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Engaging Younger Veterans Struggling with Addictions

Engaging Younger Veterans Struggling with Addictions. Kellie Rollins, Psy.D. Psychologist, Substance Abuse Programs San Francisco VA Medical Center Assistant Clinical Professor University of California, San Francisco.

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Engaging Younger Veterans Struggling with Addictions

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  1. Engaging Younger Veterans Struggling with Addictions Kellie Rollins, Psy.D. Psychologist, Substance Abuse Programs San Francisco VA Medical Center Assistant Clinical Professor University of California, San Francisco

  2. Disclosures: No Commercial Interest No Financial relationshipsNo Relevant financial relationships No Conflict of Interest

  3. Overview • Profile of OEF/OIF/OND Veterans • Addiction prevalence • Best Practices Summary • For SUD w/in the VA • Opioid Replacement Treatment Clinic (ORT) - San Francisco VA Medical Center • Young Adults Recovery Group • Q&A

  4. “The 9/11 Generation” - Barack Obama OEF - Operation Enduring Freedom October 7, 2011 – present. OIF - Operation Iraqi Freedom March 30, 2003 - redesignated.  OND - Operation New Dawn September 1, 2010 - present.

  5. OEF / OIF / OND • Over 5 million American men and women served in the ranks of the US armed forces since 9/11/2001. • Over 2 million US Troops deployed to Iraq & Afghanistan since 09/11. • 1.6 million active duty.

  6. OEF / OIF / OND • 1/3 have mental health diagnoses or serious psychosocial problems • 1/5 dx with SUD • 15% unemployment • 78% divorce rate • Significant homelessness • Elevated risk of suicide

  7. Scope of the SUD problem • Alcohol Dependence rate doubled in the last 5 years (US Army figure). • 27% of Army active duty misuse alcohol (Santiago et al., 2010). • Youngest service members at highest risk (Bray et al., 2009; Jacobson et al., 2008). • High correlation between substance misuse and PTSD (Jacobson et al., 2008).

  8. Veterans vs Non-Veterans – % of SUD by age

  9. Serious Psychological Distress (SPD), SUD, and Co-Occurring SPD and SUD in the Past Year among Veterans, by Age: 2004 to 2006 SAMHSA, 2004, 2005 and 2006 NSDUHs

  10. Prevalence of SPD, SUD, SPD/SUD past year among Veterans, by gender: 2004-2006 SAMHSA, 2004, 2005 and 2006 NSDUHs

  11. Rx Drug Use/Abuse Increasing rates of opioid use for pain among Veterans aged 18-30. NIDA Brief, April, 2011 Doubled from 2002-2005 Tripled from 2005-2008

  12. Co-occurring Triad

  13. VAMCs with Onsite OTP and/or Buprenorphine Treatment (BT)

  14. San Francisco Veterans AffairsMedical Center Opioid Replacement Treatment Clinic (ORT) Methadone & Buprenorphine Interdisciplinary Treatment Team

  15. SFVAMC ORT Best Practices

  16. Young Adults Recovery Group SFVAMC, Substance Abuse Programs

  17. Group Themes

  18. No Script for Treating Younger Veterans “Younger veterans are difficult to engage! They have life on their minds.” Dr. Sam Wan, 2010, 2011, 2012 NO Rx

  19. Q & A

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