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.
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.
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4. Seal K et al, JAMA. 2012;307(9):940-947)