Opioid and sedative misuse among veterans wounded in combat

Abstract

Background: Military veterans wounded in combat are a high-risk group for emotional and physical distress, which may be exacerbated by misuse of prescription opioids and sedatives. The goal of the current study was to examine the prevalence and correlates of prescription opioid and sedative misuse among veterans wounded in combat.

Method: We recruited veterans from the Combat Wounded Coalition (n = 212; 84% non-Hispanic White; 97.6% male) to complete an online survey of mental health and substance use disorder symptoms, assessed via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptoms Measure, the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, the Pain Enjoyment General Activity Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Prescription opioid and sedative misuse was assessed by frequency of use in the past year that was not currently prescribed or using more than prescribed.

Results: Participants reported high rates of past year prescription opioid misuse (46.2%) and sedative misuse (21.7%). Misuse of both opioids and sedatives was associated with the most distress, including greater depression, anger, sleep disturbance, AUDIT scores, PTSD symptoms, suicidality, and pain interference. In multivariable multinomial logistic regression analyses, greater sleep disturbance (OR = 1.73) was associated with greater odds of sedative misuse versus no misuse. Higher AUDIT scores were associated with greater risk of sedative misuse (OR = 1.16) versus opioid misuse only.

Conclusions: Military veterans wounded in combat have high rates of prescription opioid misuse and sedative misuse. Sleep problems and AUDIT scores might help identify veterans who are at most risk for opioid and sedative misuse.

Keywords: Mental health; Opioid misuse; Sedative misuse; Substance use disorders; Wounded veterans.