Service Era Risk Factors for Non-Medical Opioid Use Among United States Military Veterans 2017-2019 Public

Abstract

Objective: The opioid epidemic is a major problem among United States military veterans; however, little is known about how the prevalence of opioid misuse among veterans has changed over time. We sought to determine the prevalence of, and risks associated with non-medical prescription opioid misuse among veterans who served prior to and after September 11, 2001 (9/11).

Methods: We conducted a cross-sectional study and collected demographic and risk factor data for veterans who served on active duty (n=5,675) from the 2017-2019 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) surveys. We identified those who self-reported using prescription opioids in a manner not directed by a physician. We used logistic regression to obtain unadjusted and adjusted prevalence ratios of non-medical opioid misuse (NMOU) risk factors for veterans who served prior to and after 9/11.

Results: 3,609 veterans served pre-9/11 and 2,066 served post-9/11. Multiple factors were associated with opioid misuse, including serving post-9/11 (OR=1.76), female sex (OR=2.25), urban living environment (OR=2.81), recent drug or alcohol treatment (OR=6.23), heavy alcohol use (OR=3.75), and increased psychological distress (OR=3.36). In adjusted analysis, prevalence of NMOU was increased among pre-9/11 veterans who were non-Hispanic white (OR=4.49), engaged in risky behavior (OR=2.45), and reported heavy alcohol use (OR=3.25). Prevalence of NMOU among post-9/11 veterans was higher among those who lived in a large metro area (OR=6.83), lived in poverty (OR=2.54), and experienced increased psychological distress in the previous year (OR=2.41).

Conclusions: We found significant differences in non-medical prescription opioid use among veterans who served prior to and post 9/11. Those who served post 9/11 are more likely to misuse opioids. Female veterans were more likely than male veterans to misuse prescription opioids, and there was no evidence of statistical interaction of service era with gender. Statistical power was limited due to the small number of opioid misuse cases in this study; larger studies focusing on expanded demographic samples and military-specific risk factors are warranted. Further, there is a need for continued research on non-medical prescription opioid use risk factors for veterans, particularly as prescribing guidelines continue to evolve.

Table of Contents

CHAPTER I: Introduction

Introduction .............................................................................................. 1

Purpose of the study ................................................................................ 4

Public Health implications ..................................................................... 4

 

CHAPTER II: Manuscript 

Abstract ..................................................................................................... 7

Introduction ............................................................................................. 8

Methods ................................................................................................... 11

Results ..................................................................................................... 15

Discussion ............................................................................................... 18

Conclusions ............................................................................................ 22

Tables and Figures ................................................................................ 24

 

CHAPTER III: Conclusions

Univariate Analysis ............................................................................... 29

Multivariate Analysis ............................................................................ 30

Discussion .............................................................................................. 32

Conclusions ............................................................................................ 37

 

REFERENCES ....................................................................................... 39

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Applied Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Mot-clé	Veteran Non-Medical Opioid Use
Committee Chair / Thesis Advisor	Jeb Jones, Emory University
Committee Members	Nicholas Giordano, Emory University

Dernière modification

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Service Era Risk Factors for Non-Medical Opioid Use Among United States Military Veterans 2017-2019 ()	2022-11-28 11:43:12 -0500	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions