Chronic pain in the military is increasingly being viewed as a serious concern. As we discussed a few months ago on this blog, stereotypes and military culture had made it difficult to estimate the amount of chronic pain among soldiers. At the time, the Department of Veterans Affairs estimated that there were millions of veterans who suffered from chronic pain on a daily basis.

New research has shed even more light on chronic pain in the military, estimating that 44% of soldiers experience chronic pain. 

The study, published in the JAMA Internal Medicine journal, measured the rates of chronic pain and opioid use among an infantry brigade that was returning home from Afghanistan. The brigade was composed of 2,597 soldiers who were interviewed 3 months after returning. A small percentage of those within the study group had also been deployed to Iraq. By organizing the study, researchers were hoping to provide a quantified look at exactly how many soldiers were returning from war with chronic pain, along with their rates of opioid use.

They found that:

  • 44% of soldiers in the brigade reported that they suffered from chronic pain, that is, pain that they had been experiencing for at least 3 months
  • 15% of the returning soldiers had used opioid medications in the previous month

Opioid use, in particular, is a worrying aspect in this case. Opioids are a class of medications derived from the opium plant. Now they are often used to treat pain that has not responded to other treatments. Researchers in the study were hesitant to definitively say whether these drugs were being overprescribed or used unnecessarily. However, they did note that of those prescribed opioid medications, 17 people in the study reported no pain and 144 described the pain as mild.

Unfortunately, overuse has been linked to risks of dependence, addiction, and overdose. Besides these very serious risks are other side effects like nausea, constipation, cognitive changes, sexual dysfunction, and respiratory issues.

The main types of opioids being prescribed are:

  • Morphine
  • Codeine
  • Thebaine
  • Hydrocodone
  • Oxycodone
  • Fentanyl
  • Methadone

In the JAMA study, they also compared the rates of opioid use and chronic pain in the military with rates among the general population. 

Researchers found that 26% of civilians suffer from chronic pain and only 4% use opioid medications. There are, obviously, differences in the rates of activity and injuries among the military. Combat injuries were the largest predictor and risk factor for developing chronic pain. An article on Healthline.com also notes that:

“Chronic musculoskeletal pain is one of the most common complaints heard in pain clinics. For U.S. military members, chronic pain is often a result of wear and tear to the body. And physical pain can often be compounded by mental angst. Many soldiers experience traumatic brain injuries, blast injuries, and post-traumatic stress, but continue working. Over time, the injuries build on one another.”

Dr. Wayne Jonas, an author on the accompanying study commentary also published in JAMA, also notes that, “You see younger people come in with pain because they’ve been jumping out of airplanes, etc. That accelerates arthritis.” The commentary, titled “Pain and Opioids in the Military: We Must Do Better,” goes on to note other detrimental impacts of this possible overuse and overprescription of opioids among the military. In conclusion, they noted that there were far greater risks than just those associated with opioid misuse.

They wrote:

“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.”

While these statistics and their implications are tough to bear, many organizations are beginning to approach this problem with compassion, outreach, and education. 

Veterans in Pain is a password-protected support group that was created for veterans, active-duty military, and their families to help them deal with their pain. Their offerings include education in pain management, online access to peer support groups, and other veteran-oriented resources. Through a partnership with the American Chronic Pain Association, Veterans in Pain also hosts multiple live events in Veterans Affairs’ facilities throughout the U.S. These events focus on pain management, wellness, and advice on starting and maintaining peer support groups.

Make the Connection is another online space for veterans to share experiences and support. Their Chronic Pain section provides tips for dealing with pain, resources for finding local healthcare and support facilities, and stories from other military personnel who suffer from chronic pain.

Finally, a military location, Fort Bragg, launched the Operation OpioidSAFE initiative to meet the challenges of opioid overuse among the veteran populations within their location. To do so, they focused on non-pharmaceutical approaches to pain management, like spinal cord stimulation and neuromodulation. They also asked soldiers to share their experiences with chronic pain and opioids. The video can be viewed here and acts as a sobering reminder of the costs of the U.S.’s reliance on opioid therapies.

Through compassion and education, many are hoping to strip back the facts about opioid use and chronic pain in the military, while helping those who suffer find help and support. 

Do you suffer from chronic pain caused by your time in the military? Share your story below or reach out to the mentioned support groups to find help.

Image by The U.S. Army via Flickr

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