The results of a new survey, published in JAMA Internal Medicine, show that 44% of soldiers returning from deployment report chronic pain and more than 15% report recent use of opioids for pain relief.
A quarter of people seeking primary health care are affected by chronic pain, for which opioids are a commonly prescribed medication. However, rates of opioid use and misuse are rising, which has led to significant numbers of hospitalizations and deaths caused by overdosing on these painkillers.
The extent of opioid use among soldiers returning from deployment has not previously been measured, so the Walter Reed Army Institute of Research in Silver Spring, MD, conducted the new study to investigate this.
The institute collected confidential surveys from one infantry brigade 3 months after they returned from Afghanistan in 2011. In total, the study looked at 2,597 participants.
Chronic pain in the study was defined by soldiers who reported pain that lasted at least 3 months, and the researchers also collected data on frequency and severity of symptoms over the past month, frequency of pain medication use, and details of the inflicted injuries.
The new survey is the first to study the extent of opioid use among soldiers returning from deployment.
Chronic pain was reported by 44% of the respondents. Of these:
- 48.3% had pain that lasted for 1 year or longer
- 55.6% had pain nearly every day
- 51.2% had moderate to severe pain
- 23.2% reported using opioids in the past month
- 57.9% reported using opioids for a few days.
The authors note that the prevalence of chronic pain at 44% of the returning soldiers, and opioid use at 15.1% among returning soldiers, are higher than the prevalence estimates of 26% and 4% respectively in the civilian population.
"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," the authors say.
In a linked commentary, Lt. Colonel Dr. Wayne B. Jonas of the Samueli Institute in Alexandria, VA, and Lt. General Dr. Eric B. Schoomaker of the Uniformed Services University of the Health Sciences in Bethesda, MD, write:
"While chronic pain 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.
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."
In April, Medical News Today reported on research that suggested tolerance to chronic pain may be influenced by genes. That study suggested that the gene variants DRD1, COMT and OPRK, and DRD2 are linked with low pain, moderate pain and high pain thresholds respectively.
In the same month, we also reported on a study that suggested low levels of vitamin D are linked to chronic pain. The results showed that people with vitamin D deficiency at the start of the study were more than twice as likely to experience chronic pain, compared with participants who had high levels of vitamin D.