This journal review looks at the effects of morphine use and its relation to the development of Post-traumatic stress disorder (PTSD) in combat victims from Iraq. PTSD refers to an anxiety syndrome that develops after exposure to events that are traumatic (Lobo et al., 2011). Such events include those that are scary or frightening such as sexual assault or disasters that occur naturally. Characteristics of PTSD include reactions of helplessness, intense fear, wounds that are severe and actions that result to a threat against one’s physical integrity or of another’s. Subsequently, this makes PTSD a common mental health issue among civilian and military persons who are seriously injured. In the repercussions of physical injury and traumatic events exposure, there is a presumption that the use of pharmacotherapy is effective in the prevention of secondary developments of PTSD. Pharmacotherapy refers to the use of medical based treatment based on drug administration, which is in stark contrast to methods such as psychotherapy, surgery and other alternative techniques (Pam, 2017). Another notable definition to look at is that of morphine. Morphine is the primary ingredient in opium, and its use first materialized in 1806 (Pam, 2017). Used as an analgesic and sedative drug, more so in patients who are terminally ill, morphine presents an effective and efficient way of reducing pain in victims who have undergone various traumatic episodes. Subsequently, in the review of this journal, the use of psychotherapy is pivotal in determining the reduction of PTSD among trauma victims.
The study method employed the use of 696 U.S. Army personnel who were injured but were without severe damage to the brain (Holbrook et al., 2010). In the case presented in the journal, the Combat Trauma Registry Expeditionary Medical Encounter Database of the Navy-Marine Corps was put to use. The Career History Archival Medical and Personnel System provided an accurate diagnosis of PTSD and verification happened in the reviews of medical records. This journal article presented sound methodological approach especially in this research topic consequently leading to impartiality in its hypothesis and overall results. Two hundred and forty-three patients among the 696 received a diagnosis of PTSD; 453 were diagnosed otherwise. The study found out that the use of morphine during the care of these victims, especially in early resuscitation, resulted in a significant lowering of the risk of PTSD development. In patients who developed PTSD, 61% received morphine while those in whom there was no occurrence of PTSD, 76% received treatment through morphine (Holbrook et al., 2010). In careful consideration of other variables such as severity of the injury, age, mechanism of injury, amputation status and other select factors that were injury-related, the association of morphine to the relieve of injuries remained relatively constant. This indicated a possible success rate in PTSD reduction through morphine-related pharmacotherapy.
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The conclusion of the findings in this journal article showed that the usage of morphine during the treatment of trauma resulted in a reduction of subsequent PTSD development after serious injuries experienced in combat. Combat is a highly engaging activity in which soldiers can easily get physical and psychological injuries. Therefore, such a conclusion is pivotal in the efforts that call for a reduction in PTSD among people who engage in combat. In addition, this finding settles the heated debate on morphine’s power of reducing pain in individuals. However, questions arise on the addictive tendencies of patients who use morphine for an extended period and its overall health benefits to the individual. Moreover, the question of whether the methodological approach reflects accurate accounts and if there is proper consideration of all the variables entailed arises. Such questions try to understand the impartiality, integrity and the validity of the conclusion in the research problem based on the methodology involved.
This research topic is profoundly interesting since it deals with a pertinent issue faced in everyday life and the fact that secondary PTSD prevention is a new area of research. More so, in the military personnel, the occurrence of PTSD is highly common, and its reduction has been a subject of constant research. A researcher asks the question of why and how. Subsequently, such questions give rise to the explanations of pertinent issues within the society. Ultimately, in picking this topic, more minds become engaged on how to reduce the effects of PTSD on people who have undergone various kinds of trauma. The literature, introduction and discussion were thorough. According to the article, Post-Traumatic Stress Disorder is a well-documented and seriously significant mental health consequence among civilians who are injured and military personnel survivors of traumatic events. Currently, the focus of research in the area of trauma-related outcomes is that of PTSD. However, it is critical to note that the focus is tending towards the recognition of prolonged effects on the general health status in regards to the quality of life after a stressful and traumatic ordeal.
The article’s literature presents in-depth knowledge and understanding of the key issues in the research topic and without any doubt, shows the relevance of the research and the background needed to comprehend the entirety of the problem in question fully. The literature indicates that the current understanding and knowledge of the neurobiology and pathogenesis of PTSD gives sound theoretical standpoint on the relation of the role of pharmacotherapy in preventing the secondary occurrence of PTSD. The principal aim of pharmacotherapy is the reduction and the impediment of consolidated memory associated with conditioned responses to fear during a time after a person experiences a traumatic event. The use of such a strategy is based on the hypothesis that opiates, beta-adrenergic and anxiolytics, which are psychotherapeutic agents, could be effective in the prevention of the development of PTSD. According to the literature, studies have been done on the efficiency of psychotherapeutic drugs that lead to the prevention of secondary PTSD development. Consequently, Saxe and his colleagues drew a conclusion on the preventive effect of morphine in children who had undergone the traumatic effect of injuries related to fire *(Saxe et al., 2001). Other studies of psychotherapeutic agents that are putative such as propranolol and benzodiazepines have proven unpredictable in their results.
This study drew its data from the Combat Trauma Registry Expeditionary Medical Encounter Database of the U.S. Navy-Marine Corps (CTR EMED). This data reflects a broad and forthcoming clinical database design that preserves the clinical records of casualties sustained during the invasion of Iraq. The efforts of morphine use during early resuscitation and the period of trauma care are thoroughly examined in injured personnel from the Navy-Marine Corps. The basis of this study was from the data that related to the study population, injury-specific data, and data related to PTSD. Regarding the study demographic information, there was the identification of military personnel who were injured and brought to forward treatment facilities during major combats in operation Iraqi freedom that took place for 36 months. In the injury-specific data, clinical data was obtained from the CTR EMED of the Navy-Marine Corps. Data collected on PTSD showed the diagnoses of this disorder from the system on Career History Archival Medical and Personnel. Ultimately, data collection on this study was sound and reflected the researcher’s perspective on the research agenda. Statistical analysis revealed that the primary outcome was status with respect to the diagnosis of PTSD and that this was the dependent variable. Dependent in the sense that status is affected by other variables such as the efficacy of morphine in treating secondary PTSD.
Overall, this work remains pivotal in psychological studies since post-traumatic stress disorder upsets the cognitive functions of the affected individual and later on results in other behavioral inconsistencies. Therefore, the reduction of secondary PTSD done through initial treatment with morphine is an important field that requires impeccable research. Such kind of research ultimately improves the standards of psychology and renders certain psychology presumptions such as the permanent effect of traumatic experiences on individuals outdated. In the discussion section of the journal article, the researchers admit that there is little information regarding the consequences of morphine use after an acute injury on the rates of PTSD in adults. Most of the results are substantiated by a pioneer study by Saxe and colleagues *(Saxe et al., 2001). Insofar as this is the case, there is enough empirical evidence to support the research hypothesis of this journal article. Bryant and colleagues recently showed that in using morphine, the reduction of the overall effects of PTSD among adults who are injured is eventually plausible. This went a long way in displaying the implications of the research study and the efficiency of morphine as a drug that has proven usable in treating PTSD. As a result, the implications for this research are immense and show the need for such works in the shedding of light on psychological issues.
With the impacts in mind, it is important to look at the limitations of this research, more so in the interpretation of data so that there is a proposition of amendments and in understanding the future course of this investigation. First, is that the research basis is observational, which renders it impossible to draw a causal inference from the result. In the future, a more factual approach is needed to provide sound results. Such an approach based on observation was primarily used in this journal article because this research field of pharmacotherapy for the secondary prevention of post-traumatic PTSD is new and has few empirical evidence to render a strong hypothesis. Secondly, for the future of this research to flourish, there is a need for integral medical data. In this research, the medical data had the essential aspect and was reliable since it was obtained from a trustworthy source. Therefore, with such data integrity, the future of this research is quite promising and will eventually reveal more truths regarding the subject of the study. The third and final limitation that needs overcoming is the question of the dose-response relationship between the risk of developing PTSD and morphine administration. Such a relationship is crucial because it gives certainties to the process of psychotherapeutic implementation.
In conclusion, this research employs sound methodology and research design. Using statistical information from military databases, the researcher has clearly argued out the evidence of morphine use in promoting a reduction of the onset of secondary PTSD. The statistical information displayed is sound and integral, leading to an in-depth understanding of the characteristics of patients, injury mechanisms, use of morphine and other psychotherapeutic medications and the eventual association of morphine use to the reduction of the risk of PTSD. The research boldly displays the effects of using other psychotropic medications and the use of morphine as the best alternative in treating stresses brought about by trauma. Given these integral methods and the overall research design, this article journal clearly shows a comprehensive understanding of its research topic.
References
Holbrook, T., Galarneau, M., Quinn, K., & Dougherty, A. (2010). Morphine Use after Combat Injury in Iraq and Post-Traumatic Stress Disorder. The New England Journal Of Medicine , 362 , 110-117.
Lobo, I., Oliveira1, L., David, I., Pereira, M., Volchan, E., Rocha-Rego, V., Figueira I., & Mocaiber, I. (2011). The neurobiology of posttraumatic stress disorder: dysfunction in the prefrontal-amygdala circuit? Psychology & Neuroscience , 4 :2, 191 – 203.
Pam, M. (2017). What is MORPHINE? definition of MORPHINE (Psychology Dictionary) . Psychology Dictionary . Retrieved 2 May 2017, from http://psychologydictionary.org/morphine/
Pam, M. (2017). What is PHARMACOTHERAPY? definition of PHARMACOTHERAPY (Psychology Dictionary) . Psychology Dictionary . Retrieved 2 May 2017, from http://psychologydictionary.org/pharmacotherapy/
Saxe, G., Stoddard, F., & Courtney, D. (2001). Relationship between acute morphine and the course of PTSD in children with burns. J Am Acad Child Adolesc Psychiatry , 40 , 915-921.
