VA doctors prescribe far more opioids to rural veterans, perhaps due to lack of long-term treatment alternatives

Rural veterans got almost a third more opioids than urban veterans from doctors in the Department for Veterans Affairs, according to a study of outpatient prescription practices in 2016.

Opioid prescribing in the Veterans Health Administration among rural veterans declined from 2012 to 2016, but rural "rates remain 32 percent higher than urban counterparts," said the study, published in the most recent issue of the journal Military Medicine.

One reason: More rural vets use opioids long-term; rates of short-term use among rural and urban vets were similar, according to the study. A 2017 study also found that rural vets were far more likely to use opioids long-term. "The findings suggest that rural veterans with chronic pain use opioids for long periods because alternative treatments are available primarily in urban areas," Wyatt Olson reports for Stars and Stripes. "The hypothesis is supported by the study’s finding that VA facilities serving rural areas with more dense populations of veterans had smaller rural-urban differences in dispensed opioid volume — as compared to facilities treating the sparsest rural populations of veterans."