Non-drug therapies given to patients with chronic pain may reduce the risk of long-term adverse outcomes, such as alcohol and drug disorder and self-induced injuries, including suicide attempts, according to a study published in the Journal of General Internal Medicine.
The study found that service members with chronic pain who received non-drug therapies while in the military, such as massage or acupuncture, had a significantly lower risk of new onset alcohol or drug disorder; poisoning with opioids and related narcotics, barbiturates, or sedatives; and suicidal thoughts and attempts.
Esther Meerwijk, VA Palo Alto Health Care System, Palo Alto, California, and colleagues reviewed the VA health records of more than 140,000 Army soldiers who reported chronic pain following their deployment to Iraq or Afghanistan from 2008 to 2014. The most common types of chronic pain were joint discomfort, back and neck issues, and other problems involving muscles or bones.
“Chronic pain is associated with adverse outcomes, such as substance use and suicidal thoughts and behavior,” said Meerwijk. “It made sense that if non-drug treatments are good at managing pain, their effect would go beyond only pain relief. However, I was surprised that the results of our analyses held, despite our attempts to prove them wrong. Often enough in research, significant results disappear once you start controlling for variables that can possibly affect the outcome of the study.”
The researchers controlled for length of a service member’s care in VA, whether the Veteran had been exposed to non-drug therapies in VA, and the number of days a VA patient received opioids. They also tested to see if service members who received non-drug treatments were healthier to begin with and if more Veterans who received non-drug therapies died before any of the adverse outcomes occurred.
The largest difference was seen with regard to accidental poisoning with opioids or other pain drugs. Those who received non-drug therapies were 35% less likely to injure themselves than those who didn’t receive such therapies while in the service. Service members who received non-drug treatments were also at lower risk down the road for self-inflicted injuries, including suicide attempts (17% less likely), suicidal ideation (12% less likely), and alcohol or drug use disorders (8% less likely).
The median age of the cohort was 26 years, and the median length of deployment was a little more than 1 year.
The research is part of the Substance Use and Psychological Injury Combat Study (SUPIC), the largest and longest observational study to date of pain management and behavioural health conditions in Army service members returning from Iraq and Afghanistan.