Veterans With History of Non-Medical Painkiller Abuse More Likely To Use Heroin

By McCarton Ackerman 08/29/16

Researchers are recommending that doctors screen veterans for non-medical painkiller use regardless of whether they are going to prescribe opioids. 

Veterans With History of Non-Medical Painkiller Abuse More Likely To Use Heroin

A new study has shown that U.S. military veterans with a history of non-medical use of opioid painkillers are more likely to eventually begin using heroin.

The findings were published in the latest issue of the journal Addiction. Researchers at Brown University and Yale University followed nearly 3,400 U.S. military veterans for a period of 10 years—none of whom reported ever having used heroin or misused painkillers when the study first began.

By 2012, 500 veterans had started using heroin—of them, 386 had also started using opioid painkillers for non-medical reasons.

The researchers concluded that vets who misused painkillers were 5.4 times more likely to begin using heroin—while receiving a short-term prescription for opioid medication decreased that likelihood to 1.7 times.

Other significant factors leading to heroin use included being male (2.6 times more likely) and abusing stimulants (2.1 times more likely). Interestingly, longer-term prescriptions of opioid medication was not seen as a significant risk factor.

"Our findings demonstrate a pattern of transitioning from non-medical use of prescription opioids to heroin use that has only been demonstrated in select populations," said study co-author David Fiellin, a Yale public health and medical professor. “Our findings are unique in that our sample of individuals consisted of patients who were receiving routine medical care for common medical conditions."

Corresponding author Brandon Marshall, an assistant professor in the Brown University School of Public Health, acknowledged that veterans face "a constellation of risks" for substance abuse. He recommended that “screening for non-medical painkiller use, whether you are prescribing an opioid or not, may be effective to prevent even more harmful transitions to heroin or other drugs.”

Based on a federal spending bill signed into law last year by President Obama, the Veterans Administration must follow guidelines set by the Centers for Disease Control and Prevention, which discourage prescribing opioids for chronic pain. But many veterans have complained that their dosages were cut without receiving an examination, and that the amount of medication they receive is insufficient to treat their symptoms.

“They just cut my meds to one oxycodone every 12 hours, which gives me absolutely no relief,” wrote Harvey Williams, a Vietnam vet, to the Pain News Network. “There must be something that the Veterans Administration can do to treat severe pain in the vets. It's not fair for us to be sprayed with Agent Orange, return back to the United States, develop diabetes and in turn have severe neuropathy and pain for the rest of our lives and not be treated.”

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.