Health Care Providers Treating SUD - Mental Health

Health Care Provider

Substance Use Disorder

A number of resources are available to health care providers who work with Veterans and may be concerned about a Veteran experiencing substance use disorder (SUD).

Training for Health Care Providers

2008 Update of the United States Clinical Practice Guideline (CPG)

This paper expands the literature on tobacco dependence and its treatment.

2008 Update of the U.S. Public Health Service CPG

This is a quick reference for clinicians treating tobacco use and dependence.

Course Reviewing the VA/DoD 2012 Clinical Practice Guidelines

This course reviews the VA/DoD 2012 clinical practice recommendations for managing substance use disorders and PTSD through psychotherapy and pharmacology.

NIDAMED

This resource provides a selection of booklets and fact sheets for both clients and providers.

Substance Abuse and Mental Health Services Administration (SAMHSA)

This agency website provides fact sheets, videos, brochures, and more.

Veterans Health Administration Tobacco Use Treatment Guidance

This presentation discusses evidence-based tobacco use treatment. Part 2 of the presentation discusses smoking cessation among populations with mental health conditions.

Opioid Overdose Education and Naloxone Distribution (OEND)

To prevent fatal opioid overdoses, VA developed a national OEND program to train Veterans on how to prevent, recognize, and respond to an opioid overdose. The following brief videos show clinicians discussing OEND with Veterans and training them to use VA national naloxone kits.

• Opioid Overdose Education and Naloxone Distribution (OEND)
• Introduction to Naloxone for People with Opioid Use Disorders
• Introduction to Naloxone for People Taking Prescribed Opioids
• How to Use the VA Intranasal Naloxone Kit
• How to Use the VA Intramuscular Naloxone Kit

Resources To Share With Veterans

Alcoholics Anonymous

This international fellowship supports people with alcohol use disorders.

Cocaine Anonymous Online

This 12-step program is modeled closely after Alcoholics Anonymous.

Crystal Meth Anonymous

This fellowship offers an opportunity for people who have used crystal meth to share their experiences — and their strength and support.

Marijuana Anonymous

This organization supports those seeking to stop using marijuana.

MedlinePlus

This website answers health questions by bringing together information from the National Library of Medicine, the National Institutes of Health, and other government agencies and health-related organizations.

Narcotics Anonymous

This international, community-based association of recovering drug users sponsors more than 28,000 weekly meetings in 113 countries.

National Alcohol and Drug Addiction Recovery Month

Sponsors of this month provide resources throughout the year to promote the societal benefits of treatment for alcohol and drug use disorders.

Recovery and the Military: Treating Veterans and Their Families

This resource examines treatment availability and alcohol and drug addiction treatment options available for Veterans and their families.

Rethinking Drinking

This website offers valuable research-based information on drinking habits and how they may affect your health, along with support for making a change.

SMART Recovery

This international program aims to help people recover from all types of substance use and addictive behaviors, including alcohol and drug misuse and gambling. SMART Recovery sponsors face-to-face meetings around the world and daily online meetings.

SmokefreeVET

This VA program provides interactive tools for building a quit plan, information on why smokers smoke, and helpful tips and information on how to quit.

Treatment for Alcohol Problems: Finding and Getting Help

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides information on the latest research-based treatments and what to consider when choosing among them.

VetChange.org 

This free and confidential online program was created for Veterans and active duty Service members who are concerned about their drinking.

Encourage your patients to learn more about SUD and explore resources and connected care options offered by VA.

Treatment Options

Evidence-based psychotherapy or “talk therapy” is effective for treating substance use disorders. Each VA medical center offers one or more talk therapies as well as effective medications for the treatment of SUDs. Many VA medical centers and clinics provide other clinical services for SUD in addition to the evidence based treatments listed below.

Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD)

CBT-SUD teaches Veterans how to reduce their substance use to improve their quality of life, usually in weekly meetings with a therapist for about 12 weeks. The treatment helps Veterans develop more balanced and helpful thoughts about themselves, others, and the future. It also helps Veterans manage the urge to drink or use drugs, effectively refuse alcohol and drug use opportunities, learn a problem-solving approach to deal with substance use, and achieve their personal goals.

Motivational Interviewing (MI) and Motivational Enhancement Therapy (MET)

MI involves a conversation between the Veteran and provider to draw out and strengthen motivation for change. The MI approach explores the reasons why you might want to make a change and the potential benefits of the change.

MET is a version of MI that involves a brief assessment with feedback and focuses specifically on changing alcohol and/or substance use. MET is particularly helpful when Veterans are first considering making changes or are unsure about the extent of their problems with alcohol and drug misuse. If you’re concerned about your alcohol or drug use — or the substance use of someone you care about — and you’re unsure about treatment options (if any) to pursue, MET can help.

Contingency Management (CM)

CM is an evidence-based treatment for Veterans who misuse drugs, specifically cocaine, methamphetamine, or marijuana. In CM, the Veteran receives rewards for abstinence that is verified by urine drug screens. The rewards increase when abstinence is consistently shown in repeated negative test results. Extensive research on CM has shown that is a very effective treatment for helping Veterans maintain abstinence and stay in treatment.

Medical Options

VA offers proven medication options that reduce cravings, prevent the recurrence of substance use, and reduce the risk of death from substance use disorder. They include:

• Buprenorphine, injectable naltrexone, or methadone for opioid use disorder
• Acamprosate, disulfiram, naltrexone, and topiramate for alcohol use disorder
• Nicotine replacement therapy, bupropion, and varenicline for tobacco use disorder

When indicated, VA provides medically managed detoxification to stop substance use safely and provide services to stabilize the patient.

Read more about effective medications for opioid use disorder.

In Veterans' Own Words

Clinicians can use Make the Connection as a tool to engage with Veterans or their family members who may be reluctant to seek support.

View more videos on Make the Connection.

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