Wednesday, March 7, 2012

PTSD Raises Likelihood of Opioid Medication Use

Veterans of the wars in Iraq and Afghanistan who are diagnosed with mental disorders are about twice as likely to be prescribed opioid pain medications and to have worse clinical outcomes than their counterparts seen in the VA health system. A study of 141,029 veterans treated for noncancer pain found that 6.5 percent with no mental health diagnosis were prescribed opioids, compared with 11.7 percent of those with a mental health diagnosis but not PTSD, and 17.8 percent with PTSD. Vets with PTSD were also more likely to receive higher doses or more than one drug and were at significantly increased risk for depression, anxiety, an alcohol or drug use disorder, and traumatic brain injury.

“These findings support further efforts to improve care of patients with comorbid pain and PTSD because of the heightened risk of self-medication with opioids and substance abuse in veterans with PTSD,” wrote Karen Seal, M.D., M.P.H., of the University of San Francisco, and colleagues in the March 7 Journal of the American Medical Association. “These patients may benefit from biopsychosocial models of pain care including evidence-based nonpharmacologic therapies and nonopioid analgesics.”

For comprehensive information on the diagnosis and treatment of PTSD, see American Psychiatric Publishing’s Clinical Manual for Management of PTSD.

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