Veterans with Stress Disorders Given Painkillers

Veterans of Iraq and Afghanistan who have PTSD (post-traumatic stress disorder) have an increased risk of succumbing to drug and alcohol abuse, but they are more than twice as likely to be prescribed opioid painkillers like morphine, oxycodone and hydrocodone.

A new government study also found veterans with PTSD and chronic pain who already have a substance abuse problem are five times as likely to be given opioid painkiller prescriptions.  Drug overdoses, violent behavior, accidents and suicides occur at higher rates among these same vets.

The drugs that are being given to veterans, which include OxyContin and Vicodin, are known to cause severe addiction problems.  The findings of the study suggest that doctors treating veterans who are suffering from the pain of catastrophic physical injuries as well as mental disorders caused by the trauma of war need to be more careful about prescribing highly addictive narcotic drugs for pain.  In many cases, therapies that don’t involve drugs should be used to treat pain.

The study, which was sponsored by the U.S. Department of Veteran Affairs, involved Iraq and Afghanistan veterans who were treated for non-cancer induced pain between 2005 and 2010.  More than 140,000 men and women were involved in the study, with nearly half affected by PTSD and other mental disorders.

Data release by the Army to the Associated Press in 2011 indicates that treatment referrals for opiate abuse among U.S. military personnel rose between 2000 and 2009.  This underscores what seems to be a lack of awareness on the part of many VA doctors about the dangers of opioid painkillers.  Dr. Robert Kerns, program director for pain management with the VA, says the study is valuable because it emphasizes the growing concern about using opioid drugs when treating chronic pain in young veterans.  According to Dr. Kerns, these drugs should only be used to treat chronic pain as one component of a comprehensive plan for pain management.

The authors of the study, which was published in the Journal of the American Medical Association, attribute much of the problem to a shortage of knowledgeable professionals prepared to deal with the problems of soldiers returning from war.  Few VA primary care doctors are trained to deal with the management of comorbid pain and PTSD.

Dr. William Becker, a professor at Yale University and doctor who treats veterans with substance abuse issues, praises the study for bringing attention to this complex problem.  According to Dr. Becker, treatment for veterans should include behavioral counseling and physical therapy in addition to the management of chronic pain.  “I think this paper is going to send another strong message that this has really got to become the standard of care.”  Our facility has information about treating both men and women suffering from PTSD and addiction.

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