PhD 2005 234). This was not an isolated trend, and the fiscal crises at the state level also caused cutbacks in the Medicaid program, which led to severe cutbacks in mainstream substance abuse (SA) services (Richard Tessler. PhD 2005 234). Discerning the general population impact of the declining capacity of the VHA to treat substance use disorders is difficult because the large majority of veterans do not have substance use problems services (Richard Tessler. PhD 2005 238). Reduced access to services may not be a problem for the majority: however, declining availability of SA treatment may be no small matter for the minority with clinical needs (Richard Tessler. PhD 2005 238). The Veterans Administration does acknowledge this issue of the decline in getting substance abuse treatment for our veterans. This has been much more challenging in recent years due to the influx in disability claims from the wars in Iraq, and …show more content…
Petrakis, MD, Robert Rosenheck, MD, Rani Desai, PhD 2010 185). Many Veterans Battle Substance Abuse” and drawn attention to associated violence and legal problems among returning troops (Ismene L. Petrakis, MD, Robert Rosenheck, MD, Rani Desai, PhD 2010 185). They also suggest that substance use disorders may disproportionally affect veterans from the current conflicts, and especially those veterans who also have psychological problems (Ismene L. Petrakis, MD, Robert Rosenheck, MD, Rani Desai, PhD 2010 185). However, actual rates of substance use disorders among veterans with PTSD and other mental illnesses are not well documented and there are limited data comparing veterans of recent conflicts with those of earlier wars (Ismene L. Petrakis, MD, Robert Rosenheck, MD, Rani Desai, PhD 2010 185). (1) there are high rates of substance use disorders among those with mental illness, ranging from 21–35% across major diagnostic groups; (2) the highest rates of comorbidity occur among those with bipolar disorder and schizophrenia; and (3) there are differences in rates of comorbidity in veterans of different war eras (Ismene L. Petrakis, MD, Robert Rosenheck, MD, Rani Desai, PhD 2010 188). One unexpected finding is the relatively lower rate of comorbidity among those with