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Clinical Considerations in the Treatment of Substance Use Disorders with Veterans

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Abstract

This article addresses issues associated with the treatment of substance use disorders (SUD) in the U.S. veteran population. First, we examine special considerations regarding the assessment of alcohol and drug use in veterans. Second, we discuss current treatment approaches that have demonstrated efficacy in this population, with special consideration the issue of co-morbidity (especially SUD and Posttraumatic Stress Disorder). Third, we discuss two strategies to coordinate treatment of SUD: stepped care as a way to implement these treatments for SUD alone, and integrated treatment for SUD and co-morbid disorders. Finally, we discuss promising future directions for the treatment of SUD in the veteran population, including examination of mechanisms of behavior change, formal involvement of the veteran’s family in treatment, and use of existing datasets.

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References

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of mental disorders (DSM-IV). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Dalton, A., Saweikis, M., & McKellar, J. D. (2004). Health services for VA substance use disorder patients: Comparison of utilization of fiscal year 2005, 2004, 2003 and 2002, from www.chce.research.med.va.gov/pdf/2005yellowbook.pdf.

  • Darkins, A., Ryan, P., Kobb, R., Foster, L., Edmonson, E., Wakefield, B., et al. (2008). Care Coordination/Home Telehealth: The systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemedicine Journal and E-Health, 14(10), 1118–1126.

    Article  PubMed  Google Scholar 

  • Druss, B. G., & Rosenheck, R. A. (1997). Use of medical services by veterans with mental disorders. Psychosomatics, 38(5), 451–458.

    PubMed  CAS  Google Scholar 

  • Eggleston, A. M., Straits-Troster, K., & Kudler, H. (2009). Substance use treatment needs among recent veterans. North Carolina Medical Journal, 70, 54–58.

    PubMed  Google Scholar 

  • Foa, E. B., Hembree, E. A., & Rothbaum, E. O. (2007). Prolonged exposure therapy for PTSD. New York: Oxford.

    Google Scholar 

  • Hankin, C. S., Spiro, A., I. I. I., Miller, D. R., & Kazis, L. (1999). Mental disorders and mental health treatment among U.S. Department of Veterans Affairs outpatients: The Veterans Health Study. American Journal of Psychiatry, 156, 1924–1930.

    PubMed  CAS  Google Scholar 

  • Higgins, S. T., Silverman, K., & Heil, S. H. (Eds.). (2007). Contingency management in substance abuse treatment. New York: Guilford.

    Google Scholar 

  • Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008). Mild traumatic brain injury in U.S. Soldiers returning from Iraq. New England Journal of Medicine, 358, 453–463.

    Article  PubMed  CAS  Google Scholar 

  • Jacobsen, I. G., Ryan, M. A. K., Hooper, T. I., Smith, T. C., Amoroso, P. J., & Boyko, E. J. (2008). Alcohol use and alcohol-related problems before and after military combat deployment. Journal of the American Medical Association, 300, 663–675.

    Article  Google Scholar 

  • Kaplan, M. S., Huguet, N., McFarland, B. H., & Newsom, J. T. (2007). Suicide among male veterans: A prospective population-based study. Journal of Epidemiological Community Health, 61(7), 619–624.

    Article  Google Scholar 

  • Management of SUD Working Group. (2009). Management of substance use disorders (SUD), version 2.0. Washington, DC: Department of Veterans Affairs.

    Google Scholar 

  • McKay, J. R., Van Horn, D. H., Oslin, D. W., Lynch, K. G., Ivey, M., Ward, K., et al. (2010). A randomized trial of extended telephone-based continuing care for alcohol dependence: Within-treatment substance use outcomes. Journal of Consulting and Clinical Psychology, 78(6), 912–923.

    Article  PubMed  Google Scholar 

  • Miller, W. R. (1995a). Motivational enhancement therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence (Vol. 2). New York: DIANE Publishing.

    Google Scholar 

  • Miller, W. R. (1995b). Motivational enhancement with drug abusers. Albequerque, NM: University of New Mexico Press.

    Google Scholar 

  • Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA, 298(18), 2141–2148.

    Article  PubMed  CAS  Google Scholar 

  • Monti, P. M., Kadden, R. M., Rohsenow, D. J., Cooney, N. L., & Abrams, D. B. (2002). Treating alcohol dependence: A coping skills training guide (2nd ed.). New York: Guilford.

    Google Scholar 

  • Mueser, K. T., Drake, R. E., Turner, W., & McGovern, M. (2006). Comorbid substance use disorders and psychiatric disorders. In W. R. Miller & K. M. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 115–133). New York, NY: Guilford Press.

    Google Scholar 

  • Murphy, S. A., Collins, L. M., & Rush, A. J. (2007a). Customizing treatment to the patient: Adaptive treatment strategies. Drug and Alcohol Dependence, 88(Suppl. 2), S1–S3.

    Article  PubMed  Google Scholar 

  • Murphy, S. A., Lynch, K. G., Oslin, D., McKay, J. R., & TenHave, T. (2007b). Developing adaptive treatment strategies in substance abuse research. Drug and Alcohol Dependence, 88(Suppl. 2), S24–S30.

    Article  PubMed  Google Scholar 

  • Myers, R. J., & Miller, W. R. (Eds.). (2001). A community reinforcement approach to addiction treatment. New York: Cambridge University Press.

    Google Scholar 

  • Najavits, L. M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. New York: Guilford.

    Google Scholar 

  • Nowinski, J. (2003). Twelve step facilitation with Ce test. Center City, MN: Hazelden Publishing.

    Google Scholar 

  • Nowinski, J. (2006). Twelve step facilitation outpatient facilitator guide. Center City, MN: Hazelden Publishing.

    Google Scholar 

  • O’Farrell, T. J., & Fals-Stewart, W. (2006). Behavioral couples therapy for alcoholism and drug abuse. New York, NY: Guilford Press.

    Google Scholar 

  • Perlis, M. L., Jungquist, C., Smith, M. T., & Posner, D. (2006). Cognitive behavioral treatment of insomnia: a session-by-session guide. New York: Springer.

    Google Scholar 

  • SAMHSA. (2007). Results from the 2007 National Survey on Drug Use and Health: National findings. Rockville, MD: Office of Applied Studies, NSDUH.

    Google Scholar 

  • Seal, K. H., Bertenthal, D., Miner, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: Mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167(5), 476–482.

    Article  PubMed  Google Scholar 

  • Tanielian, T. L., & Jaycox, L. (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: Rand Corporation.

    Google Scholar 

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Acknowledgment

This work was supported by National Institute on Alcohol Abuse and Alcoholism Grant R01-AA27838 to Brian Borsari.

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Correspondence to Brian Borsari.

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The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government.

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Borsari, B., Capone, C., Mastroleo, N.R. et al. Clinical Considerations in the Treatment of Substance Use Disorders with Veterans. J Contemp Psychother 41, 247–253 (2011). https://doi.org/10.1007/s10879-011-9172-6

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  • DOI: https://doi.org/10.1007/s10879-011-9172-6

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