Alcohol-involved overdose deaths in US veterans

Area of Science:

• Public Health
• Epidemiology
• Substance Use Disorders

Background:

• Alcohol-involved overdose deaths are increasing, frequently co-occurring with other substances.
• These deaths are understudied compared to other overdose causes.

Purpose of the Study:

• To examine trends in alcohol-related overdose mortality among Veterans.
• To compare patient characteristics and treatment receipt across different categories of alcohol overdose deaths.

Main Methods:

• Utilized national Veterans Health Administration (VHA) records linked to National Death Index data (2012-2018).
• Analyzed trends and compared patient demographics and treatment for alcohol-only, alcohol+opioids, and alcohol+other substances overdose deaths.

Main Results:

• 2421 Veterans died from alcohol-involved overdose between 2012-2018, with a 57% increase in the rate.
• Veterans with co-involved substances were more likely to be Black or Hispanic and have opioid use disorder, but less likely to have diagnosed alcohol use disorder (AUD).
• Less than 33% received substance use disorder clinic treatment; only 9.5% received AUD medication and 24.8% psychotherapy in the year prior to death.

Conclusions:

• Alcohol overdose is rising, particularly with co-occurring opioid and other substance involvement.
• A significant gap exists in effective AUD treatment, with most patients not receiving medication or psychotherapy.
• There is an urgent need to identify at-risk Veterans and target AUD treatment within healthcare settings.