• Intensive substance use treatment programs must be available for all veterans who require them to establish early remission from an SUD.
  • Multiple (at least two) empirically validated psychosocial interventions must be available for all patients with SUDs who need them, whether psychosocial intervention is the primary treatment or an adjunctive component of a coordinated program that includes pharmacotherapy.
  • Pharmacotherapy with approved, appropriately regulated opioid agonists (e.g., buprenorphine or methadone) must be available to all patients diagnosed with opioid dependence for whom it is indicated and for whom there are no medical contraindications in addition to, and directly linked with, psychosocial treatment and support.
  • If agonist treatment is contraindicated or not acceptable, antagonist medication (e.g., naltrexone) must be available and considered for use when needed.
  • Patients with an SUD must be offered long-term management for that disorder and any other coexisting psychiatric and general medical conditions. The patient’s condition must be monitored in an ongoing manner, and care must be modified, as appropriate, in response to changes in the patient’s clinical status.

SOURCE: VHA Handbook 1160.01 (VA, 2008).

or another contingency order), VA health care is a relatively new source of care for these personnel returning from deployments to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) (38 U.S.C. § 1710[a], 38 CFR §§ 17.36, 17.38 [2009]). ADSMs discharged from service also have new eligibility. Specifically, this recent policy change states that

any veteran who has served in a combat theater after November 11, 1998, including OEF/OIF veterans, and who was discharged or released from active service on or after January 28, 2003, has up to 5 years from the date of the veteran’s most recent discharge or release from active duty service to enroll in VA’s health care system and receive VA health care services.13


13 National Defense Authorization Act of 2008, Public Law 110-181, 110th Congress (January 28, 2008).

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