Presented at the 2012 AAPM Annual Meeting « Back

Opiate Prescription Practices for an Army Ranger Battalion

MAJ Jeffrey M. Tiede, MD, jeffrey.m.tiede@us.army.mil¹, COL John Rogers¹, Mary Ellen Earwood, MD¹, (1) Dwight D. Eisenhower Army Medical Center, Ft. Gordon, GA

Note: The views expressed in this abstract are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. Introduction: Our military leaders are concerned with the increasing abuse of opioids among active duty soldiers. Epidemiologic data on opiate use, substance abuse, and concomitant pain morbidity is essential in order to develop comprehensive programs of soldier functional rehabilitation. Materials and Methods: Using the Military Health System Mart data warehouse, we collected data from an Army Ranger Battalion of 797 soldiers for the fiscal year 2010. Collected data included opiate prescriptions as well as incidence of chronic pain, substance abuse, and traumatic brain injury. We defined chronic pain as soldiers with multiple, recurring diagnoses of common conditions seen in pain clinics such as lumbar spondylosis. Substance abuse totals the soldiers referred to the Army Substance Abuse Program or to an inpatient substance abuse treatment facility. Results: 205/797 soldiers (26%) took an opiate with a total of 379 prescriptions. 469/797 (59%) had been treated with muscle relaxants. 161/797 (20%) suffered from chronic pain. 9/797 (1%) carried a diagnosis of substance abuse. Discussion: It is estimated that 116 million Americans suffer from chronic pain.¹ It is difficult to imagine chronic pain prevailing in active duty soldiers, but years of up-tempo deployments in two wars has had a significant impact on even our most elite forces. Internal documents suggest that almost 14% of all Army soldiers were prescribed some form of opiate; and according to Inspector General Reports, 25%-35% of all soldiers in units for the wounded were either dependent or addicted to controlled substances. Although we did not ask the specific incidence of dependence or pathologic intake of opiates in our cohort, we did find that over ¼ of these elite soldiers received an opiate prescription during FY10. This highlights the need for further study on long term outcomes of opiates and reiterates the need for judicious and educated prescription practices. References: 1)Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011.

Funding: None