Alcohol-involved overdose deaths in US veterans

Lin, Lewei Allison; Bonar, Erin E.; Zhang, Lan; R, Girard; Coughlin, Lara N.

doi:10.1016/j.drugalcdep.2021.109196

Cited by 8 publications

(4 citation statements)

References 38 publications

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“…Affecting over 40 million people in the USA, SUD is a leading contributor to disability-adjusted life years [ 4 , 10 ]. Deaths resulting from drug and alcohol-related overdoses have been rising, now accounting for over 100,000 lives lost annually in the United States [ 11 , 12 ]. These trends have been further exacerbated by the COVID-19 pandemic [ 13 , 14 ].…”

Section: How Gastroenterologists and Hepatologists Can Impact The Pub...mentioning

confidence: 99%

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Haque

Fiellin

2022

Dig Dis Sci

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Section: How Gastroenterologists and Hepatologists Can Impact The Pub...mentioning

confidence: 99%

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Haque

Fiellin

2022

Dig Dis Sci

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“…Rates of heavy alcohol use, binge drinking, and associated alcohol-related problems have also been shown to be higher among those exposed to combat [ 48 , 49 ]. A recent study using VA records linked to National Death Index data examined trends in alcohol-related overdose mortality between 2012–2018 and found that 2,421 veterans died from an alcohol-involved overdose and as expected, the vast majority of these deaths also involved opioids [ 50 ].…”

Section: Intersecting Epidemics – Biopsychosocial Pain In Veterans An...mentioning

confidence: 99%

“…In addition to addressing perceived barriers to VA care, when considering how to best address polysubstance- and alcohol-involved overdose, the importance of co-location of services and resources for veterans is critical to ensure veterans in need have access. A recent study found that only 33% of those who died from alcohol-involved overdose received treatment in a substance use disorder clinic in the year preceding death, compared to 65% who were seen in mental health and 86% in primary care [ 50 ]. Moreover, some veterans use the VA infrequently and only for specific services.…”

Section: Preventing and Responding To Overdose Among The Veteran Popu...mentioning

confidence: 99%

U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts

et al. 2022

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U.S. military veterans have been heavily impacted by the opioid overdose crisis, with drug overdose mortality rates increasing by 53% from 2010–2019. Risk for overdose among veterans is complex and influenced by ongoing interaction among physiological/biological, psychological, and socio-structural factors. A thorough understanding of opioid-related overdose among veterans, one that goes beyond simple pharmacological determinism, must examine the interplay of pain, pain treatment, and stress, as well as psychological and social experiences—before, during, and after military service. Comprehensive efforts to tackle the overdose crisis among veterans require interventions that address each of these dimensions. Promising interventions include widespread naloxone distribution and increased provision of low-threshold wrap-around services, including medications for opioid use disorder (MOUD) and holistic/complementary approaches. Interventions that are delivered by peers – individuals who share key experiential or sociodemographic characteristics with the population being served – may be ideally suited to address many of the barriers to opioid-related risk mitigation common among veterans. Community care models could be beneficial for the large proportion of veterans who are not connected to the Veterans Health Administration and for veterans who, for various reasons including mental health problems and the avoidance of stigma, are socially isolated or reluctant to use traditional substance use services. Interventions need to be tailored in such a way that they reach those more socially isolated veterans who may not have access to naloxone or the social support to help them in overdose situations. It is important to incorporate the perspectives and voices of veterans with lived experience of substance use into the design and implementation of new overdose prevention resources and strategies to meet the needs of this population. Key messages U.S. military veterans have been heavily impacted by the opioid overdose crisis, with drug overdose mortality rates increasing by 53% from 2010–2019. The risks for overdose that veterans face need to be understood as resulting from an ongoing interaction among biological/physiological, psychological, and social/structural factors. Addressing drug overdose in the veteran population requires accessible and non-judgemental, low threshold, wraparound, and holistic solutions that recognise the complex aetiology of overdose risk for veterans.

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“…Alcohol-related deaths were rising prior to 2020 [1,2], and accelerated during the novel SARS-CoV-2 (COVID-19) pandemic [3,4]. The increase in alcohol-related mortality during COVID-19 suggests a decrease in alcohol use disorder (AUD) treatment utilization and/or an increase in treatment need that has not been met in this vulnerable population.…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID‐19 on trends in alcohol use disorder treatment in Veterans Health Administration

et al. 2023

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Background and Aims The COVID‐19 pandemic disrupted health‐care provision in the United States and prompted increases in telehealth‐delivery of care. This study measured alcohol use disorder (AUD) treatment trends across visit modalities before and during COVID‐19. Design, Setting, Participants and Measurements We conducted a national, retrospective cohort study with interrupted time‐series models to estimate the impact of COVID‐19 on AUD treatment in the Veterans Health Administration (VHA) in the United States during pre‐COVID‐19 (March 2019 to February 2020) and COVID‐19 (March 2020 to February 2021) periods. We analyzed monthly trends in telephone, video and in‐person visits for AUD treatment and compared patient and treatment characteristics of patients receiving AUD treatment between the pre‐COVID‐19 and COVID‐19 periods. AUD was defined using International Classification of Diseases, 10th revision (ICD‐10) codes for alcohol abuse (F10.1) and alcohol dependence (F10.2), which have previously been used to study AUD in VHA. Findings The predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the beginning of the pre‐COVID period was 13.8% (n = 49 494). The predicted percentage decreased by 4.3% (P = 0.001) immediately at the start of the COVID‐19 period due to a decline in AUD psychotherapy. Despite an increase of 0.3% per month (P = 0.026) following the start of COVID‐19, the predicted percentage of VHA patients with an AUD diagnosis receiving any AUD treatment at the end of the study period remained below the pre‐COVID‐19 period. In February 2021, AUD psychotherapy visits were primarily delivered by video (50%, 58 748), followed by in‐person (36.6%, 43 251) and telephone (13.8%, 16 299), while AUD pharmacotherapy visits were delivered by telephone (38.9%, 3623) followed by in‐person (34.3%, 3193) and video (26.8%, 2498) modalities. Characteristics of VHA patients receiving AUD treatment were largely similar between pre‐COVID‐19 and COVID‐19 periods. Conclusions Despite increased telehealth use, the percentage of United States Veterans Health Administration patients with an alcohol use disorder (AUD) diagnosis receiving AUD treatment declined during COVID‐19 (March 2020 to February 2021) mainly due to a decrease in psychotherapy.

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Alcohol-involved overdose deaths in US veterans

Cited by 8 publications

References 38 publications

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts

The impact of COVID‐19 on trends in alcohol use disorder treatment in Veterans Health Administration

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