Military veterans' overdose risk behavior: Demographic and biopsychosocial influences

Bennett, Alex S.; Watford, Jon Alexander; Elliott, Luther; Wolfson‐Stofko, Brett; Guarino, Honoria

doi:10.1016/j.addbeh.2019.106036

Cited by 16 publications

(16 citation statements)

References 55 publications

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“…For example, long-term chronic pain can potentially exacerbate depressive symptoms and, ultimately, suicidal ideation, or severe depression may aggravate physical pain (Baria et al, 2018). As indicated by research, social factors can also exacerbate physical and mental health concerns and can serve to increase overdose risk for some who are using opioids to manage various forms of pain or to manage opioid dependency (Baria et al, 2018;Bennett et al, 2017a;Bennett et al, 2019;Gatchel, 2004). Incorporating discussion of these topics into clinical interviews with veterans who use opioids may have the potential to destigmatize opioid use disorder.…”

Section: Discussionmentioning

confidence: 99%

Between- and within-person associations between opioid overdose risk and depression, suicidal ideation, pain severity, and pain interference

Cleland

Bennett

Elliott

et al. 2020

Drug and Alcohol Dependence

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Background: To better understand overdose (OD) risk and develop tailored overdose risk interventions, we surveyed 234 opioid-using veterans residing in New York City, 2014-2017. Our aim was to better understand how predictors of OD may be associated with physical and mental health challenges, including pain severity and interference, depression and suicidal ideation over time.Methods: Veterans completed monthly assessments of the Overdose Risk Behavior Scale (ORBS), pain severity and interference, suicidal ideation, and depression for up to two years and were assessed an average of 14 times over 611 days. To estimate between-person and within-

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Section: Discussionmentioning

confidence: 99%

Between- and within-person associations between opioid overdose risk and depression, suicidal ideation, pain severity, and pain interference

Cleland

Bennett

Elliott

et al. 2020

Drug and Alcohol Dependence

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“…Reports suggest that nearly two-thirds of veterans experience pain [ 3 ], with even greater pain prevalence observed among certain veteran cohorts [ 4 - 6 ]. This pain experience leads to negative consequences including functional impairment [ 7 ], increased stress and mental health concerns [ 8 , 9 ], substance abuse [ 8 , 9 ], risky opioid use [ 10 ], impaired sleep [ 9 ], decreased quality of life [ 11 ], and increased health care utilization [ 12 ]. Accordingly, safe and effective strategies are needed to help veterans manage pain.…”

Section: Introductionmentioning

confidence: 99%

Understanding Adoption and Preliminary Effectiveness of a Mobile App for Chronic Pain Management Among US Military Veterans: Pre-Post Mixed Methods Evaluation

Hogan¹,

Etingen²,

McMahon³

et al. 2022

JMIR Form Res

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Background The Veterans Health Administration Pain Coach mobile health app was developed to support veterans with chronic pain. Objective Our objective was to evaluate early user experiences with the Pain Coach app and preliminary impacts of app use on pain-related outcomes. Methods Following a sequential, explanatory, mixed methods design, we mailed surveys to veterans at 2 time points with an outreach program in between and conducted semistructured interviews with a subsample of survey respondents. We analyzed survey data using descriptive statistics among veterans who completed both surveys and examined differences in key outcomes using paired samples t tests. We analyzed semistructured interview data using thematic analysis. Results Of 1507 veterans invited and eligible to complete the baseline survey, we received responses from 393 (26.1%). These veterans received our outreach program; 236 (236/393, 60.1%) completed follow-up surveys. We conducted interviews with 10 app users and 10 nonusers. Among survey respondents, 10.2% (24/236) used Pain Coach, and 58% (14/24) reported it was easy to use, though interviews identified various app usability issues. Veterans who used Pain Coach reported greater pain self-efficacy (mean 23.1 vs mean 16.6; P=.01) and lower pain interference (mean 34.6 vs mean 31.8; P=.03) after (vs before) use. The most frequent reason veterans reported for not using the app was that their health care team had not discussed it with them (96/212, 45.3%). Conclusions Our findings suggest that future efforts to increase adoption of Pain Coach and other mobile apps among veterans should include health care team endorsement. Our findings regarding the impact of Pain Coach use on outcomes warrant further study.

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“…Social factors that have been found to significantly influence the development and outcome of opioid use disorders include poverty and economic inequality, unemployment, levels of urban and rural development, the extent and quality of social support networks, religious or spiritual involvement, and cultural values and practices [10][11][12][13][14][15][16]. These factors affect influence individual-level variables such as affective responses, self-image and self-efficacy, social status, loneliness, coping skills and attitudes towards drug use, thereby altering a given person's likelihood of engaging in or continuing to use opioids [17][18][19]. It is therefore plausible that some of the observed cross-national or cross-regional variation in opioid use disorders may be due to one or more of these social variables.…”

Section: Introductionmentioning

confidence: 99%

“…Examining these associations may be of significant importance in identifying countries or regions that are at future risk of opioid "crises" or "epidemics", and instituting preventive or early treatment strategies, though such findings may not be applicable to individual cases. This is particularly important in low-or middle-income countries with lessdeveloped health infrastructure, and which may be overwhelmed by a full-blown opioid crisis [19,20].…”

Section: Introductionmentioning

confidence: 99%

What Are the Correlates of Global Variations in the Prevalence of Opioid Use Disorders? An Analysis of Data From the Global Burden of Disease Study, 2019

Rajkumar¹

2021

Cureus

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The recent opioid crisis in North America has brought the problem of opioid use disorders (OUD) into clinical and public health focus, with experts warning that other countries or regions may be at future risk of experiencing such crises. The existing literature suggests that a wide range of social, cultural and economic factors may be associated with the onset, course and outcome of OUD in individuals. The current study uses data on the estimated prevalence of OUDs across 115 countries, obtained from the Global Burden of Disease Study, 2019, to examine the bivariate and multivariate associations between national prevalence of OUD and these factors. MethodsData on the estimated prevalence of OUDs was obtained via a database query from the Global Burden of Disease (GBD) Collaborative Network database for the year 2019. Recent (2018-2019) data on 10 relevant variables identified in the literature (gross national income, economic inequality, urbanization, social capital, religious affiliation and practice, unemployment, divorce, cultural individualism, and prevalence of depression) were obtained from the GBD, World Bank and Our World in Data databases. After transformation to a normal distribution, bivariate and univariate analyses were conducted to identify the significance and strength of the associations between these variables and the prevalence of OUD. ResultsOf the 10 variables studied, all variables except the divorce rate and religious affiliation were significantly correlated with the prevalence of OUD on bivariate analyses, though the strength of these associations was in the poor to fair range. On multivariate analysis, a significant association was observed only for the prevalence of depression, with trends towards a positive association for cultural individualism and unemployment, and a protective trend observed for religious practice. DiscussionThough subject to certain limitations inherent in cross-sectional analyses, these results suggest that certain variables may be associated with a higher prevalence of OUD at the national level. Replication and refinement of these analyses may prove useful in identifying countries or regions at risk of a future opioid epidemic or crisis, which could facilitate the institution of preventive measures or early intervention strategies.

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Military veterans' overdose risk behavior: Demographic and biopsychosocial influences

Cited by 16 publications

References 55 publications

Between- and within-person associations between opioid overdose risk and depression, suicidal ideation, pain severity, and pain interference

Between- and within-person associations between opioid overdose risk and depression, suicidal ideation, pain severity, and pain interference

Understanding Adoption and Preliminary Effectiveness of a Mobile App for Chronic Pain Management Among US Military Veterans: Pre-Post Mixed Methods Evaluation

What Are the Correlates of Global Variations in the Prevalence of Opioid Use Disorders? An Analysis of Data From the Global Burden of Disease Study, 2019

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