Diagnostic profiles associated with long-term opioid therapy in active duty servicemembers.
Steven Dufour, Amanda Banaag, Andrew J Schoenfeld and 3 others
PMID 37162022WHAT IT FOUND
Active duty servicemembers with complex combinations of pain and mental health conditions were far more likely to receive long-term opioid therapy than those with single issues.
The 'Multisystem Multimorbid' profile had over nine times the odds of long-term use compared to the 'Relatively Healthy' group.
Key findings
01Servicemembers classified as 'Multisystem Multimorbid' had an odds ratio of 9.24 for receiving long-term opioid therapy compared to the 'Relatively Healthy' class.
02The 'Multisystem Multimorbid' class comprised less than 1% of the opioid-prescribed sample but accounted for 7.5% of all long-term opioid therapy cases.
03American Indian/Alaska Native servicemembers had the highest odds of long-term opioid therapy (OR = 1.27) compared to White servicemembers, contrary to general population trends.
STILL TO COME
What they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relies on prescription fill data, which does not confirm whether patients actually took the medication as prescribed. Diagnoses were only counted if present within seven days of the prescription, potentially underestimating the true burden of chronic conditions in the 'Relatively Healthy' class. The sample is limited to active duty military, who may have different healthcare access and behaviors than the general civilian population. The study period (2016-2019) overlaps with significant changes in military pain care policies, which may confound the results.
Declared interests
The study was deemed exempt from human subjects review by the Institutional Review Board of Uniformed Services University. No specific funding sources or author conflicts of interest are detailed in the provided text beyond the institutional affiliation.
The easy way to misread this
Do not assume that a patient with a single condition like acute musculoskeletal pain is at the same high risk for long-term opioid therapy as those with multiple co-occurring conditions. The risk is heavily concentrated in the 'Multisystem Multimorbid' profile, which is rare but carries significantly higher odds.