LECTURE 8 HYPOTHESIS TESTING AND STATISTICAL SIGNIFICANCE MSc (Addictions) Addictions Department.
Engaging Younger Veterans Struggling with Addictions
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Transcript of Engaging Younger Veterans Struggling with Addictions
Engaging Younger Veterans Struggling with Addictions
Kellie Rollins, Psy.D.Psychologist, Substance Abuse Programs
San Francisco VA Medical CenterAssistant Clinical Professor
University of California, San Francisco
Disclosures: No Commercial Interest
No Financial relationshipsNo Relevant financial relationships
No Conflict of Interest
Overview• Profile of OEF/OIF/OND Veterans– Addiction prevalence
• Best Practices Summary– For SUD w/in the VA
• Opioid Replacement Treatment Clinic (ORT)- San Francisco VA Medical Center
• Young Adults Recovery Group• Q&A
“The 9/11 Generation”- Barack Obama
OEF - Operation Enduring FreedomOctober 7, 2011 – present.
OIF - Operation Iraqi Freedom March 30, 2003 - redesignated.
OND - Operation New Dawn
September 1, 2010 - present.
OEF / OIF / OND • Over 5 million American men and
women served in the ranks of the US armed forces since 9/11/2001.
• Over 2 million US Troops deployed to Iraq & Afghanistan since 09/11.
• 1.6 million active duty.
OEF / OIF / OND• 1/3 have mental health diagnoses or
serious psychosocial problems • 1/5 dx with SUD• 15% unemployment• 78% divorce rate • Significant homelessness• Elevated risk of suicide
Scope of the SUD problem
• Alcohol Dependence rate doubled in the last 5 years (US Army figure).
• 27% of Army active duty misuse alcohol (Santiago et al., 2010).
• Youngest service members at highest risk (Bray et al., 2009; Jacobson et al., 2008).
• High correlation between substance misuse and PTSD (Jacobson et al., 2008).
Veterans vs Non-Veterans – % of SUD by age
18-25 26-54 55 or older0
5
10
15
20
25
30 29
14.4
3.9
27
13.3
3.2
VeteransNonveterans
NSDUH, November 2004
Serious Psychological Distress (SPD), SUD, and Co-Occurring SPD and SUD in the Past Year among
Veterans, by Age: 2004 to 2006
SPD SUD Co-occurring0
5
10
15
20
25
30
20.9
25
8.411.2 11.3
2.74.3 4.4
0.7
Aged 18-25Aged 26-54Aged 55 or older
SAMHSA, 2004, 2005 and 2006 NSDUHs
Prevalence of SPD, SUD, SPD/SUD past year among Veterans, by gender: 2004-2006
SAMHSA, 2004, 2005 and 2006 NSDUHs
Disorder Males Females
SPD 6.5% 14.5%
SUD 7.2% 5.8%
SPD/SUD 1.5% 2.0%
Rx Drug Use/Abuse
• Doubled from 2002-2005
• Tripled from 2005-2008
Increasing rates of opioid use for pain among Veterans aged 18-30.
NIDA Brief, April, 2011
Co-occurring Triad
VAMCs with Onsite OTP and/or Buprenorphine Treatment (BT)
20%
26%51%
3% VAMCs with both OTP and BT (28/139)
VAMCs with Neither OTP or BT (36/139)
VAMCs with BT Only (71/139)
VAMCs with only OTP (4/139)
San Francisco Veterans AffairsMedical Center
Opioid Replacement Treatment Clinic(ORT)
Methadone &Buprenorphine
Interdisciplinary Treatment Team
SFVAMC ORT Best Practices
Young Adults Recovery Group SFVAMC, Substance Abuse Programs
Group Themes
No Script for Treating Younger Veterans
NO Rx
“Younger veterans are difficult to engage! They have life
on their minds.”Dr. Sam Wan, 2010, 2011, 2012
Q & A