Substance Use Disorders in the U.S. Armed Forces
Substance Use Disorders in the U.S. Armed Forces

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2013-03-21

Total Pages: 350

ISBN-13: 0309260558

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Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

Pain Management and the Opioid Epidemic
Pain Management and the Opioid Epidemic

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-09-28

Total Pages: 483

ISBN-13: 0309459575

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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Evaluation of the Department of Veterans Affairs Mental Health Services
Evaluation of the Department of Veterans Affairs Mental Health Services

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-03-29

Total Pages: 467

ISBN-13: 0309466601

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Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Medications for Opioid Use Disorder Save Lives
Medications for Opioid Use Disorder Save Lives

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2019-06-16

Total Pages: 175

ISBN-13: 0309486483

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The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Combating Tobacco Use in Military and Veteran Populations
Combating Tobacco Use in Military and Veteran Populations

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-10-21

Total Pages: 381

ISBN-13: 0309146844

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The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.

Mental Health, Inc.
Mental Health, Inc.

Author: Art Levine

Publisher: Abrams

Published: 2017-08-15

Total Pages: 310

ISBN-13: 1468315315

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The mental health system in America is hardly the front-burner issue it should be, despite lip service about reform after each new tragic mass killing. Yet every American should care deeply about fixing a system a presidential commission reported was in “shambles.” By some measures, 20 percent of Americans have some sort of mental health condition, including the most vulnerable among us—veterans, children, the elderly, prisoners, the homeless.With Mental Health, Inc., award-winning investigative journalist Art Levine delivers a Shock Doctrine-style exposé of the failures of our out of control, profit-driven mental health system, with a special emphasis on dangerous residential treatment facilities and the failures of the pharmaceutical industry, including the overdrugging of children with antipsychotics and the disastrous maltreatment of veterans with PTSD by the scandal-wracked VA.Levine provides compelling narrative portraits of victims who needlessly died and some mentally ill people who won unexpected victories in their lives by getting smart, personalized help from “pyschosocial” programs that incorporate safe and appropriate prescribing, along with therapy and social support. He contrasts their stories with corrupt Big Pharma executives and researchers who created fraudulent marketing schemes. Levine also tells the dramatic David vs. Goliath stories of a few brave reformers, including Harvard-trained psychiatrist and researcher Dr. Stefan Kruszewski, who has acted as a whistleblower in several major cases, leading to important federal and state settlements; in addition, the book spotlights pioneering clinicians challenging outmoded, drug-and-sedate practices that leave 90 percent of people with serious mental illness too disabled to work.By taking a comprehensive look at mental health abuses and dangerous, ineffective practices as well as pointing toward solutions for creating a system for effective, proven and compassionate care, Art Levine’s essential Mental Health, Inc. is a call to action for politicians and citizens alike—needed now more than ever.

Rethinking Substance Abuse
Rethinking Substance Abuse

Author: William R. Miller

Publisher: Guilford Press

Published: 2011-08-18

Total Pages: 337

ISBN-13: 1606236997

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While knowledge on substance abuse and addictions is expanding rapidly, clinical practice still lags behind. This book brings together leading experts to describe what treatment and prevention would look like if it were based on the best science available. The volume incorporates developmental, neurobiological, genetic, behavioral, and social–environmental perspectives. Tightly edited chapters summarize current thinking on the nature and causes of alcohol and other drug problems; discuss what works at the individual, family, and societal levels; and offer robust principles for developing more effective treatments and services.

The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder
The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder

Author: American Psychiatric Association

Publisher: American Psychiatric Pub

Published: 2018-01-11

Total Pages: 226

ISBN-13: 0890426821

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Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.