioid painkillers, according to a new study.

When surveying more than 140,000 veterans from Afghanistan and Iraq who had been diagnosed with some sort of pain, the study’s authors found that veterans with any mental health diagnosis, including depression, anxiety disorders, or drug and alcohol abuse, were 2.4 more times likely to be prescribed opioid painkillers, like oxycodone and hydrocodone, than veterans without any mental health diagnosis.

When looking at veterans diagnosed with PTSD, in particular, that rate was even higher. 17% of those with PTSD were prescribed opioids compared to just 6.5% of veterans without any mental health diagnosis.

The study, published in the Journal of the American Medical Association and conducted by Dr. Karen Seal of the San Francisco Veteran's Administration Medical Center and her co-authors, is the first national-level study of veterans from Iraq and Afghanistan to look at correlations between mental diagnosis and pain treatment.

“Nearly half of all Veterans returning to this country and presenting for care at the VA had pain problems. A percentage of these patients also suffer from mental health problems of the invisible injuries of war such as depression but in more cases, PTSD,” says Seal.

Since the mid-1990s there has been an increasing awareness of how to treat pain. In 2000, the VA adopted the idea of “pain as the 5th vital sign.” Because of the increased awareness of pain treatment, the prescription of opioids has nearly doubled, nationally, since 1994.

However, with increased use of opioids, there is also an increasing rate of misuse and overdose. According to the CDC, every 19 minutes, someone dies from an unintentional drug overdose and opioids are the most commonly associated drugs involved in these deaths. Prescription drugs are involved in more overdose deaths than heroin and cocaine combined, according to the CDC.

The study followed the veterans over the course of a year, to determine their opioid use. The authors found veterans with PTSD, were also at highest risk for self-inflicted injuries and alcohol-related, drug-related, and opioid-related accidents and overdoses.

“These patients tend to receive higher dose opiates than their counterparts and would request early refills of their opiates which indicates that they are using them more quickly than they should be,” says Seal.

In addition, veterans with PTSD were the most likely to be prescribed more than one opioid, as well as benzodiazepines. Another point of concern, because the combination of these two families of drugs, can lead to an overdose.

The authors emphasized that the study didn’t find that PTSD or other mental health diagnosis caused increased pain or opioid use. Rather, the study was an alarm to the consequences of pain management through opioids.

“We now need to start considering alternative solutions to relieving our patient’s pain and suffering,” Seal noted.

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Filed under: Medications • Pain • PTSD

soundoff (5 Responses)
  1. GA1966

    Alllow veterans the use of medical cannabis, problem solved. Cannabis has been proven to help with PTSD and its use also helps reduce the need for so many opioid painkillers. Cannabis also can cure cancers, google it!

    March 7, 2012 at 12:29 | Report abuse | Reply
    • Jeremy

      Vets are allowed to use cannabis in states that have accepted it for medical use. I am a Texas veteran with degenerative disk disease, anxiety disorder, and periodic limb movement disorder. The VA has drug tested me for everything except cannabis. Pills are addicting and cannabis is not so I pick the safest route.

      March 7, 2012 at 16:13 | Report abuse |
  2. muzzylu

    It's too bad that it is taking so long for people to get medical marijuana. Sometimes people just drift into excessive drinking or lots of opiates to self-medicate for pains or depression, if they had access to medical marijuana, they could have relief of their pain. I have back pain and medical marijuana does help. Instead of medicating with opiates, booze, or other harmful drugs, medical marijuana taken in edibles really works for me and many others.
    Great e-book on medical marijuana: MARIJUANA – Guide to Buying, Growing, Harvesting, and Making Medical Marijuana Oil and Delicious Candies to Treat Pain and Ailments by Mary Bendis, Second Edition. This book has great recipes for easy marijuana oil, delicious Cannabis Chocolates, and tasty Dragon Teeth Mints. goo.gl/iYjPn  goo.gl/Jfs61

    March 7, 2012 at 20:04 | Report abuse | Reply
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    April 14, 2012 at 12:10 | Report abuse | Reply
  4. Jack Yianitsas

    I am a veteran of war. For five years, I experienced the debilitating symptoms of fear, anxiety, and depression. Often these symptoms are diagnosed by physicians as panic attack disorder or anxiety disorder. In a constant state of anxiety and panic, I searched desperately for a way out of my forest of despair. Following what seemed to be an almost insurmountable degree of frustration and disappointment, I found the way to permanent recovery from my severe anxiety symptoms. I have created a website to help others, including fellow veterans. Please visit my website @ http://www.frompanictopeace.com for more information.

    July 6, 2012 at 11:07 | Report abuse | Reply

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