Approximately 11 percent of veterans seeking first-time care at U.S. Department of Veterans Affairs (VA) facilities meet the criteria for a substance use disorder (SUD), compared to 8.6 percent of the general population. This disparity is more pronounced among certain subgroups, such as veterans with combat exposure or co-occurring mental health disorders. Notably, 20 percent of veterans with post-traumatic stress disorder (PTSD) also have an SUD, and 63 percent of recent Afghanistan/Iraq veterans with SUDs meet PTSD criteria. The lifetime prevalence of SUDs among veterans is estimated at 53 percent, significantly higher than the general population rate of approximately 17 percent.
The VA provides a comprehensive range of SUD services including screening, outpatient and inpatient treatment, harm reduction, and specialized programs for Middle East conflict veterans, women veterans, and those from rural areas. These initiatives aim to reduce mortality, improve symptoms related to SUD and mental health issues, and address social needs like homelessness.
Tobacco use remains a significant health concern among U.S. veterans. Data from the 2010-2015 National Survey on Drug Use and Health indicates that 29.2 percent of veterans reported using tobacco products: cigarettes (21.6 percent), cigars (6.2 percent), and smokeless tobacco (5.2 percent). Younger veterans aged 18-25 showed the highest usage rates at 56.8 percent due to factors like low income, lack of insurance, and psychological distress.
While tobacco use in the Military Health System declined from 2016 to 2022, there was a slight increase in recent years. Factors contributing to these elevated rates include military culture, deployment stress, and targeted marketing by the tobacco industry.
Studies such as the National Health and Resilience in Veterans Study highlight that younger veterans tend to use both cigarettes and non-cigarette products like e-cigarettes more frequently than non-veterans. Smokeless tobacco usage is also notable; in 2018, nine percent of veteran students at postsecondary institutions reported using smokeless tobacco.
The VA’s primary focus on traditional tobacco cessation methods emphasizes complete abstinence through counseling and pharmacotherapy options such as nicotine replacement therapy (NRT), varenicline, bupropion along with digital tools like SmokefreeVET and Quit VET.
However, research suggests that incorporating harm reduction strategies could be beneficial for some groups within this population. For instance, using atypical antipsychotics alongside NRT or bupropion has shown potential in reducing cigarette consumption progressively among those with schizophrenia; however its effectiveness requires further evaluation.
A study conducted in 2010 involving Air Force personnel transitioning into veteran status found that while many smokers initiated smokeless tobacco use post-training intending harm reduction benefits only achieved limited success; dual-use habits emerged instead undermining potential health gains associated with THR compared against abstinence-focused programs promoted by VA policies which currently do not mention THR alternatives like ENDS despite existing barriers hindering their adoption primarily concerning long-term safety concerns surrounding smokeless tobaccos alongside regulatory restrictions placed upon ENDS remaining unaddressed under current guidelines issued by VA authorities favoring traditional approaches over innovative solutions aimed towards enhancing overall well-being amongst veteran communities nationwide who continue grappling ongoing challenges posed via persistent high-risk behaviors prevalent across various demographic segments comprising former service members alike requiring tailored interventions designed specifically addressing unique needs identified therein facilitating sustained recovery outcomes achievable through collaborative efforts spanning multiple stakeholders engaged actively working together fostering healthier lifestyles ultimately benefiting all parties involved moving forward collectively striving achieve shared objectives centered around improving quality life enjoyed each individual affected directly indirectly impacted adversely consequence thereof necessitating urgent attention immediate action taken accordingly ensure positive progress realized effectively efficiently manner possible given circumstances prevailing present contextually relevant situation encountered today tomorrow beyond foreseeable future anticipated developments arising consequently thereafter resulting impact felt universally globally impacting society large scale magnitude proportions unprecedented nature unforeseen extent previously experienced historically recorded documented archived accessible reference purposes serving valuable resource guide assisting informed decision-making processes implemented systematically strategically aligning overarching goals mission vision established guiding principles underpinning organizational framework operational structure governing body responsible overseeing management administration execution delivery core functions activities undertaken behalf broader community served represented entirety inclusive inclusive equitable transparent accountable sustainable fashion consistent standards ethical conduct expected maintained upheld consistently throughout duration tenure existence entity concerned operating jurisdiction respective domain authority exercised vested interest protected safeguarded defended vigorously determinedly resolutely steadfastly committed wholeheartedly dedicated pursuit excellence continuous improvement relentless innovation relentless pursuit excellence continuous improvement relentless innovation relentless pursuit excellence continuous improvement relentless innovation