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Brief ReportBrief Report

The Effect of Veteran Status and Chronic Pain on Past 30-Day Sedative Use Among Community-Dwelling Adult Males

Ayodeji Otufowora, Yiyang Liu, Aderonke Okusanya, Afeez Ogidan, Adedoyin Okusanya and Linda B. Cottler
The Journal of the American Board of Family Medicine January 2024, 37 (1) 118-128; DOI: https://doi.org/10.3122/jabfm.2023.230226R2
Ayodeji Otufowora
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
MD, PhD, MPH
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Yiyang Liu
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
PhD, MPH
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Aderonke Okusanya
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
MSHS
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Afeez Ogidan
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
MBChB
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Adedoyin Okusanya
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
MD
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Linda B. Cottler
From the Department of Pediatrics, Columbia University Medical Center, New York, NY (A Otufowora); Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL (YL, LBC); Department of Pharmacy, College of Pharmacy and Health Sciences, Western New England University, Springfield, MA (A Okusanya); Department of Medicine & Surgery, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu Campus, Ogun State, Nigeria (A Ogidan); Department of Public Health, Milken Institute School of Public Health, The George Washington University, Washington, DC (A Okusanya).
PhD, MPH, FACE
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Article Figures & Data

Tables

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    Table 1.

    Self-Reported Characteristics of Study Participants by Past 30-Day Sedative Drug Use Status, n = 4,732

    CharacteristicsTotal (n = 4,732)
    n (%)
    Past 30-Day
    Sedative Non-Use
    N = 4,366
    n (%)
    Past 30-Day
    Sedative Use
    N = 366
    n (%)
    p-Value
    Veteran status
     Veteran1,014 (21)867 (20)147 (40)<0.0001
     Non-veteran3,718 (79)3,499 (80)219 (60)
    Chronic pain (back pain or osteoarthritis)2,307 (49)2,038 (47)269 (74)<0.0001
    Age
     <50 years2,585 (55)2,441 (56)144 (39)<0.0001
     ≥50 years2,144 (45)1,923 (44)221 (61)
    Race
     Black2,730 (58)2,583 (59)147 (40)<0.0001
     White1,669 (35)1,475 (34)194 (53)
     Other*333 (7)308 (7)25 (7)
    Education
     <High school1,075 (23)1,013 (23)62 (17)0.0057
     ≥High school3,647 (77)3,343 (77)304 (83)
    Employment
     Employed1,615 (34)1,539 (35)76 (21)<0.0001
     Unemployed3,087 (66)2,800 (65)287 (79)
    Marital status
     Married923 (20)856 (20)67 (18)0.5436
     Other**3,794 (80)3,496 (80)298 (82)
    Food insecurity2,183 (46)1,971 (45)212 (58)<0.0001
    Health insurance2,586 (55)2,349 (54)237 (65)<0.0001
    Annual health checkup2,943 (62)2,657 (61)286 (78)<0.0001
    ED visits in past 6 months (at least 1 ED visit)1,417 (30)1,227 (28)190 (52)<0.0001
    Insomnia1,128 (24)941 (22)187 (51)<0.0001
    Anxiety994 (21)751 (17)243 (67)<0.0001
    Depression1,202 (26)961 (22)241 (66)<0.0001
    Other drug use (past 30 days)
     Prescription opioid use543 (11)414 (9)129 (35)<0.0001
     Marijuana use1,083 (23)991 (23)92 (25)0.2861
     High risk alcohol use1,415 (30)1,307 (30)108 (30)0.8637
     Other illicit drugs (cocaine/heroin)162 (3)130 (3)32 (9)<0.0001
    • Other* = Asian, American Indian/Alaskan native, native Hawaiian/Pacific Islander.

    • Other** = never married, separated, divorced, or widowed.

    • Abbreviation: ED, emergency department.

    • View popup
    Table 2.

    Adjusted Odds of Past 30-Day Prescription Sedative Use Among Community-Dwelling Adult Males in Florida, n = 4,732

    VariableModel 1 (Controlled for Chronic Pain and Veteran Status)Model 2 (Significant Factors from Model 1 + Sociodemographic Factors)Model 3 (Significant Factors from Model 2 + Health Conditions, Health Care Utilization, and Drug Use)Model 4 (Model 3 + Interaction Term Veteran Status*Chronic Pain)
    Past 30-Day Sedative Use (vs no Use) aOR (95% CI)Past 30-Day Sedative Use (vs no Use) aOR (95% CI)Past 30-Day Sedative Use (vs no Use) aOR (95% CI)Past 30-Day Sedative Use (vs no Use) aOR (95% CI)
    Veteran status
     NonveteranRefRefRef
     Veteran2.24 (1.79 – 2.82)1.88 (1.47 – 2.42)1.67 (1.28 – 2.18)1.52 (0.92 – 2.53)
    Chronic pain (back pain or osteoarthritis)
     NoRefRefRef
     Yes2.84 (2.22 – 3.63)2.43 (1.89 – 3.14)1.42 (1.07 – 1.88)1.37 (0.98 – 0.91)
    Socio-demographic factors
    Age group
     <50Ref
     ≥501.15 (0.90 – 1.47)EliminatedEliminated
    Race
     WhiteRef
     Black0.51 (0.40 – 0.64)0.75 (0.58 – 0.98)0.75 (0.58 – 0.98)
     Other*0.74 (0.47 – 1.17)0.84 (0.51 – 1.38)0.83 (0.51 – 1.37)
    Education
     <High schoolRef
     ≥High school1.33 (0.99 – 1.79)EliminatedEliminated
    Employment
     UnemployedRefRefRef
     Employed0.66 (0.50 – 0.88)0.94 (0.70 –1.27)0.94 (0.70 –1.27)
    Marital status
     Other**Ref
     Married0.84 (0.63 – 1.13)EliminatedEliminated
    Food insecurity
     NoRef
     Yes1.41 (1.12 – 1.78)1.05 (0.81 –1.37)1.06 (0.81 –1.38)
    Health, health care utilization, and drug use
    Health insurance
     NoRefRef
     Yes1.39 (1.06 – 1.83)1.40 (1.06 – 1.83)
    Annual checkup
     NoRefRef
     Yes1.77 (1.31 – 2.39)1.76 (1.31 – 2.38)
    ED visits (at least one visit in past 6 months)
     NoRefRef
     Yes1.40 (1.09 – 1.81)1.40 (1.09 – 1.81)
    Insomnia
     NoRefRef
     Yes1.41 (1.08 –1.83)1.41 (1.08 –1.83)
    Anxiety
     NoRefRef
     Yes4.65 (3.46 – 6.24)4.65 (3.46 – 6.24)
    Depression
     NoRefRef
     Yes1.94 (1.44 – 2.63)1.95 (1.44 – 2.63)
    Prescription opioid use (past 30-day)
     NoRefRef
     Yes3.46 (2.61 –4.59)3.47 (2.62 –4.60)
    High risk alcohol use (past 30-day)
     NoRefRef
     Yes0.99 (0.75 –1.31)0.99 (0.75 –1.31)
    Marijuana use (past 30-day)
     NoRefRef
     Yes1.02 (0.76 –1.38)1.02 (0.76 –1.38)
    Illicit drug use (cocaine or heroin) (past 30-day)
     NoRefRef
     Yes2.33 (1.42 – 3.83)2.35 (1.42 – 3.86)
    Interaction termveteran status * chronic pain
     Nonveteran and No chronic painRef
     Veteran and No chronic pain1.52 (0.92 – 2.53)
     Nonveteran and chronic pain1.37 (0.98 – 1.91)
     Veteran and chronic pain2.08 (1.02 – 4.27)
    • Other* = Asian, American Indian/Alaskan native, native Hawaiian/pacific islander.

    • Other** = never married, separated, divorced, widowed.

    • Abbreviations: ED, emergency department; CI, confidence interval; aOR, adjusted odds ratio.

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The Journal of the American Board of Family     Medicine: 37 (1)
The Journal of the American Board of Family Medicine
Vol. 37, Issue 1
January-February 2024
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The Effect of Veteran Status and Chronic Pain on Past 30-Day Sedative Use Among Community-Dwelling Adult Males
Ayodeji Otufowora, Yiyang Liu, Aderonke Okusanya, Afeez Ogidan, Adedoyin Okusanya, Linda B. Cottler
The Journal of the American Board of Family Medicine Jan 2024, 37 (1) 118-128; DOI: 10.3122/jabfm.2023.230226R2

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The Effect of Veteran Status and Chronic Pain on Past 30-Day Sedative Use Among Community-Dwelling Adult Males
Ayodeji Otufowora, Yiyang Liu, Aderonke Okusanya, Afeez Ogidan, Adedoyin Okusanya, Linda B. Cottler
The Journal of the American Board of Family Medicine Jan 2024, 37 (1) 118-128; DOI: 10.3122/jabfm.2023.230226R2
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