Pain and Opioid Use in Returning Troops
Written by Editor   
Wednesday, July 02, 2014 08:34 AM

Nearly half of a U.S. Army infantry brigade back home from Afghanistan reported experiencing pain for at least the past 3 months, and 15% said they had used opioids in the past month -- including some who indicated they were not in pain, researchers said. These numbers are much higher than reported in the civilian population and don't appear to correspond exclusively to combat injuries.

The results "suggest a large unmet need for assessment, management, and treatment of chronic pain and related opioid use and misuse in military personnel after combat deployments."

Two physicians with military connections said the findings were worrisome in the context of service readiness.  "The nation's defense rests on the comprehensive fitness of its service members -- mind, body, and spirit. Chronic pain and use of opioids carry the risk of functional impairment of America's fighting force."  The physicians also used the figures provided to suggest that much of the opioid use was inappropriate. Opioids are supposed to be prescribed only for moderate to severe pain, and their balance of benefit versus risk in chronic pain is not clearly positive, the physicians noted.  "We must transform ourselves in the way we manage pain."

Researchers surveyed some 2,600 brigade members 3 months after returning from a tour in Afghanistan, asking about their histories of pain and use of pain medications. Chronic pain was defined as pain lasting at least 3 months.  They found prevalences of 26% reported chronic plain and 4% reported opioid use.

A substantial minority of those with pain and using opioids had not been injured in combat.  

  • 44% said they had experienced pain meeting the definition of chronic
  • 23% reported moderate pain in the past month and 8% reported severe pain
  • 3% indicated they had used opioids at least half the days of the past month; another 3% said they used such drugs nearly every day

 For the group with chronic pain the following were noted:

  • 48% said it had lasted 1 year or more
  • 31% said they experienced pain nearly every day; another 25% characterized it as constant
  • 48% indicated their pain was generally mild (1-4 on a 10-point scale); 38% called it moderate (5-6); 14% said it was severe (7-10).
  • 80% reported using over-the-counter pain medications, 19% used non-opioid prescription products, and 23% used opioids
  • About two-thirds of those using opioids took them less than half the days of the past month