A 10 Year Analysis of Chronic Pelvic Pain (CPP) and Chronic Narcotic Use (CNU) in the Female Veteran Population [8H]

INTRODUCTION: Narcotics are prescribed to treat debilitating pelvic pain without proved efficacy, and with significant harm risk. Our objective was to compare chronic narcotic use (CNU) and average narcotic doses prescribed 5 years prior and following chronic pelvic pain (CPP) diagnosis. METHODS: We used the validated Veteran’s affairs corporate database warehouse. Time 0 was the 1st CPP diagnosis date by ICD-9 codes. Outpatient narcotic prescriptions were summed for the 5 years preceding and following CPP diagnosis; oral narcotics were converted to morphine equivalents (ME). CNU was defined as greater than 90 narcotic use days per year; drug abuse/overdose rates were defined by ICD-9 codes. RESULTS: 73,319 women met inclusion criteria of non-cancer CPP with average age of 40.1 ± 11.5 years; 37.3% minority, with an average BMI of 29.4± 6.0 kg/m2 and 34.6% had a history of military sexual trauma. Five years prior to CPP diagnosis, 10-12% of women were on CNU. Five years following diagnosis, CNU increased to 14-16% (or by 10,477 women/5 years, p < 0.001). Average narcotic doses ranged from 31.4 mg to 37.7 mg ME per dose and did not increase over the years (p=0.158). During the 10 year period, 12.7% (9,304) women were diagnosed as drug abusers and 3.3% (2,384 women) had an overdose. Drug overdose significantly increased after the diagnosis of CPP from 1.2% (954 women) to 2.0% (1430 women) of the entire CPP population (P < 0.001). CONCLUSION: Drug abuse is common in women with CPP, CNU increases after CPP diagnosis, as does drug overdose.