Research letter examines reports of chronic pain, opioid use by US soldiers

In a survey of U.S. soldiers returned from deployment, 44 percent reported chronic pain and 15.1 percent reported recent use of opioid pain relievers.

The prevalence of chronic pain and use associated with deployment is not well known, although there are large numbers of wounded service members. The authors assessed the prevalence of chronic pain and opioid use following deployment in active-duty infantry who were not seeking treatment.

How the Study Was Conducted: Surveys were collected in 2011 from an infantry brigade three months after service members returned from Afghanistan. The final sample included 2,597 soldiers who had been deployed to Afghanistan or Iraq. Chronic pain was defined as that lasting at least three months.

Results: Most of the 2,597 survey participants were men, 18 to 24 years old, high school-educated, married and of junior enlisted rank. Nearly half (45.4 percent) reported combat injuries. Past-month opioid use was reported by 15.1 percent of soldiers and among them 5.6 percent of the soldiers reported no past-month pain, while 38.5 percent, 37.7 percent and 18.2 percent reported mild, moderate and severe pain, respectively. Chronic pain was reported by 44 percent of soldiers. Of these, 48.3 percent reported pain duration of a year or longer, 55.6 percent reported nearly daily or a constant frequency of pain, 51.2 percent reported moderate to severe pain and 23.2 percent reported opioid use in the past month.

Discussion: "The prevalence of chronic pain (44 percent) and opioid use (15.1 percent) in this nontreatment-seeking infantry sample were higher than estimates in the civilian population of 26 percent and 4 percent respectively. … 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 deployments." Robin L. Toblin, Ph.D., M.P.H., of the Walter Reed Army Institute of Research, Silver Spring, Md., and colleagues said in their JAMA Internal Medicine paper.

In a related commentary, Wayne B. Jonas, M.D., LTC (Ret.) of the Samueli Institute, Alexandria, Va., and Eric B, Schoomaker, M.D., Ph.D., LTG (Ret.) of the Uniformed Services University of the Health Sciences, Bethesda, Md., write: "In a study by Toblin et al of one of the Army's leading units published in this issue of JAMA Internal Medicine, 44 percent of the soldiers had chronic pain, and 15.1 percent regularly used opioids."

"While and opioid use have been a long-standing concern of the military leadership, this study is among the first to quantify the impact of recent wars on the prevalence of pain and narcotic use among soldiers," they continue.

"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," they note.

More information: JAMA Intern Med. Published online June 30, 2014. DOI: 10.1001/jamainternmed.2014.2726
JAMA Intern Med. Published online June 30, 2014. DOI: 10.1001/jamainternmed.2014.2114

add to favorites email to friend print save as pdf

Related Stories

Low tolerance for pain? The reason may be in your genes

Apr 20, 2014

Researchers may have identified key genes linked to why some people have a higher tolerance for pain than others, according to a study released today that will be presented at the American Academy of Neurology's 66th Annual ...

Mind over matter: Beating pain and painkillers

Feb 04, 2014

With nearly one-third of Americans suffering from chronic pain, prescription opioid painkillers have become the leading form of treatment for this debilitating condition. Unfortunately, misuse of prescription opioids can ...

Recommended for you

Express Scripts turns to AbbVie in huge hepatitis C deal

1 hour ago

The nation's largest pharmacy benefits manager is throwing its weight into a fight over the high cost of treating hepatitis C, saying it will cover a drug from AbbVie while pulling back on those from rival drugmakers.

FDA OKs Cubist antibiotic for serious infections

Dec 20, 2014

The Food and Drug Administration has approved a new medicine to fight complex infections in the abdomen and urinary tract, the fourth antibiotic the agency has approved since May.

Xtoro approved for swimmer's ear

Dec 18, 2014

(HealthDay)—Xtoro (finafloxacin otic suspension) eardrops have been approved by the U.S. Food and Drug Administration to treat swimmer's ear, clinically known as acute otitis externa.

Drug interaction identified for ondansetron, tramadol

Dec 18, 2014

(HealthDay)—In the early postoperative period, ondansetron is associated with increased requirements for tramadol consumption, according to a review and meta-analysis published online Dec. 10 in Anaesthesia.

New system targets germs in donated blood plasma

Dec 17, 2014

(HealthDay)—A new system designed to eliminate germs in donated blood plasma and reduce the risk of transmitting a plasma-borne infection has been approved by the U.S. Food and Drug Administration.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.