Veterans with PTSD get risky painkillers

These vets are at high risk for drug and alcohol abuse, but they're twice as likely to get prescriptions for addictive painkillers than vets with only physical pain, according to the study, billed as the first national examination of the problem. Iraq and Afghanistan vets with PTSD who already had substance-abuse problems were four times more likely to get these drugs than vets without mental health-problems, the study found.

Subsequent suicides, other self-inflicted injuries, and drug and alcohol overdoses were all more common in vets with PTSD who got these drugs. These consequences were rare but still troubling, the study authors said.

The results underscore the challenge of treating veterans with devastating physical injuries and haunting memories of the horrors of war. But the findings also suggest that physicians treating these veterans should offer less risky treatment, including therapies other than drugs, the study authors and other experts say.

Opium-based drugs like morphine and hydrocodone can dull physical pain. Relatively few veterans are prescribed such drugs. But some doctors likely prescribe them for vets who also have mental pain "with the hope that the emotional distress that accompanies chronic pain will also be reduced. Unfortunately, this hope is often not fulfilled, and opioids can sometimes make emotional problems worse," said Michael Von Korff, a chronic-illness researcher not involved in the study.

The research involved all veterans of Iraq and Afghanistan who were diagnosed with non-cancer physical pain from October 2005 through December 2010 - or 141,029 men and women. Half of them also were diagnosed with post-traumatic stress disorder or other mental-health problems. The results were published Tuesday in the Journal of the American Medical Association. The Department of Veterans Affairs paid for the study.