The impact of substance use disorders on treatment engagement among justice-involved veterans with posttraumatic stress disorder

Psychol Serv. 2019 Nov;16(4):564-571. doi: 10.1037/ser0000238. Epub 2018 Apr 30.

Abstract

Veterans involved with the criminal justice system represent a particularly vulnerable population who experience high rates of both posttraumatic stress disorder (PTSD) and substance use disorders (SUD). This study sought to investigate whether having co-occurring SUD is a barrier to PTSD treatment. This is a retrospective observational study of a national sample of justice-involved veterans served by the Veterans Health Administration Veterans Justice Outreach program who had a diagnosis of PTSD (N = 27,857). Mixed effects logistic regression models with a random effect for facility (N = 141 medical centers) were utilized to estimate the odds of receiving each type of PTSD treatment as a function of having a SUD diagnosis. Results indicate that a majority of veterans with PTSD served by the Veterans Justice Outreach program have an SUD diagnosis (73%), and having a co-occurring SUD was associated with higher odds of receiving PTSD treatment, after adjusting for demographic differences. Although not without limitations, these results suggest that among justice-involved veterans enrolled in the Veterans Health Administration with PTSD, having an SUD comorbidity is not a barrier to PTSD treatment and may in fact facilitate access to PTSD treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Comorbidity
  • Criminal Law / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / therapy*
  • Substance-Related Disorders / epidemiology*
  • United States / epidemiology
  • United States Department of Veterans Affairs / statistics & numerical data
  • Veterans / statistics & numerical data*
  • Young Adult