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Substance Use

"When I got back, especially at first, it was impossible to turn my brain off and fall asleep at night. Drinking was a quick and easy way to combat that, but also one that caused a lot more problems later on."
(Source: Make the Connection website)

Basics

Substance Use and Dependence Basics

8.3% of VA patients meet criteria for a Substance Abuse Disorder, other than nicotine dependence (2010). In addition, approximately 20% of VA enrollees are current smokers. (Source: Quality Enhancement Research Initiative, QUERI)

Indicators of Substance Misuse Include:

  • Substance-related difficulties in fulfilling obligations in work, school, or home
  • Using substances in hazardous situations such as driving while drinking
  • Legal problems related to substance use
  • Social or interpersonal problems related to the effects of using substances

Indicators of Substance Dependence Include:

  • Tolerance: the ability to drink alcohol or use drugs in greater quantities over time
  • Compulsive behavior: the inability to stop drinking alcohol or using drugs in spite of negative life consequences
  • Withdrawal: experiencing symptoms such as feeling sick and distressed when attempting to quit drinking alcohol or using drugs

Problems with drinking or drug use may occur in response to stress, or in combination with posttraumatic stress disorder, depression, or other mental health and medical conditions.

See the Make the Connection website to learn more about the signs of problematic drug or alcohol use and related problems. You may also want to visit the website to listen to Veteran stories regarding their experiences with substance use and related difficulties.

Assessment

Assessing for a Substance Use Problem

There are many screening tools to assess drug and alcohol misuse. This section provides information about some widely used screening tools for alcohol, nicotine, and other drug misuse. Positive screening serves as a very valuable early warning sign that can identify potential substance use problems before they get worse. See the Online Resources section to learn about additional tools.

Client Materials

Client Educational Materials

Brochures, Booklets, and Handouts on Substance Misuse:

  • Download a brochure to encourage Veterans to discuss and self-assess for substance misuse.
  • Take a look at the handouts for clients on alcohol and other drug use on the AfterDeployment website. These include information on topics such as:
    • Tips for drinking moderately
    • How to know if there is a problem
    • Substance use and combat stress
  • NIDA provides a selection of booklets and fact sheets for both clients and providers.

Online Workshop for Clients:

The AfterDeployment website offers an online client workshop and assessments to provide more information about assessing and treatment of alcohol and other drug use.

Drinker's Check-up:

A psychoeducational program for the client to help them to better understand whether their alcohol use is problematic and potential steps to help.

Treatment & Training

Treatment and Training

Referring to VA

Referring to VA

Among the many behavioral health services available through VA is treatment for Substance Use Disorders (SUD). VA also is an innovator in SUD treatment by supporting research and development of best practices.

Learn More About VA Services for Veterans with Substance Use Disorders:

What Should I Consider When Referring?

If your client screens positive for substance misuse, they may be referred to specialized SUD treatment, behavioral medicine, or more general mental health services for further evaluation and possible treatment. In addition to individual services, Veterans can also find SUD treatment groups where they can connect with and receive support from other Veterans.

How Do I Refer?

Below are various ways to connect with VA to refer a client or to support the services your Veteran client is currently receiving:

  • The VA SUD program locator can help you find a SUD program at a local VA Medical Center.
  • If your Veteran client has served in Operations Enduring Freedom (OEF) or Iraqi Freedom (OIF), you may also speak with your local OEF/OIF coordinator.
  • To find contact information for your local VA medical Center or Vet Center, use the VA program locator.
  • You may also call VA's general information line: 1-800-827-1000.
  • For referral to treatment resources and facilities other than VA, a useful resource is the Substance Abuse Mental Health Services Administration (SAMHSA) Substance Abuse Treatment Facility Locator.

Online Resources

Online Resources

  • National Center for PTSD: A goldmine of materials and resources about PTSD for provider and client with resources that address co-occurring PTSD and Substance Use Disorders as well.
  • AfterDeployment: Information and materials on SUD and other associated conditions for the Veteran and his/her family.
  • Make the Connection: Veteran stories and educational information about a variety of signs, symptoms, and conditions for your client. This site also provides direction for the Veteran about next steps to take to seek treatment or resources.
  • QUERI: The VA Quality Enhancement Research Initiative (QUERI) Substance Use Disorders Website provides information for clinicians and researchers.
  • Facts About Buprenorphine: Learn the facts about Buprenorphine for the treatment of Opioid Addiction. Buprenorphine Fact Sheet English (PDF) / Buprenorphine Fact Sheet Spanish (PDF); Buprenorphine Resource Guide (PDF) (SAMHSA Products)
  • Self-Help Toolkit: The 3- step Referral Method: A Product Developed by SUD QUERI, this toolkit teaches a strategy for engaging SUD clients in self-help care. The 3-Step Referral Method is an empirically validated method for referring patients to self-help programs. This step-by-step method augments standard referral practices with the addition of a few new components. The method was found to improve patient attendance and engagement in self-help programs and abstinence rates at one year. Protocol and handouts on this site.
  • The Rethinking Drinking Program: This is a NIAAA program addressing alcohol misuse. Includes information on alcohol misuse and provides tools such as a booklet for client's that discusses healthy drinking guidelines and self-assessment.
  • National Institutes: National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse
  • Searchable Assessment Libraries: These sites have many SUD and related issues assessment instruments available for download.
  • Alcoholics Anonymous: For meeting information, contact a local A.A. resource that provides meeting times and locations. Use this link for a list of meeting resources by state and province in the U.S. and Canada.

Cool Tool

Cool Intervention and Technology

My HealtheVet:

Veterans can self-administer a brief screen about alcohol, tobacco products, and other drugs at the VA My HealtheVet website. Enrollment in My HealtheVet can be done right on the website.

Veterans enrolled in VA can manage their health information - appointments, prescriptions, labs, blood tests and even exchange messages with their health care team.

The VA My HealtheVet website can be found at: https://www.myhealth.va.gov/.

Useful Resources



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