Demographic, diagnostic, and service utilization characteristics of veterans diagnosed with suicide attempt, substance dependence, both, or neither at discharge from Department of Veterans Affairs (DVA) hospitals in fiscal year 1994 (FY94) were compared using the DVA's discharge abstract database. Four groups of veterans were studied: (1) substance-abusing suicidal inpatients (n = 1,459), (2) substance-abusing nonsuicidal inpatients (n = 123,808), (3) nonsubstance-abusing suicidal inpatients (n = 632), and (4) nonsubstance-abusing nonsuicidal inpatients (n = 402,906). Substance-abusing suicidal veterans had higher rates of substance abuse than substance-abusing nonsuicidal veterans. Substance-abusing suicidal veterans had a higher mean number of inpatient treatment episodes and a larger proportion of discharges against medical advice than the other three inpatient groups. Psychiatric and substance use disorders are more prevalent among substance-abusing suicidal veterans than among veterans with only substance use disorders or suicidal conduct.
Native American (NA) veterans have rarely been the focus of investigational efforts. We review studies relevant to an assessment of NA substance-use disorders, and discuss findings of the Drug Abuse Treatment Services Evaluation Project pertaining specifically to NA veterans. A larger proportion of NA veterans discharged from VA inpatient care in FY93 were diagnosed with a substance-use disorder compared to the total population of veterans discharged that year. Substance-dependent NAs were more likely to be diagnosed with alcohol-use disorders and posttraumatic stress disorder, and less likely to be diagnosed with drug-use disorders and other psychiatric disorders than substance-dependent veterans generally.
Substance use disorders and associated comorbidities are endemic among women treated in VA hospitals. Additional studies examining characteristics of indigent women with substance use disorders are needed.
The Department of Veterans Affairs is the largest provider of drug dependence treatment services in the United States. However, a national evaluation of primarily drug-dependent veterans has never been reported. Findings from the Drug Abuse Treatment Services Evaluation Project, a three-year investigation of drug dependence treatment within the Department of Veterans Affairs, are discussed. Demographic and diagnostic data are presented for the population of 46,047 inpatients discharged with drug dependence diagnoses in Fiscal Year 1991. Patient subtypes and clinical issues of growing relevance to the treatment of drug-dependent veterans are discussed.
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