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A study or 696 injured military personnel suggests that the use of morphine in trauma care may be a protective factor against the subsequent development of PTSD after serious injury. The study's findings were based on an examination of military records from a medical encounter database.
The study, entitled "Morphine Use After Combat Injury in Iraq and Post-Traumatic Stress Disorder," was led by Troy Lisa Holbrook Ph.D., of the Naval Health Research Center in San Diego, and was published in the New England Journal of Medicine.
It has been observed that certain drugs appear to decrease or impede memory consolidation and the conditioned response to fear after a person goes through a traumatic event. Based on this, some authorities have speculated that agents such as opiates, anxiolytics, and beta-adrenergic antagonists might be used to prevent the development of PTSD.
However, few studies have actually examined the efficacy of medications to prevent PTSD in the aftermath of major trauma, the authors write. A study by Saxe and colleagues reported a protective effect of morphine for child burn victims with regard to PTSD (Saxe G, et al.: J Am Acad Child Adolesc Psychiatry, 2001). Studies of other agents, including benzodiazepines and propranolol, have shown inconsistent results. The authors write that little is known about the effect of morphine administration as part of trauma care on seriously injured adults.
Using data from the U.S. Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database (CTR EMED), the present study authors examined the effect of morphine use during early resuscitation and trauma care on the prevalence of PTSD in injured military personnel. Injuries were incurred during Operation Iraqi Freedom, between January 2004 and December 2000.
Of the 790 injured military personnel considered for inclusion in the study, 60 were excluded because they had serious traumatic brain injury (a contraindication for morphine treatment) and 34 were excluded because clinical or medication data was incomplete. This left 696 injured …