Prevalence of opioid pain reliever use and the relationship with mental health among soldiers

Background: Opioid pain reliever (OPR) use in the civilian population has increased dramatically in the last decade. This increase is associated with epidemic levels of abuse, addiction, and overdose hospitalizations and deaths. Few studies have examined the prevalence and correlates of OPR use in the military. Methods: Survey data were examined from cross-sectional surveys of soldiers' mental and physical health obtained while deployed to Afghanistan during summer 2010 (n=1000) and 3-months post-deployment during July 2011 (n=2722). Participants were asked about pain, types of pain medications used, and mental health symptoms. Results: Among deployed soldiers, 37.2% reported pain and 1.1% reported OPR use. Of soldiers in the post-deployment sample, 62.9% reported pain and 15.3% reported OPR use. Among those with pain, 3.0% of deployed soldiers reported OPR use compared to 23.9% of post-deployment soldiers. Adjusting for demographic variables, mental health symptoms were associated with OPR use in the post-deployment sample (Adjusted Odds Ratio (AOR) = 2.1, 95% Confidence Interval (CI): 1.5 – 2.9), but not in the deployed sample (AOR = 1.2, 95% CI: 0.3 – 5.9). Conclusions: While the proportion of soldiers who reported pain in the post-deployment sample is not quite double that of the deployed sample, the percentage of OPR use among soldiers who have pain in the post-deployment is eight times that of the deployed sample. Further, mental health symptoms were associated with OPR use in the post-deployment, but not during deployment. Possible explanations for these differences and implications will be discussed.