title: Prevalence and correlates of specialty substance use disorder treatment for Department of Veterans Affairs Healthcare System patients with high alcohol consumption.
abstract: OBJECTIVE
  Current substance use disorder (SUD) treatment guidelines suggest that SUD treatment may be indicated for individuals with elevated levels of alcohol consumption. The Department of Veterans Affairs (VA) considers patients with AUDIT-C scores of ≥8 as candidates for specialty care, however rates of SUD treatment based on AUDIT-C cutoffs remain understudied. We sought to identify SUD treatment rates and to identify patient characteristics that were associated with SUD treatment for VA patients with elevated AUDIT-C scores.
  
  
  METHODS
  The study sample included 10,384 ambulatory care VA patients with AUDIT-C scores of ≥8, who had not received SUD treatment in the past 60 days. Data were ascertained from the 2005 Survey of Health Experiences of Patients, a confidential mailed patient satisfaction survey (results were not available to providers). The outcome variable was the receipt of VA specialty SUD treatment in the year after the survey completion, as ascertained by VA administrative data. We identified rates of SUD treatment, and conducted unadjusted F tests and adjusted logistic regression analyses to identify patient characteristics that were associated with treatment entry.
  
  
  RESULTS
  Approximately 3.9% of veterans with AUDIT-C scores of ≥8 received SUD treatment in the year after being surveyed. Adjusted analyses revealed that treatment was more likely among persons with a mental health diagnosis (OR=3.31, CI=2.30-4.76) and among racial/ethnic minority groups.
  
  
  CONCLUSIONS
  Very few veterans who reported elevated alcohol consumption on SHEP received specialty SUD treatment in the year after being surveyed. Increased efforts should be made to intervene with patients who have elevated levels of alcohol consumption.
authors.affiliation: George Warren Brown School of Social Work, Washington University, Campus Box 1196, St. Louis, MO 63130, USA. jeglass@wustl.edu
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Glass
authors.forename: Brian E
authors.initials: BE
authors.lastname: Perron
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chermack
authors.forename: Scott
authors.initials: S
authors.lastname: Ratliff
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D000553:Ambulatory Care; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*