Opioid and Nonpharmacologic Treatments Among Soldiers With Chronic Pain and Posttraumatic Stress Disorder.

Researchers studied over 576,000 U.S. Army soldiers returning from deployment in Iraq and Afghanistan to understand how chronic pain and post-traumatic stress disorder (PTSD) affect their treatment needs. They found that 12.2% of soldiers had chronic pain, 5.1% had PTSD, and 1.8% suffered from both conditions together. Among those with both chronic pain and PTSD, about 80% received non-drug treatments like therapeutic exercise, chiropractic care, acupuncture, or biofeedback, while 31% were prescribed opioids for more than 30 days.

The study revealed important findings about acupuncture specifically. Among soldiers with both chronic pain and PTSD, those who received acupuncture or biofeedback had 20% lower odds of being prescribed long-term opioids compared to those who didn't receive these treatments. Other non-drug treatments like exercise and chiropractic care didn't show the same protective effect against opioid use. This suggests that acupuncture may be particularly helpful for managing pain in people who also struggle with PTSD, potentially reducing their need for long-term pain medications.

For patients dealing with both chronic pain and PTSD, this research suggests that acupuncture could be a valuable part of a comprehensive treatment plan. It may help manage pain effectively while reducing reliance on opioid medications, which carry risks of dependence and side effects. The combination of addressing both physical pain and psychological stress through integrated care appears important for optimal outcomes. To get started with acupuncture, seek a licensed acupuncturist with experience treating both pain conditions and trauma-related disorders.

This retrospective cohort study analyzed 576,425 active duty U.S. Army soldiers returning from deployment (2008-2014) to examine treatment patterns for chronic pain and PTSD. Prevalence rates were 12.2% for chronic pain, 5.1% for PTSD, and 1.8% for comorbid conditions. Among soldiers with both diagnoses, 80.3% received nonpharmacologic treatment and 31.4% received opioid prescriptions exceeding 30 days' supply.

Multivariate logistic regression analysis revealed that comorbid PTSD without nonpharmacologic treatment increased odds of protracted opioid use (OR=1.4, 95% CI=1.3-1.6). Critically, PTSD combined with acupuncture or biofeedback demonstrated reduced odds of extended opioid prescriptions (OR=0.8, 95% CI=0.7-0.9), while therapeutic exercise and chiropractic treatments showed variable associations.

Clinical implications suggest acupuncture and biofeedback may be particularly effective modalities for reducing opioid dependence in patients with comorbid chronic pain and PTSD. The significant healthcare utilization in this population indicates need for integrated treatment protocols addressing both psychological and physical pain components to optimize outcomes and minimize long-term opioid exposure.