Did you check for PTSD or mTBI before prescribing opioid pain medications?
Post-Traumatic Stress Disorder (PTSD) and mild Traumatic Brain Injury (mTBI or concussion) are increasing in the U.S., and are often undiagnosed. Chronic pain frequently accompanies both conditions, which can intersect with each other and opioid pain medications in dangerous ways:
- Up to half of patients with PTSD and up to 95% of people suffering TBI develop chronic pain.
- PTSD is strongly associated with opioid use and abuse.
- PTSD and TBI often co-occur and amplify overlapping symptoms.
Providers who know what to look for and who understand the treatment options for PTSD, mTBI and chronic pain can dramatically help their patients.
Understand PTSD, mTBI and Chronic Pain
COPE-REMS CME equips you with the information and tools you need to treat patients with chronic pain.
7 Things You Should Know about PTSD and Use of Opioid Pain Medications
- About 25 million people in the U.S. will have PTSD at some point in their lives, and approximately one-third of veterans who have served in Iraq and Afghanistan return with PTSD and/or some form of mild Traumatic Brain Injury (mTBI). Chronic pain frequently accompanies both conditions. But the conditions themselves may go undiagnosed.
- Effective treatment of PTSD can dramatically improve patients’ lives. But failure to treat or improper treatment with opioid pain medicines can make some aspects of PTSD (e.g., avoidance) worse.
- PTSD and TBI often co-occur and amplify overlapping symptoms. PTSD is strongly associated with opioid use and abuse; TBI may also be a risk factor for abuse.
- Returning veterans with pain and PTSD are three times more likely to receive opioids compared to those without any mental health disorders. They are also more likely to be prescribed higher doses and dangerous drug combinations.
- Treating chronic pain with long-term opioids may slow recovery in people with PTSD and TBI.
- Psychotherapy is the first-choice treatment for PTSD, although the right pharmacotherapy can help. PTSD and chronic pain tend to improve together.
- Providers who know what to look for and understand the treatment options for PTSD and mTBI can reduce risk and help patients turn their lives around.
Did you check for PTSD before prescribing ER/LA opioids?
COPE-REMS CME equips you with the clinical information and tools to make sensible decisions. COPE includes a special section on PTSD and mTBI.
References:
1. Andreski P, Chilcoat H, Breslau N (1998). Post-traumatic stress disorder and somatization symptoms: a prospective study. Psychiatry Research 79, 131–138.
2. Uomoto JM, Esselman PC. Traumatic brain injury and chronic pain: Differential types and rates by head injury severity. Arch Phys Med Rehabil. 1993;74:61-64.
3. Sherman KB, Goldberg M, Bell KR. Traumatic brain injury and pain. Phys Med Rehabil Clin N Am. 2006;17:473-490.
4. Seal K et al, JAMA. 2012;307(9):940-947)
1. Andreski P, Chilcoat H, Breslau N (1998). Post-traumatic stress disorder and somatization symptoms: a prospective study. Psychiatry Research 79, 131–138.
2. Uomoto JM, Esselman PC. Traumatic brain injury and chronic pain: Differential types and rates by head injury severity. Arch Phys Med Rehabil. 1993;74:61-64.
3. Sherman KB, Goldberg M, Bell KR. Traumatic brain injury and pain. Phys Med Rehabil Clin N Am. 2006;17:473-490.
4. Seal K et al, JAMA. 2012;307(9):940-947)