Table 4.
Cox Proportional Hazard Ratios (NPT Exposed in MHS/Not Exposed; 95% CI) and the Kaplan-Meier Log-Rank Test Results for Adverse Outcomes in the VHA (N = 142,539)
| Log-rank test | Hazard ratios adjusted for VHA covariates* | ||||
|---|---|---|---|---|---|
| χ2, P† | No | P | Yes | P | |
| New-onset alcohol and/or drug use disorders‡ | 0.92 (0.90–0.94) | < 0.001 | 0.90 (0.88–0.91) | < 0.001 | |
| Accidental poisoning with opioids, related narcotics, barbiturates, or sedatives | 6.52, P = 0.01 | 0.65 (0.51–0.83) | 0.001 | 0.61 (0.48–0.79) | < 0.001 |
| Intentional poisoning with opioids, related narcotics, barbiturates, or sedatives | 2.72, P = 0.10 | 0.82 (0.67–0.99) | 0.04 | 0.79 (0.65–0.96) | 0.02 |
| Suicide ideation | 30.32, P < 0.001 | 0.88 (0.84–0.91) | < 0.001 | 0.83 (0.80–0.86) | < 0.001 |
| Self-inflicted injuries, including suicide attempts | 13.34, P < 0.001 | 0.83 (0.77–0.90) | < 0.001 | 0.80 (0.74–0.87) | < 0.001 |
All data based on propensity score-weighted data (Kaplan-Meier survival curves and Cox proportional hazards models)
NPT nonpharmacological treatment, MHS Military Health System, VHA Veterans Health Administration
*VHA covariates include length of a service member’s observation in the VHA, exposure to NPT in the VHA, and days supply of opioids in the VHA
†The Kaplan-Meier log-rank test combines results of χ2 tests of the probability of an event between two groups across time
‡Based on those not diagnosed with alcohol and/or drug abuse or dependence while in the MHS (n = 105,562)