VA Study: Rural veterans prescribed ‘dramatically’ more opioids

IOWA CITY, Iowa (KCRG) - A new study by VA Health Care shows a difference in what veterans are prescribed for pain. Researchers with the VA say veterans in rural communities are prescribed “dramatically” more opioids to treat chronic pain than those in more urban areas.

This study found that veterans living in rural areas were being prescribed opioids 45% more to treat chronic pain than veterans living in urban areas from 2016 to 2023. This study originally started in Iowa but over the years has been picked up by teams across the country. Researchers started noticing this trend years ago, as fewer veterans were being prescribed opioids.

The VA has a few theories, but this study was mostly observational. Over the years, opioids have been a common treatment for chronic pain, something VA researchers say 30-65% of veterans live with. One element is the different ways chronic pain is treated outside of medicine.

Conditions like chronic pain could make a bad combination with poor access to healthcare facilities in rural areas.

”The literature does suggest that veterans who live in rural areas do experience increased barriers to care,” Dr. Rena Courtney, the lead researcher for this study, said. “If you think about driving distance and the time that’s associated with that, there are some challenges that come up for veterans in rural areas.”

The VA is trying to combat this by getting more specialty care in small communities at rural VA centers. They’re doing that by sending out mobile care units and encouraging patients to use telehealth programs.

”Increasing access to care is one of the national priorities,” Courtney said. “One of the options is providing specialty care through our community based outpatient clinics... so that the drive time is reduced.“

Courtney also shared that there is an interest to use alternative methods. She says 10% of people prescribed opioids become addicted. Along with that, in some cases, long-term opioid use can result in worse chronic pain.

“There are risks to using opioid medications as well as taking folks off of opioid medications,” Courtney said. “It really becomes a fine balance for clinicians who are working with folks who have chronic pain to determine whether or not the risks outweigh the benefits.”

Because of those risks, Courtney says it’s important for healthcare providers to explore non-pharmaceutical treatments.

“It’s a real call to action for those of us who are working in this area to get creative with the ways that we are making non pharmacological approaches more accessible in rural communities for our veterans,’ Courtney said.