Substance Abuse Treatment:

VA Programs Serve Psychologically and Economically Disadvantaged Veterans

HEHS-97-6: Published: Nov 5, 1996. Publicly Released: Nov 5, 1996.

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Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) substance abuse program and the effect of VA reorganization on this program, focusing on: (1) characteristics of veterans who receive substance abuse treatment; (2) services VA offers to veterans with substance abuse disorders; (3) methods VA uses to monitor the effectiveness of its substance abuse treatment programs; (4) community services available to veterans who suffer from substance abuse disorders; and (5) implications of changing VA methods for delivering substance abuse treatment services.

GAO found that: (1) in fiscal year 1995, VA substance abuse treatment units served about 180,000 veterans; (2) about one half of the inpatients were homeless at the time of admission and about one third had psychiatric disorders; (3) many of these veterans were chronically unemployed, had problems maintaining relationships, reported low incomes, or were criminal offenders; (4) VA provides a variety of treatment settings and approaches; (5) between fiscal years 1991 and 1996, VA funding for treatment increased from $407 million to $589 million to accommodate growth in the substance abuse treatment program; (6) VA lacks the necessary data to adequately measure and fully evaluate the efficacy of its many treatment programs and has primarily relied on utilization information and recidivism rates to monitor the quality of its substance abuse treatment programs; (7) VA is developing a performance monitoring system based on treatment outcome measures; (8) numerous non-VA substance abuse treatment programs are also available to and used by veterans; (9) many veterans treated in community-based public programs are like those treated in VA programs; (10) if VA stopped treating veterans for substance abuse, resulting societal costs may shift to welfare or other social services, other federal or state substance abuse treatment programs, and the criminal justice system; (11) VA cannot ascertain the implications of contracting for these services, since it lacks critical information on the health care needs of eligible veterans, the number of veterans who might seek care, and actual cost of treating veterans with substance abuse disorders; and (12) VA officials have not decided how substance abuse treatment services will be delivered and what outcome measures will be used to evaluate treatment and program effectiveness.

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