ABSTRACT
Substance use disorders have been called “the most serious public health concern in the United States,” (Schneider Institute for Public Health Policy, 2001). The costs of substance use disorders (SUDs) are enormous, with epidemiologic studies estimating that one-seventh of all civilian healthcare dollars spent in the United States are attributable to substance use (Merrill, 1999). Substance use is also a serious issue for some military Veterans and active duty soldiers. For example, the National Survey on Drug Use and Health found that almost 60 percent of Veterans reported recent alcohol use and 7.4 percent reported heavy use (Wagner, Harris, Federman, et al., 2007). These rates were higher than those found in civilians, although rates of substance abuse and dependence diagnoses were similar to civilian rates. Wagner and colleagues also found that rates of marijuana use (3.5%) or other illicit substance use (1.7%) were also higher than civilian rates, although rates of abuse and dependence were not higher. More recent data on service members returning from Iraq deployments (Santiago, Wilk, Milliken, et al., 2010) indicated that 27 percent of Army soldiers had positive responses to an alcohol screening measure, were likely to engage in risky behaviors (e.g., drunk driving), and had experienced negative consequences (e.g., missing work). These data suggest that professionals providing care to Veterans in a variety of settings need a basic familiarity with substance use issues.
