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Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization.

ABSTRACT: OBJECTIVE:Several epidemiological studies have reported that veterans and nonveterans have comparable substance use disorder (SUD) prevalence and SUD treatment rates for SUD and treatments of several types. No studies have compared functioning among veterans with SUD to veterans without SUD or to nonveterans. METHOD:We investigated the prevalence of past-year and lifetime SUD (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), overall and by substance, and estimated the association with physical and mental health functioning and treatment utilization and need among veterans and nonveterans in a nationally representative sample. RESULTS:Predicted prevalence of any past-year SUD, with and without tobacco use disorder (TUD), among veterans was 32.9% and 17.1%, and prevalence of any lifetime SUD, with and without TUD, was 52.5 and 38.7%, respectively. Veterans had higher prevalence of past-year and lifetime SUD for some substances (e.g., tobacco, alcohol) but not others (e.g., cannabis, opioid). Lower physical and mental health functioning was found among veterans, relative to nonveterans, and participants with SUD, relative to those without SUD, and veterans with SUD reported the lowest functioning across all domains. More veterans than nonveterans received any SUD treatment and SUD treatment in specific domains (e.g., self-help). About 70% of veterans with past-year SUD did not receive treatment, but only 5.4% reported needing and not receiving treatment. CONCLUSIONS:Relative to nonveterans, veterans have higher prevalence of past-year TUD and lifetime alcohol use disorder or TUD and lower physical or mental health functioning. A minority of veterans receive SUD treatment, and few report unmet need for treatment.

SUBMITTER: Boden MT

PROVIDER: S-EPMC6308169 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization.

Boden Matthew Tyler MT Hoggatt Katherine J KJ

Journal of studies on alcohol and drugs 20181101 6

<h4>Objective</h4>Several epidemiological studies have reported that veterans and nonveterans have comparable substance use disorder (SUD) prevalence and SUD treatment rates for SUD and treatments of several types. No studies have compared functioning among veterans with SUD to veterans without SUD or to nonveterans.<h4>Method</h4>We investigated the prevalence of past-year and lifetime SUD (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), overall ...[more]

PMID: 30573015

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Project description:BackgroundOur aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost.MethodsThe National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur).ResultsLifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00-2.37) and SUD (3.5; 95% CI 3.22-3.81).ConclusionsWe found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.

Dataset Information

Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization.

Publications

Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization.

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