Soldiers with PTSD, other mental health issues, more likely to get high-risk opioids

Veterans of Afghanistan and Iraq with mental health issues, especially post-traumatic stress disorder (PTSD), were more likely to receive high-risk opioids for pain, and those with PTSD were more likely to suffer adverse clinical outcomes, according to a new study.

The increased risk of adverse clinical outcomes included alcohol-, drug-, and opioid-related accidents, and overdose, as well as self-inflicted injuries.

The study was published in the March 7 issue of JAMA.

“Our results revealed that veterans with PTSD-prescribed opioids for pain used higher doses for longer periods and experienced substantially more adverse clinical outcomes than veterans with other or no mental health disorders,” the authors stated.

Researchers conducted a retrospective cohort study involving 141,029 veterans of Iraq and Afghanistan who received at least 1 non-cancer pain-related diagnosis within 1 year of entering the Department of Veteran Affairs healthcare system from October 1, 2005, through December 31, 2010.

Approximately 15,675 veterans were prescribed opioids within a year of their initial pain diagnosis. Of those who were prescribed pain medications, veterans with PTSD were more likely than those without mental-health disorders to received higher-dose opioids (22.7% vs 15.9%). Veterans with PTSD were also more likely to receive 2 or more opioids concurrently, receive sedative hypnotics concurrently, or obtain early opioid refills.