Narcotic analgesics are another threat to ... - Fitness For Health

Veterans of the wars in Iraq and Afghanistan who suffer from psychiatric disorders, especially posttraumatic stress disorder (PTSD) are more likely than mentally healthy veterans using prescription narcotic analgesics, a new study finds.

The use of opioid analgesics such as OxyContin, Percocet and Vicodin, can be addictive and cause serious problems, say researchers.


?Veterans who used these narcotic analgesics had worse clinical outcomes,? said lead researcher Dr. Karen Seal, Medical Center Veterans Affairs (VA) in San Francisco. ?These results included wounds and injuries, alcohol and drug overdoses, opioid overdose, injuries from violence and even suicide. This was particularly true in the group with PTSD,? said Seal.

In the study of pain patients, those suffering from PTSD, a condition characterized by anxiety, were more than twice as likely to receive opioids than those not suffering from mental health problems. Seal said that these veterans were more likely to seek relief for the pain to seek treatment for mental health.

?We are trying to change that situation,? said Seal. Primary care physicians should screen patients for mental health problems and abuse of drugs or alcohol, and provide the first alternatives to opioid analgesics, as referring to mental health care or pain, he said.

The report appears in the March 7 issue of the Journal of the American Medical Association.

For the study, the Seal team observed the association between mental health problems and poor outcome (including accidents, overdoses and self-harm) with the use of prescription painkillers more than 140,000 veterans treated for pain in VA hospitals October 2005 to December 2010.

Almost 16,000 patients were prescribed analgesics for 20 or more days, the researchers found.

About 18 percent of veterans with PTSD and almost 12 percent of those with other mental health problems such as depression and anxiety were prescribed opioid analgesics, compared with less than 7 percent of those without problems Mental Health, results showed.

Veterans with PTSD were more likely to take higher doses and more of a painkiller mentally healthy veterans. They were also more likely than others to take sedatives and fill your prescriptions quickly, the researchers noted.

?This indicates they may be using their pain faster than prescribed and automedic?ndose? said Seal.

In addition, veterans with PTSD who also abused drugs were much more likely to prescribe them narcotic painkillers that those without mental health problems, the study found.

Jennifer Vasterling, chief of psychology at the VA Healthcare System of Boston and professor of psychiatry at the Faculty of Medicine, Boston University, said this study highlights the powerful combination of PTSD and pain.

?This study reinforces that the harmful effects of trauma in war zones and PTSD are comprehensive and go beyond the emotional symptoms negatively affecting other aspects of health and performance,? said Vasterling.

The poor results associated with greater use of prescription painkillers have ?significant implications for clinical management of pain in veterans with PTSD and pain,? said Vasterling.

Another expert, Simon Rego, director of psychology training at Montefiore Medical Center in New York City, said the study?s findings are troubling. ?We also know that veterans with PTSD have high rates of substance abuse disorders, and is believed to opioid therapy in patients with worse mental health substance abuse and mental health problems over time? he asked.

It is possible that veterans with mental health problems, especially PTSD, find barriers to mental health treatment and often use the VA primary care, where doctors may lack the specialized training for pain management and PTSD, he said.

?Clearly, further efforts to improve care for patients with pain and PTSD, and should take extra care when prescribing opioids to alleviate their distress,? Rego recommended.

The Department of Veterans Affairs acknowledged the concern about the abuse of prescription drugs, and said in a statement Tuesday that he was glad the study. ?While this research recognizes that VA is a leader in the administration of therapy for PTSD and pain, we recognize that much work remains ahead,? the statement said.

That work includes associate primary care physicians with nurses, mental health providers, pharmacists and social workers, said VA.

Source: http://corefitnessandhealth.com/2012/03/narcotic-analgesics-are-another-threat-to-traumatized-war-veterans-according-to-a-study.html

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