Gender differences in substance use treatment utilization the year prior to deployment in army service members

Wooten, Nikki R.; Mohr, Beth A.; Lundgren, Lena; Adams, Rachel Sayko; Merrick, Elizabeth L.; Jeffery, Diana D.; Williams, Thomas V.; Larson, Mary Jo

doi:10.1016/j.drugalcdep.2014.02.676

Cited by 4 publications

(4 citation statements)

References 35 publications

(44 reference statements)

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“…With exceptions, 39 prior studies have found women to be less likely to obtain various alcohol-related services. [40][41][42] Because the stigma of alcohol misuse [43][44][45] may be higher among women, 46 they may be more likely to under-report their alcohol use and conceal the severity of their alcohol problems.…”

Section: Discussionmentioning

confidence: 99%

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

2016

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BACKGROUND: There is limited data on the extent to which indicated alcohol interventions are delivered in U.S. ambulatory care settings. OBJECTIVE: To assess the receipt of alcohol-related services, including assessment of use, advice to reduce drinking, and information about alcohol treatment, during ambulatory care visits. DESIGN: Secondary data analysis of the 2013 National Survey on Drug Use and Health, a cross-sectional, nationally representative survey of civilians in the non-institutionalized U.S. general population (response rate 71.7 %). PARTICIPANTS: Adult ambulatory care users in the public use data file who did not obtain emergency or inpatient services (n = 17,266). MAIN MEASURES: Measurements included respondents' alcohol consumption, heavy episodic drinking, alcohol use disorder, healthcare use, and receipt of alcoholrelated interventions. KEY RESULTS: Approximately 71.1 % of ambulatory care users received an alcohol assessment. Among pastmonth heavy episodic drinkers without an alcohol use disorder who reported receiving an alcohol assessment, 4.4 % were advised to cut back. Among individuals with alcohol abuse and alcohol dependence who reported receiving an alcohol assessment, 2.9 % and 7.0 %, respectively, were offered information about treatment. CONCLUSIONS: Rates of alcohol screening and assessment were relatively high among adults who attended healthcare visits, but rates of intervention were low, even when individuals were assessed for use. Efforts are needed to expand delivery of interventions when patients are identified as positive for risky drinking, hazardous alcohol use, and alcohol use disorders during ambulatory care visits.

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Section: Discussionmentioning

confidence: 99%

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

2016

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“…Although alcohol-related health-risk behaviors (e.g., driving while intoxicated) are higher for males than females in the general population and military (Ames and Cunradi, 2004; Center for Disease Control, n.d.), females are more vulnerable to alcohol-related problems at lower levels of consumption (Brown et al, 2010). When this is taken into account, Army females demonstrate higher rates of unsafe drinking compared to males (Lande et al, 2007), and those with symptoms of alcohol dependency show greater risk of injury, co-occurring health conditions, death, and may also be more likely than males to go un-diagnosed by health providers until symptoms have progressed (Lande et al, 2007; Wooten et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

Medical-encounter mental health diagnoses, non-fatal injury and polypharmacy indicators of risk for accident death in the US Army enlisted soldiers, 2004–2009

Lewandowski‐Romps

Schroeder

Berglund

et al. 2018

Preventive Medicine

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Accidents are a leading cause of deaths in U.S. active duty personnel. Understanding accident deaths during wartime could facilitate future operational planning and inform risk prevention efforts. This study expands prior research, identifying health risk factors associated with U.S. Army accident deaths during the Afghanistan and Iraq war. Military records for 2004-2009 enlisted, active duty, Regular Army soldiers were analyzed using logistic regression modeling to identify mental health, injury, and polypharmacy (multiple narcotic and/or psychotropic medications) predictors of accident deaths for current, previously, and never deployed groups. Deployed soldiers with anxiety diagnoses showed higher risk for accident deaths. Over half had anxiety diagnoses prior to being deployed, suggesting anticipatory anxiety or symptom recurrence may contribute to high risk. For previously deployed soldiers, traumatic brain injury (TBI) indicated higher risk. Two-thirds of these soldiers had first TBI medical-encounter while non-deployed, but mild, combat-related TBIs may have been undetected during deployments. Post-Traumatic Stress Disorder (PTSD) predicted higher risk for never deployed soldiers, as did polypharmacy which may relate to reasons for deployment ineligibility. Health risk predictors for Army accident deaths are identified and potential practice and policy implications discussed. Further research could test for replicability and expand models to include unobserved factors or modifiable mechanisms related to high risk. PTSD predicted high risk among those never deployed, suggesting importance of identification, treatment, and prevention of non-combat traumatic events. Finally, risk predictors overlapped with those identified for suicides, suggesting effective intervention might reduce both types of deaths.

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“…Behavioral health problems and service delivery in WTUs are examined to identify modifiable risk and protective factors predicting SUDs, WTU assignment, length of assignment, and treatment effectiveness. Differences by service component, sex, and race/ethnicity are examined, given unique military and deployment experiences of NGR, women, and racial minorities (Wooten, Adams, & Davis, ; Wooten et al, ; Wooten et al, ).…”

Section: Discussionmentioning

confidence: 99%

Army Warrior Care Project (AWCP): Rationale and methods for a longitudinal study of behavioral health care in Army Warrior Transition Units using Military Health System data, FY2008–2015

Wooten

Brittingham

Hossain

et al. 2019

Int J Methods Psych Res

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Objectives Warrior Transition Units (WTUs) are specialized military units co‐located with major military treatment facilities providing a Triad of Care involving primary care physicians, case managers, and military leadership to soldiers needing comprehensive medical care. We describe the rationale and methods for studying behavioral health care in WTUs and characterize soldiers assigned to WTUs. Methods The Army Warrior Care Project (AWCP) analyzes U.S. Department of Defense Military Health System data to examine behavioral health problems and service utilization among Army soldiers who were assigned to WTUs after returning from Afghanistan and Iraq deployments, FY2008–2015. Results WTU members (N = 31,094) comprised 3.5% of the AWCP cohort (N = 883,091). Almost all (96.5%) had one WTU assignment for a median of 327 days; 77.3% were assigned before deployment ended, ≤30 or >365 days post‐deployment; 59.4% had deployment‐related behavioral health diagnoses. Conclusions An overwhelming majority of soldiers had one WTU assignment for almost a year. A substantial proportion of WTU soldiers had psychological impairment, which limited performance of their military duties. The AWCP is the first longitudinal study of redeployed soldiers assigned to WTUs and provides a unique opportunity to advance our understanding of behavioral health among soldiers needing comprehensive medical care after combat deployments.

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Gender differences in substance use treatment utilization the year prior to deployment in army service members

Cited by 4 publications

References 35 publications

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

Medical-encounter mental health diagnoses, non-fatal injury and polypharmacy indicators of risk for accident death in the US Army enlisted soldiers, 2004–2009

Army Warrior Care Project (AWCP): Rationale and methods for a longitudinal study of behavioral health care in Army Warrior Transition Units using Military Health System data, FY2008–2015

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