Juvenile offenders have a high prevalence of trauma exposure and posttraumatic stress disorder (PTSD) symptoms, as well as aggressive behavior. However, relationships between exposure to different specific types of traumatic events, PTSD symptoms, and aggression have not been systematically investigated. Subgroups of male juvenile offenders were identified based on their self-reported exposure to different types of traumatic events. Male juvenile offenders who endorsed multiple types of trauma exposure or traumatic exposure involving violence endorsed higher levels of PTSD symptomatology but not selfreported aggression. In addition, meeting the DSM-IV PTSD diagnosis Criterion A for traumatic exposure was associated with more severe emotional and behavioral problems in the youth who were exposed to community violence. Implications for theory and research on violent trauma and polyvictimization, and the use of self-report trauma history and PTSD measures for screening, with youth involved in the juvenile justice system, are discussed.

In this prospective longitudinal study, the authors investigated the association between marijuana use over a period of 13 years and subsequent health problems at age 27. A community sample of 749 participants from upstate New York was interviewed at mean ages of 14, 16, 22, and 27 years. Marijuana use over time was significantly associated with increased health problems by the late twenties, including respiratory problems, general malaise, neurocognitive problems, and lower academic achievement and functioning. Effective prevention and intervention programs should consider the wide range of adverse physiological and psychosocial outcomes associated with marijuana use over time.

The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56% had contact with VA health care. Prevalence of mental health disorders was 57%; of whom 77% entered mental health treatment within a month of diagnosis. Prevalence of substance use disorders was 49%; of whom 37% entered substance use disorder treatment within a month of diagnosis. For veterans exiting prison, increasing access to VA health care, especially for rural veterans, and for substance use disorder treatment, are important quality improvement targets.

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Objectives: A variety of patients – including women, older, racial/ethnic minority, rural, homeless, and justice-involved patients – are vulnerable to experiencing poor healthcare access and quality, such as lower quality substance use disorder treatment, than other populations. The current study examined receipt of medications for opioid use disorder by vulnerable populations within Veterans Health Administration (VHA) facilities to determine whether there are patient and facility factors that are associated with disparities in care. Methods: Using national VHA clinical/administrative data from Fiscal Year 2017, we calculated receipt of medications for opioid use disorder using the American Society for Addiction Medicine quality measure specifications. A mixed-effects logistic regression model tested whether patient vulnerability (ie, women, older age, racial/ethnic minority, rural residence, homeless, and justice-involved) and facility (eg, regional location, availability of a methadone clinic) characteristics were associated with medication receipt. Results: Among the 53,568 veterans at VHA facilities diagnosed with opioid use disorder in Fiscal Year 2017, vulnerable populations – including women, older, Black, rural, homeless, and justice-involved veterans – had lower odds of receiving medications for opioid use disorder than their nonvulnerable counterparts. Veterans had higher odds of receiving medications at facilities with a higher proportion of patients with opioid use disorder, but lower odds of receiving medications at facilities in the Southern region compared to the Northeast region of the United States. Conclusions: Quality improvement efforts targeted at vulnerable populations are needed at the VHA to ensure these groups receive the same quality of substance use disorder treatment as other veterans.