BOX 7-3
Access Standards of the Veterans Health
Administration for SUD Care

Treatment Modalities

  • Pharmacotherapy and psychosocial interventions are important treatment options for veterans with SUDs.
  • Regardless of the particular intervention chosen, motivational interviewing style must be used during therapeutic encounters with patients, and the common elements of effective interventions must be emphasized.

Screening and Brief Intervention

  • At least annual screening must be provided across settings for alcohol misuse and tobacco use.
  • Targeted case finding must be conducted for use of illicit drugs or misuse of prescription or over-the-counter agents.
  • Further assessments must be performed to determine the level of misuse and to establish a diagnosis.
  • Referral to treatment must be offered for those with dependence.
  • All providers must systematically promote the initiation of treatment and ongoing engagement in care for patients with SUDs.

Other Program Standards

  • Appointments for follow-up treatment must be provided within 1 week of completion of medically supervised withdrawal management.

(VA and DoD, 2010).11 A recent Government Accountability Office (GAO) (2011b) study concluded that in general, the VA service delivery system is comprehensive, but the actual provision of specialty services varies among VA facilities. Starting in 2004, VA medical facilities became authorized TRICARE providers and expanded the SUD continuum of care available to certain ADSMs living near one of these facilities (DoD, 2011b). TMA reported to the committee, however, that few ADSMs accessed VA treatment through TRICARE during 2011 (West Region = 15, North Region = 77, and South Region = 18).12

As members of the National Guard and Reserves are not eligible for direct care unless activated (i.e., placed on federal orders for deployment


11 Personal communication, Daniel Kivlahan, Department of Veterans Affairs, November 16, 2011.

12 Personal communication, Frank Lee, TRICARE Management Activity, March 2, 2012.

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