Introduction
•Substance use disorders (SUD), such as alcohol abuse and drug addiction, are serious health conditions that affect many Americans, including a substantial number of veterans who receive care from the Department of Veterans Affairs (VA). SUDs are a concern for both older veterans and veterans ofthe current operations in Iraq and Afghanistan. According to VA, about 420,000 of the over 5 million veterans receiving care at VA had SUD diagnoses in fiscal year 2009.*
•Identification and treatment of veterans with SUDs is important,as SUDs can have harmful effects on veterans’ physical, psychological, and social well-being. For example, substance use is a primary risk factor for both homelessness and suicide among veterans.
•It is also important to identify and counsel veterans who may not meet the diagnostic criteria for an SUD—that is, they may not abuse or be dependent on alcohol or drugs—but use substances to a degree that puts them at risk for developing an SUD or other health problems.
•VA’s SUD treatment services have been evolving in recent years. VA’s 2004 mental health strategic plan** noted that its system of SUD services had been in decline since the mid-1990s and that VA needed to improve access to care for veterans with SUDs. Since then, VA has taken steps to enhance its SUD services.
Objectives
You asked us to review VA’s provision of SUD services. This briefing provides an overview of:
•The challenges that VA officials and providers reported facing in their efforts to provide SUD services to veterans who have or are at risk for SUDs.
•The national efforts VA has recently undertaken to improve its SUD services for veterans who have or are at risk for SUDs.
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