Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008

Over the past 5 years, diagnoses for opiate abuse or dependency and post-traumatic stress disorder (PTSD) have increased across all U.S. military services. Moreover, in the United States, opiate prescription dependence and abuse has now surpassed all other illicit drugs of abuse with the exception of marijuana. Some research indicates that PTSD is predictive of substance dependence and abuse, while other research suggests that substance dependence and abuse may lead to events that trigger PTSD. This dichotomy has not been extensively explored within a military population.

Using conditional multiple logistic regression analysis, a matched case-control study with 18,606 active-component U.S. military service members was conducted to examine the relationship between opiate dependence or abuse and PTSD.

Among the 18,606 service members included in the analysis, 21% were cases and 79% were controls. Thirteen percent of service members with substance dependence or abuse diagnosis had a prior PTSD diagnosis compared to 1% of controls. After, adjusting for sociodemographic and military characteristics, the odds of having a prior diagnosis of PTSD was 28 (95% CI: 21.24-37.78) times greater for service members with opiate abuse/dependency compared to controls.

These findings suggest active duty military personnel diagnosed with PTSD should be closely monitored to reduce the likelihood of future morbidity because of opiate dependence or abuse.