Morphine use after combat injury in Iraq and post-traumatic stress disorder
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BACKGROUND: Post-traumatic stress disorder (PTSD) is a common adverse mental health outcome among seriously injured civilians and military personnel who are survivors of trauma. Pharmacotherapy in the aftermath of serious physical injury or exposure to traumatic events may be effective for the secondary prevention of PTSD. METHODS: We identified 696 injured U.S. military personnel without serious traumatic brain injury from the Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. Complete data on medications administered were available for all personnel selected. The diagnosis of PTSD was obtained from the Career History Archival Medical and Personnel System and verified in a review of medical records. RESULTS: Among the 696 patients studied, 243 received a diagnosis of PTSD and 453 did not. The use of morphine during early resuscitation and trauma care was significantly associated with a lower risk of PTSD after injury. Among the patients in whom PTSD developed, 61% received morphine; among those in whom PTSD did not develop, 76% received morphine (odds ratio, 0.47; P<0.001). This association remained significant after adjustment for injury severity, age, mechanism of injury, status with respect to amputation, and selected injury-related clinical factors. CONCLUSIONS: Our findings suggest that the use of morphine during trauma care may reduce the risk of subsequent development of PTSD after serious injury.
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Morphine has been studied as a possible intervention for fear memory consolidation, but it is unclear whether its analgesic properties reduce the potency of the CS+ or act through a separate mechanism.
“Morphine has also been studied as a possible intervention of fear memory consolidation; however, it is not clear whether morphine's analgesic properties act to reduce the potency of the CS+ or are acting through a separate mechanism (61, 62).”
From Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors (2014) · cites this paper as [62]
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- Authors
- Holbrook, T. L., Galarneau, M. R., Dye, J. L., Quinn, K., & Dougherty, A. L.
- Affiliations
- Naval Health Research Center (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2010-01-14
- Volume
- 362
- Issue
- 2
- Pages
- 110-117
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2117408205
- Cited by
- 429
- References
- 37
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 17 · 2023: 11 · 2022: 26 · 2021: 10 · 2020: 41 · 2019: 22 · 2018: 30 · 2017: 20 · 2016: 28 · 2015: 33 · 2014: 37 · 2013: 40 · 2012: 34
- FWCI
- 47.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- morphine, post-traumatic stress disorder, war injuries, military personnel, trauma care, opioid analgesics, secondary prevention, injury severity, Iraq War
- MeSH terms
- Adult, Analgesics, Opioid, Drug Utilization, Emergency Medical Services, Emergency Treatment, Female, Humans, Male, Military Medicine, Military Personnel, Morphine, Risk, Stress Disorders, Post-Traumatic, United States, Warfare, Wounds and Injuries, Survivors, Iraq War, 2003-2011, Young Adult
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