Substance Use Among Women Veterans: Epidemiology to Evidence-Based Treatment

Cucciare, Michael A.; Simpson, Tracy L.; Hoggatt, Katherine J.; Gifford, Elizabeth J.; Timko, Christine

doi:10.1080/10550887.2013.795465

Cited by 40 publications

(28 citation statements)

References 84 publications

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“…For example, women are currently underrepresented in SUD treatments studies (Cucciare, Simpson, Hoggatt, Gifford, & Timko, 2013) and intervention studies overall. There has been only one clinical trial evaluating an evidence-based PTSD treatment specifically among women Veterans (Schnurr et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Military Sexual Trauma and Co-occurring Posttraumatic Stress Disorder, Depressive Disorders, and Substance Use Disorders among Returning Afghanistan and Iraq Veterans

Gilmore

Brignone

Painter

et al. 2016

Women's Health Issues

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Purpose Posttraumatic stress disorder (PTSD), depressive disorders (DD), and substance use disorders (SUD) are prevalent among Veterans. A positive military sexual trauma (MST) screen is associated with higher likelihood of each of these disorders. The current study examined the associations between MST, gender, and co-occurring PTSD, DD, and SUD among Veterans receiving services at the Veterans Affairs (VA) to inform assessment and treatment. We were specifically interested in the interactions between MST and gender on co-occurring disorders. Methods The sample included 494,822 VA service seeking Veterans (12.5% women) deployed to Iraq and Afghanistan who recently separated from the military and were screened for MST between 2004 and 2013. Main Findings Veterans with positive MST screens had higher odds than those with negative screens of individual and co-occurring PTSD, DD, and SUD. The association between positive MST screens and diagnostic outcomes including PTSD was stronger for women than for men, and the association between positive MST screens and some diagnostic outcomes, including DD, was stronger for men than for women. Conclusions These results highlight the importance of assessing for and recognizing the potential MST and gender interactions in the clinical context among Veterans with co-occurring PTSD, DD, and/or SUD.

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Section: Discussionmentioning

confidence: 99%

Military Sexual Trauma and Co-occurring Posttraumatic Stress Disorder, Depressive Disorders, and Substance Use Disorders among Returning Afghanistan and Iraq Veterans

Gilmore

Brignone

Painter

et al. 2016

Women's Health Issues

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“…In addition, subgroups of women may have particularly lower likelihood of utilizing services because of the combination of gendered barriers and additional social disadvantages. For instance, women's alcohol problem characteristics and barriers to alcohol services could be exacerbated by demographic and contextual factors, such as minority race/ethnicity (Zemore et al., ), minority sexual orientation (Pennay et al., ), military service (Cucciare et al., ), or rural residence (Booth et al., ).…”

Section: Studies On Gender Differences In Alcohol Services Utilizationmentioning

confidence: 99%

Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

Gilbert

Pro

Zemore

et al. 2019

Alcoholism Clin & Exp Res

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Background: The majority of adults with alcohol use disorders do not obtain help, and women are less likely to utilize alcohol services than men. We sought to quantify gender differences in alcohol services utilization, overall and by type, using national longitudinal data and to explore potential gender differences in perceived need for help and reasons for not seeking help.Methods: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions from White, African American, and Hispanic adults (n = 2,592) who met DSM-IV criteria for alcohol abuse or dependence at Wave 1 (2000 to 2001). We tested gender differences in Wave 2 (2004 to 2005) services utilization, perceived need for help, and treatment barriers using Rao-Scott chi-square tests and assessed predictors of outcomes in multivariable logistic regression, adjusting for problem severity, co-occurring disorders, and demographics.Results: Women had much lower odds than men of utilizing any alcohol service (adjusted odds ratio [aOR] 0.53; 95% confidence interval [95% CI]: 0.33, 0.86), specialty services (aOR 0.41; 95% CI 0.19, 0.87), and 12-step groups (aOR 0.39; 95% CI 0.21, 0.71). Perceived need for help among those who had not used any services was very low (5%), with no gender difference. Further, men and women reported equivalent numbers of treatment barriers and the same rank order for the most frequently endorsed barriers. However, women were twice as likely as men to think a problem would get better by itself-the most frequent reason for not seeking help (47% vs. 24%, p < 0.001), and men were more likely than women to report unsuccessful past help-seeking and not thinking anyone could help (19% vs. 3%, p < 0.001 and 17% vs. 5%, p = 0.001, respectively).Conclusions: Consistent with previous studies, women were less likely to utilize alcohol services than men. Future interventions should address low problem recognition, and tailoring to gender-specific barriers may help close the disparity in services utilization.

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“…These tools and strategies might include taking advantage of co-located mental health professionals, using readily available VA web materials on the potential effects of alcohol use on mental health conditions and vice versa, and consulting with mental health treatment staff on how to best counsel women who may be engaging in problematic drinking and who have mental health comorbidities. Treatments tailored to women with these comorbidities are available, and the best method of linkage to these treatments is an important area for future research (Cucciare et al, 2013;2014).…”

Section: Barriersmentioning

confidence: 99%

“…'Harmful drinking' refers to a spectrum of drinking behavior ranging from drinking above low-risk limits set by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to meeting diagnostic criteria for an alcohol use disorder (AUD; American Psychiatric Association, 1995; National Institute on Alcohol Abuse and Alcoholism, 2010). It is associated with numerous negative physical and mental health outcomes among women veterans, including high rates of domestic violence, cirrhosis, depression, and posttraumatic stress disorder (Lembke et al, 2011;Chavez et al, 2012;Cucciare et al, 2013). Accurately identifying harmful drinking among women veterans is a critical first step in addressing this condition.…”

Section: Introductionmentioning

confidence: 99%

Providers’ perceptions of barriers and facilitators to disclosure of alcohol use by women veterans

Abraham

Lewis

Drummond

et al. 2016

Prim Health Care Res Dev

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Providers (n=14) were recruited from primary care at two veterans Administration Women's Health Clinics in California, United States. An open-ended interview guide was developed from domains of the consolidated framework for implementation science. Interviews elicited primary care providers' perspectives on barriers and facilitators to women veterans' (who may or may not be using alcohol in harmful ways) disclosure of alcohol use during routine clinic visits. Interview data were analyzed deductively using a combination of template analysis and matrix analysis. Findings Participants reported six barriers and five facilitators that they perceived affect women veteran's decision to accurately disclose alcohol use during screenings and openness to discussing harmful drinking with a primary care provider. The most commonly described barriers to disclosure were stigma, shame, and discomfort, and co-occuring mental health concerns, while building strong therapeutic relationships and using probes to 'dig deeper' were most often described as facilitators. Findings from this study may enhance provider-patient discussions about alcohol use and help primary care providers to better identify problematic drinking among women veterans, ultimately improving patient outcomes.

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Substance Use Among Women Veterans: Epidemiology to Evidence-Based Treatment

Cited by 40 publications

References 84 publications

Military Sexual Trauma and Co-occurring Posttraumatic Stress Disorder, Depressive Disorders, and Substance Use Disorders among Returning Afghanistan and Iraq Veterans

Military Sexual Trauma and Co-occurring Posttraumatic Stress Disorder, Depressive Disorders, and Substance Use Disorders among Returning Afghanistan and Iraq Veterans

Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample

Providers’ perceptions of barriers and facilitators to disclosure of alcohol use by women veterans

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