Substance use disorders in military veterans: prevalence and treatment challenges

Teeters, Jenni B; Lancaster, Carol; Brown, Delisa G.; Back, Sudie E.

doi:10.2147/sar.s116720

Cited by 207 publications

(135 citation statements)

References 76 publications

(99 reference statements)

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“…Mudumbai discussed the Million Veterans Program (MVP), which tracks health outcomes in veterans (ie, a population with high opioid use) and maintains extensive EMR data. Twenty-four percent of veterans received an opioid prescription in 2009, 13 and these individuals were twice as likely to die from an accidental opioid overdose relative to the general public. 14 The MVP has expended extensive efforts to standardize phenotypes across healthcare systems, making phenotypic harmonization with other cohorts and animal models easier.…”

Section: Panel Discussion and Recommendations: Harmonizing Phenotypmentioning

confidence: 99%

See 1 more Smart Citation

National Institute on Drug Abuse genomics consortium white paper: Coordinating efforts between human and animal addiction studies

Cates

Benca-Bachman

Guglielmo

et al. 2019

Genes Brain and Behavior

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The National Institute on Drug Abuse Genetics and Epigenetics Cross‐Cutting Research Team convened a diverse group of researchers, clinicians, and healthcare providers on the campus of the University of California, San Diego, in June 2018. The goal was to develop strategies to integrate genetics and phenotypes across species to achieve a better understanding of substance use disorders through associations between genotypes and addictive behaviors. This conference (a) discussed progress in harmonizing large opioid genetics cohorts, (b) discussed phenotypes that are used for genetics studies in humans, (c) examined phenotypes that are used for genetics studies in animal models, (d) identified synergies and gaps in phenotypic analyses of human and animal models and (e) identified strategies to integrate genetics and genomics data with phenotypes across species. The meeting consisted of panels that focused on phenotype harmonization (Dr. Laura Bierut, Dr. Olivier George, Dr. Dan Larach and Dr. Sesh Mudumbai), translating genetic findings between species (Dr. Elissa Chesler, Dr. Gary Peltz and Dr. Abraham Palmer), interpreting and understanding allelic variations (Dr. Vanessa Troiani and Dr. Tamara Richards) and pathway conservation in animal models and human studies (Dr. Robert Hitzemann, Dr. Huda Akil and Dr. Laura Saba). There were also updates that were provided by large consortia (Dr. Susan Tapert, Dr. Danielle Dick, Dr. Howard Edenberg and Dr. Eric Johnson). Collectively, the conference was convened to discuss progress and changes in genome‐wide association studies.

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Section: Panel Discussion and Recommendations: Harmonizing Phenotypmentioning

confidence: 99%

“…13 and these individuals were twice as likely to die from an accidental opioid overdose relative to the general public. 13 and these individuals were twice as likely to die from an accidental opioid overdose relative to the general public.…”

Section: Perceived Challenges and Areas For Improvement: Harmonizinmentioning

confidence: 95%

National Institute on Drug Abuse genomics consortium white paper: Coordinating efforts between human and animal addiction studies

Cates

Benca-Bachman

Guglielmo

et al. 2019

Genes Brain and Behavior

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“…In turn, opioid pain management is a significant risk factor for later opioid and heroin misuse in both veteran and civilian populations . Since 2012, both the Department of Defense and VHA have initiated prescription guidelines to limit long‐term medication pain management, and there is initial evidence based on analysis of VHA administrative data that these measures are reducing long‐term opiate prescription use in VHA . However, opioid misuse among veterans and the rates of substance use disorders (SUDs) remain high, suggesting the need for other measures to address this problem …”

Section: Purposementioning

confidence: 99%

“…[7][8][9][10][11] Since 2012, both the Department of Defense and VHA have initiated prescription guidelines to limit long-term medication pain management, and there is initial evidence based on analysis of VHA administrative data that these measures are reducing longterm opiate prescription use in VHA. [12][13][14][15] However, opioid misuse among veterans and the rates of substance use disorders (SUDs) remain high, suggesting the need for other measures to address this problem. 6,10,[16][17][18] It is a challenge for VHA to develop a comprehensive understanding of the trends in SUDs for veterans, including opioid use disorders, because not all veterans are enrolled in VHA.…”

mentioning

confidence: 99%

Community Treatment for Opioid Use Disorders in Urban and Rural Veterans

Turvey

Lund

Jones

et al. 2019

The Journal of Rural Health

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Purpose The recent opioid crisis is characterized by a relatively greater increase in opioid use disorder and related mortality in rural populations when compared with urban populations.1‐5 As almost a quarter of our nation's veterans reside in rural settings, the United States Veterans Health Administration (VHA) is interested in the impact of this epidemic on rural veterans. This study aims to develop a comprehensive understanding of the trends in substance use disorders (SUD) in veterans seeking treatment from community, non‐VHA providers. Methods Using Substance Abuse and Mental Health Services Administration (SAMHSA)’s Treatment Episode Data Set (TEDS), this study presents the prevalence of treatment for veterans seeking initial admission into publicly funded non‐VHA SUD treatment centers for years 2011‐2016. Comparisons were made for all SUD types. Multivariate trend analysis based on annual data from 2011 to 2016 compared urban and rural veterans for opioid use disorder treatment. Findings Both urban and rural veterans had comparable rates of treatment for SUD, though rural veterans had slightly higher rates of injectable (11.2% vs 8.7%; P < .001) and opiate drug use disorder admissions (20.7% vs 18.1%; P = .014). Both urban and rural showed an increase in admissions for opioid, heroin, and injectable drug use disorders between 2011 and 2016 (P < .001). Conclusions Comprehensive understanding of veteran SUD and treatment should include national‐level data on community non‐VHA treatment. SAMHSA's TEDS for years 2011‐2016 provides clinical information for more than 90,000 veterans and indicates continued increase in treatment seeking for opioid use disorders, particularly for rural veterans.

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“…Similarly, in a comparison of 1,700 veteran men with and without human immunodeficiency virus (HIV) infection, risky sexual behavior was relatively common, with 1 in 10 men reporting more than two sexual partners and inconsistent condom use in the last year (Cook et al, 2006). Active duty servicemen and veterans are also more likely to report heavy use of alcohol than civilian men (Teeters, Lancaster, Brown, & Back, 2017), a behavior linked to risky sexual behavior (Cook et al, 2006).…”

mentioning

confidence: 99%

Trauma and Sexual Risk: Do Men and Women Veterans Differ?

Combellick

Dziura

Portnoy

et al. 2019

Women's Health Issues

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Trauma has been associated with risky sexual behavior in diverse populations. However, little is known about this association among men and women veterans. This study hypothesized that 1) a history of trauma would be associated with risky sexual behavior among men and women veterans, 2) interpersonal trauma would predict risky sexual behavior among women, whereas noninterpersonal trauma would predict risky sexual behavior among men, and 3) military-related trauma would constitute additional risk. Using data from 567 women and 524 men veterans enrolled at the Veterans Health Administration, this study investigated the association between trauma-related experiences and risky sexual behavior in the last 12 months. Risk and protective factors that have been frequently associated with sexual behavior in previous research were also included in the model. Methods: This study was drawn from the Women Veterans Cohort Study, a national survey of veterans. Bivariate and multivariate analyses were performed after multiple imputation for missing data. Results: Predictive factors associated with risky sexual behavior differed between men and women veterans. Among women, childhood sexual victimization and intimate partner violence were associated with risky sexual behavior. Among men, binge drinking was the single significant risk factor. Military exposures were not significantly associated with risky sexual behavior in either men or women. Conclusions: This study lays the groundwork for theory-generating research into the psychological underpinnings of noted associations and underscores the importance of integrated health services to address the range of issues affecting sexual behavior and related health outcomes. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health. The Women Veterans Cohort Study (WVCS) is supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Project [IIR 12-118]. Joan Combellick had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis

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Substance use disorders in military veterans: prevalence and treatment challenges

Cited by 207 publications

References 76 publications

National Institute on Drug Abuse genomics consortium white paper: Coordinating efforts between human and animal addiction studies

National Institute on Drug Abuse genomics consortium white paper: Coordinating efforts between human and animal addiction studies

Community Treatment for Opioid Use Disorders in Urban and Rural Veterans

Trauma and Sexual Risk: Do Men and Women Veterans Differ?

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