Morphine Use After Combat Injury in Iraq and Post-Traumatic Stress Disorder

The secondary prevention of posttraumatic stress disorder PTSD using pharmacotherapy following serious physical injury or exposure to traumatic events is an evolving and important area of research. This reports objective was to examine the effect of morphine use during early resuscitation and trauma care on PTSD onset in injured military personnel. A total of 700 injured US military personnel without traumatic brain injury and with complete medication data were identified from the Navy-Marine Corps Combat Trauma Registry Deployment Health Database. Among the 243 PTSD-positive cases and 455 PTSD-negative noncases, the use of morphine in the acute postinjury resuscitation phase was significantly and protectively associated with PTSD onset. This association remained significant and independent after adjusting for injury severity. These results provide new evidence that morphine or other opiate compounds may protect against the development of PTSD after serious injury. These findings have important implications for future pharmacological interventions to reduce PTSD incidence after serious injury and exposure to traumatic events. They have the potential to wield a profound impact on PTSD prevention and provide a foundation for continuing to improve twenty-first century trauma care.