The associations of opioid and benzodiazepine prescriptions with injuries among US military service members.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
02 May 2024
02 May 2024
Historique:
received:
19
12
2023
accepted:
18
03
2024
medline:
6
5
2024
pubmed:
6
5
2024
entrez:
6
5
2024
Statut:
aheadofprint
Résumé
Given the high rates of physical trauma and pain among service members, opioid-prescribing practices and use patterns have significant implications for the well-being of service members and can affect military medicine and personnel readiness. This study measured the association between prescribed opioid and benzodiazepine medications and subsequently reported injuries (accidental, alcohol and drug related, self-inflicted, and violence related) among active duty military members. Participants were service members who entered the military between January 1, 2005, and June 30, 2010. In a nested case-control design, we compared individuals with injuries to individuals without injuries with respect to their opioid and benzodiazepine prescriptions in the 30 days before the injury of an index case. We used a multiintercept, logistic regression model to compare coefficient estimates by injury type. Overall, approximately 17% of individuals with an injury and 4% of individuals without an injury had a recorded opioid prescription. Individuals with an injury of any type had greater odds of prior exposure to opioid prescriptions than controls. Although a dose-response effect was observed for all injury types, it reached a plateau sooner for natural or environmental accidents and self-inflicted injuries relative to alcohol-related and drug-related injuries, violence-related injuries, vehicle accidents, accidental falls, and other accidents. Benzodiazepine prescriptions were found in 3.5% of individuals with an injury and 0.5% of individuals without an injury. The association between benzodiazepine prescriptions and injuries was strongest for natural and environmental accidents.
Identifiants
pubmed: 38709494
doi: 10.1097/j.pain.0000000000003264
pii: 00006396-990000000-00586
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 International Association for the Study of Pain.
Références
Armed Forces Health Surveillance Center. Mental disorders and mental health problems, active component, U.S. Armed Forces, January 2000—December 2009. MSMR 2010;17:6–12.
Chihuri S, Li G. Use of prescription opioids and motor vehicle crashes: a meta analysis. Accid Anal Prev 2017;109:123–31.
Dassanayake TMP, Carter G, Jones A. Effects of benzodiazepines, antidepressants and opioids on driving. Drug Saf 2011;34:125–56.
Dembek ZF, Chekol T, Wu A. The opioid epidemic: challenge to military medicine and national security. Mil Med 2020;185:e662–e667.
Department of Veterans Affairs, Department of Defense. VA/DoD clinical practice guideline for the use of opioids in the management of chronic pain. NW Washington DC: Department of Veterans Affairs, 2022.
Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC clinical practice guideline for prescribing opioids for pain—United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1–95.
Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, Welsner CM, Silverberg MJ, Campbell CI, Psaty BM, Von Korff M. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med 2010;152:85–92.
Elzey MJ, Barden SM, Edwards ES. Patient characteristics and outcomes in unintentional, non-fatal prescription opioid overdoses: a systematic review. Pain Physician 2016;19:215–28.
Garg RK, Fulton-Kehoe D, Franklin GM. Patterns of opioid use and risk of opioid overdose death among medicaid patients. Med Care 2017;55:661–8.
Gomes T, Redelmeier DA, Juurlink DN, Dhalla IA, Camacho X, Mamdani MM. Opioid dose and risk of road trauma in Canada: a population-based study. JAMA Intern Med 2013;173:196–201.
Harrell FE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. New York: Springer, 2001.
Hayes CJ, Krebs EE, Hudson T, Brown J, Li C, Martin BC. Impact of opioid dose escalation on the development of substance use disorders, accidents, self-inflicted injuries, opioid overdoses and alcohol and non-opioid drug-related overdoses: a retrospective cohort study. Addict 2020;115:1098–12.
Hernandez I, He M, Brooks MM, Zhang Y. Exposure-response association between concurrent opioid and benzodiazepine use and risk of opioid-related overdose in medicare Part D beneficiaries. JAMA Netw Open 2018;1:e180919.
Hudson TJ, Painter JT, Martin BC, Austen MA, Williams JS, Fortney JC, Sullivan MD, Edlund MJ. Pharmacoepidemiologic analyses of opioid use among OEF/OIF/OND veterans. PAIN 2017;158:1039–45.
Jeffery DD, Luckey B, Balison BM, Klette KL. Use and abuse of prescribed opioids, central nervous system depressants, and stimulants among U.S. active duty military personnel in FY 2010. Mil Med 2014;179:1141–8.
Kazanis W, Pugh MJ, Tami C, Maddry JK, Bebarta VS, Finley EP, McGeary DD, Carnahan DH, Potter JS. Opioid use patterns among active duty service members and civilians: 2006–2014. Mil Med 2018;183:e157–e164.
Macey TA, Morasco BJ, Duckart JP, Dobscha SK. Patterns and correlates of prescription opioid use in OEF/OIF veterans with chronic noncancer pain. Pain Med 2011;12:1502–9.
Park TW, Saitz R, Ganoczy D, Ilgen MA, Bohnert AS. Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study. BMJ 2015;350:h2698.
Psychological Health Center of Excellence. DoD opioid prescriber safety training. Falls Church, VA: Defense Health Agency, 2016.
Reif S, Adams RS, Ritter GA, Williams TV, Larson MJ. Prevalence of pain diagnoses and burden of pain among active duty soldiers, FY 2012. Mil Med 2018;183:e330–e337.
Seal KH, Shi Y, Cohen G, Cohen BE, Maguen S, Krebs EE, Neylan TC. Association of mental health disorders with prescription opioids and high-risk opioid use in US veterans of Iraq and Afghanistan. JAMA 2012;307:940–947.
StataCorp. Stata statistical software: release 15. College Station: StataCorp, LLC, 2017.
Sun EC, Dixit A, Humphreys K, Darnall BD, Baker LC, Mackey S. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ 2017;356:j760.
Toblin RL, Quartana PJ, Riviere LA, Walper KC, Hoge CW. Chronic pain and opioid use in US soldiers after combat deployment. JAMA Intern Med 2014;174:1400–1.
Von Korff MV, Saunders K, Thomas Ray G, Boudreau D, Campbell C, Merrill J, Sullivan MD, Rutter CM, Silverberg MJ, Banta-Green C, Weisner C. De facto long-term opioid therapy for noncancer pain. Clin J Pain 2008;24:521–7.
Watrous JR, McCabe CT, Jones G, Farrokhi S, Mazzone B, Clouser MC. Low back pain, mental health symptoms, and quality of life among injured service members. Health Psychol 2022;39:549–57.
White JM, Irvine RJ. Mechanisms of fatal opioid overdose. Addict 1999;94:961–72.