VA Research Wrap Up: New findings on chronic pain, toxic exposure and long-term opioid use

VA’s Office of Research and Development recently published three News Briefs highlighting research findings on reducing chronic pain, the link between toxic exposure and suicide, and how long-term opioid therapy may lead to dental disease.

VA’s Whole Health approach reduces chronic pain

A study of almost 800 Veterans across six VA health systems showed that VA’s Whole Health approach to care can reduce how much chronic pain interferes with a Veteran’s daily life.

Whole Health involves individualized, interdisciplinary care focused on personal health goals, non-drug therapies and wellness coaching. After 12 months of treatment, Veterans with chronic pain receiving Whole Health care had greater improvements in pain interference than those receiving the usual care or cognitive behavioral therapy, which is a type of talk therapy. The study also demonstrated that Whole Health for chronic pain can be delivered successfully via telehealth. The results suggest the Whole Health team model can be an effective approach to managing chronic pain.

Toxic exposure linked to increased suicide risk

VA Durham researchers and their colleagues learned that Veterans who experienced multiple toxic exposures had 17% higher odds of suicidal thoughts and behaviors, compared with Veterans who did not report exposures.

The researchers assessed military exposure to nine different toxins in nearly 250,000 Veterans from the Million Veteran Program. They found each additional toxic exposure increased a Veteran’s suicide risk. This association held true across all service eras, from pre-Vietnam through post-9/11. Analysis revealed the link between toxic exposure and suicide could be attributed to the higher rates of PTSD and depression in Veterans with more exposure. The results highlight a need to consider toxic exposures when assessing Veterans for suicide risk.

Long-term opioid use may lead to dental disease

A study led by VA Connecticut researchers found long-term opioid therapy was linked to higher risk of infection-related dental disease.

The study included data on more than 2 million Veterans, 36% of whom received long-term opioid therapy. Those taking opioid medications for more than 90 days had a 24% higher chance of tooth decay, infections or tooth loss. The researchers suggest the immune suppression and reduced saliva flow caused by opioids may explain this connection. The findings suggest oral health risks need to be taken into account when prescribing long-term opioid therapy.

For more Office of Research and Development updates, visit ORD online or go to https://www.research.va.gov/news_briefs/.