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In the last decade, new policies have been put into place that require every VHA facility to have buprenorphine available as a covered medication to all veterans for whom the treatment is indicated, such as those whose needs cannot be met by OATP Opioid-Agonist Treatment Program methadone centers. In a survey of VHA medical personnel, there was still wide variability in whether treatment centers were prescribing buprenorphine or connecting patients with methadone clinics. Increasing access to OAT for opioid-dependent veterans has been an ongoing priority for the VHA Office of Mental Health Services OMHS , and several active efforts have been started to increase buprenorphine acceptance and use in the VHA, such as training more physicians in the prescribing of buprenorphine.

Studies have found that prescription opioid use is significantly associated with co-occurring PTSD symptom severity.

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PTSD patients are also more likely to use prescription opioids in combination with sedatives or cocaine. Females are more than three times as likely as males to have co-occurring PTSD symptoms and prescription opioid use problems. Younger PTSD patients years old are also at higher risk for opioid abuse.

Finding the best treatment for patients struggling with both PTSD and opioid use disorder can be challenging. Patients may deny symptoms of PTSD until they develop trust in their medical provider. For example, opioid withdrawal symptoms often look like the hyper-vigilance and heightened startle response of patients with PTSD. In fact, some researchers think that PTSD and opioid withdrawal may share the same neurobiologic circuit in the body. Individuals with prescription opioid problems are less likely to do well in treatment when they are also dealing with any kind of co-occurring psychiatric disorders, including PTSD.

While the use of drugs and alcohol among veterans is a known issue , substance abuse among active-duty members of the United States Armed Forces is itself a significant problem.

[Full text] Substance use disorders in military veterans: prevalence and treatment | SAR

This article will discuss only substance abuse by active-duty military personnel, the problems caused by it, and some of the factors that are thought to contribute to it. Abuse of alcohol or other drugs can be problematic for active-duty military personnel for many of the same reasons that substance use issues impact productivity in the private sector.

Substance Abuse 2016

Drug and alcohol abuse may lead to poor on-the-job performance. Drug and alcohol abuse could place other individuals who work with the affected person at risk. Within the military, specifically, the use and abuse of drugs and alcohol can cause problems in terms of readiness, discipline, and the mental and physical health of the service members.

It can also cause issues within the unit, disrupting the coherence that is so vital to the safety of the soldier during battle. Alcohol and prescription drugs including sedatives and opioid painkillers are more commonly abused than illicit drugs. Just over one-third either engaged in hazardous drinking behaviors or met criteria for alcohol use disorder AUD. In the Marine Corps, specifically, nearly half of these service members engaged in disordered or hazardous drinking. Testing positive for an illegal substance on a random drug screen may result in a dishonorable discharge and potential criminal charges.

Prescription Medications While a zero-tolerance policy on drug use has resulted in low levels of illicit substance use among active-duty military members, service members are not immune to the ongoing epidemic of prescription drug abuse. In just 8 years between and , the number of painkiller prescriptions written by military doctors quadrupled. Certain types of military service, whether past or present, may be associated with additional, unique risk factors.

In summary, veterans demonstrate high rates of SUDs.

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There is a clear need for the development of novel, more effective, evidence-based interventions to address the health care needs of our veterans and their family members struggling with SUDs. Efforts to overcome barriers to those seeking treatment are needed so that veterans in need of services are able to access treatment and experience long-term recovery.

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IOM Recommendations to Battle Substance Use Disorders in the US Military

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Substance Abuse Prevalence and Influence

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Substance Use Disorders in the U.S. Armed Forces

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