Substance Use Service Utilization and Barriers to Access Among Homeless Veterans: A Scoping Review

Abstract

The high prevalence of military veteran substance use (SU) when compared to their nonveteran counterparts has been described as an urgent public health issue. The commonality of severe mental and physical health comorbidities in this population affects their ability to recover and relates to the onset and maintenance of homelessness. While veteran-targeted housing and SU interventions exist, they are being underutilized. This scoping review synthesizes published peer-reviewed articles from 1990 to 2021 at the intersections of housing, substance abuse, and service utilization by homeless veterans. Qualitative thematic analysis of 119 retained peer-reviewed articles revealed five key themes: (1) the association between SU and housing stability, (2) gendered comparisons with service needs and provision, (3) consideration for comorbidities, (4) social support and relationship-centered interventions, and (5) barriers to health care services. This review offers a series of concerns, outcomes, and recommendations that might be valuable for practitioners, health care providers, and community stakeholders when implementing or re-evaluating new or existing homeless veteran treatment programs.