Substance Use Trends Among Veterans

Recent trends suggest that a combination of opioids and stimulants is now a major contributor to overdose deaths among U.S. veterans.

graph depicting the prevalence of comorbid substance use diagnoses among Veterans

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Since 2005, overdose deaths have been on the rise. In the past few years, over 184 people have died of an overdose daily, largely attributed to opioids like fentanyl.

Recent trends, however, suggest that a combination of opioids and stimulants, specifically methamphetamines, is now a major contributor to overdose deaths. United States veterans have participated in this rise in overdose deaths in large part because of their increased risk for substance use disorder, with nearly 27% of veterans misusing drugs.

Sara Warfield and colleagues analyzed medical records from the Veterans Health Administration to identify shifting trends in substance use and different combinations of substance use disorders among veterans. The researchers found that approximately two million veterans were diagnosed with at least one substance use disorder. Nearly 300,000 were diagnosed with opioid use disorder, and more than 120,000 were diagnosed with methamphetamine use disorder. In addition, diagnosis of opioid use disorder and methamphetamine use increased by 6.9% and 15.3% annually, respectively.

As shown in the figure above, methamphetamine use increased rapidly from 2014 to 2016 and continued to increase through 2019. Over 2 million people in the general population used methamphetamine in 2021. Opioid use, on the other hand, increased  9.2% every year from 2005 to 2016, but the rate remained stable in the following three years.

While the policy focus over the last decade has been on the opioid crisis, an increase in stimulant use and the combination of opioid and stimulant use disorders is a growing concern for the Veterans Health Administration.

Databyte via Sara C. Warfield, Chtianna Bharat, Robert M. Bossarte, et al. Trends in comorbid opioid and stimulant use disorders among Veterans receiving care from the Veterans Health Administration, 2005–2019. Drug and Alcohol Dependence, 2022.