Declining access to alcohol and drug abuse services among veterans in the general population

Although the Veterans Health Administration has been committed to preserving its capacity to provide specialized substance abuse (SA) services, administrative data from the late 1990s point to reduced access. To explore the possible effects of reduced access to Veterans Affairs services on veterans in the general population, we examined data from the National Household Survey of Drug Abuse from 1994 to 2001. Although the data are not longitudinal at the level of individuals, the annual nature of these surveys makes it possible to chart aggregate changes in clinical needs and service use over time. The results indicate that, whereas veterans' needs for SA services remained high and were consistent across these years, the proportion of veterans in treatment decreased. The proportion of nonveterans receiving SA treatment also decreased but not as steeply as that of veterans. This trend parallels declining delivery of specialized alcohol and drug abuse services within the Veterans Health Administration, although they do not prove a causal relationship.