DALT Fellowship Works In Progress: Exploration of Substance Use - PowerPoint PPT Presentation

Do Not Disseminate Without Permission from the Author DALT Fellowship Works In Progress: Exploration of Substance Use Patterns in Previously Incarcerated Veterans 1

2 Career and DALT Project Goals Career Goal: • Become clinical researcher designing interventions for PTSD and comorbid diagnoses. DALT-Related Project Goal: • Understanding impact of comorbid diagnoses on service utilization to inform future intervention development efforts.

3 Project Overview Dataset includes: 455 previously incarcerated Veterans released from prison between 2006-2010, and followed for 5 years. 12164 non-incarcerated Veterans drawn from the general population of Veterans also followed for 5 years. Total Veteran Sample = 12619 (All from VA North Texas system)

4 Hypothesis Greater service utilization of: • Homeless services • Psychiatric inpatient treatment • Residential substance use disorder (SUD) treatment All will be significantly associated with: • Demographics • Total % Service Connection • Felony status • Non-SUD psychiatric diagnoses • SUD-related diagnoses

5 Variables: Binary Logistic Regression Analyses Service Utilization (Dependent Variables): • Homeless Services • Inpatient Psychiatric Treatment • Residential SUD treatment Psychiatric Disorders (Independent Variables): • Psychiatric: 1) PTSD; 2) Major Depressive; 3) Bipolar; 4) Psychotic • SUD: 1) Amphetamine; 2) Cocaine; 3) Opioid; 4) Alcohol

6 Inpatient Psychiatric Services B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper .000 AGE - .027 .003 .973 .968 .979 .000 RACE - .350 .068 .704 .616 .805 - .036 .128 .779 .965 .751 1.239 GENDER .012 FELON STATUS .345 .138 1.411 1.078 1.848 .017 SERV. CONNECT % .002 .001 1.002 1.000 1.004 .133 .072 .065 1.142 .992 1.316 PTSD Dx. .000 MDD Dx. .629 .065 1.877 1.652 2.132 .000 BIPOLAR Dx. .887 .071 2.429 2.115 2.789 .000 PSYCHOTIC Dx. .981 .077 2.666 2.293 3.101 .131 .107 .218 1.141 .925 1.406 AMPHETAMINE Dx. .000 COCAINE Dx. .760 .070 2.138 1.866 2.451 .000 OPIOID Dx. .570 .081 1.768 1.509. 2.072 .003 ALCOHOL Dx. .259 .086 1.296 1.094 1.535

7 SUD Residential Services B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper .000 AGE - .017 .004 .983 .976 .991 - .094 .076 .217 .910 .784 1.057 RACE - .095 .166 .565 .909 .657 1.258 GENDER .006 FELON STATUS .376 .137 1.456 1.114 1.904 - .002 .001 .138 .998 .996 1.000 SERV. CONNECT % .150 .083 .070 1.162 .988 1.367 PTSD Dx. .001 MDD Dx. .244 .074 1.276 1.104 1.474 .049 BIPOLAR Dx. .167 .085 1.182 1.001 1.397 .000 PSYCHOTIC Dx. .321 .092 1.378 1.151 1.650 .000 AMPHETAMINE Dx. .545 .105 1.724 1.403 2.119 .000 COCAINE Dx. 2.602 .095 13.484 11.197 16.238 .000 OPIOID Dx. .621 .083 1.862 1.583. 2.189 .000 ALCOHOL Dx. 1.906 .146 6.724 5.047 8.958

8 Homeless Services B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper .00 .000 AGE - .016 .002 .984 .980 .987 .00 .009 RACE RACE - .112 .043 .894 .822 .972 .024 .091 .788 1.025 .857 1.225 GENDER .00 .000 FELON STATUS 1.035 .102 2.815 2.307 3.436 .000 SERV. CONNECT % .002 .001 1.002 1.001 1.003 .000 PTSD Dx. .558 .048 1.747 1.589 1.921 .000 MDD Dx. .579 .044 1.784 1.638 1.943 .000 BIPOLAR Dx. .277 .056 1.319 1.183 1.471 .000 PSYCHOTIC Dx. .260 .063 1.297 1.146 1.469 .008 AMPHETAMINE Dx. .214 .081 1.239 1.057 1.452 .000 COCAIN INE Dx. .283 .046 1.327 1.212 1.453 .000 OPIOID Dx. .297 .061 1.346 1.195 1.516 .098 .055 .074 1.103 .991 1.229 ALCOHOL Dx.

9 Significant Results (1) Inpatient Psychiatric Treatment: • Demographics: 1) Younger age; 2) Minority race • Felony Status history • Higher total % Service Connection • Psychiatric Diagnoses: 1) MDD; 2) Bipolar Disorder; 3) Psychotic Disorder • SUD-related Psychiatric Diagnoses: 1) Cocaine; 2) Opioid; 3) Alcohol

10 Significant Results (2) Residential Substance Use Treatment: • Demographics: 1) Younger age • Felony status history • Psychiatric Diagnoses: 1) MDD; 2) Bipolar Disorder; 3) Psychotic Disorder • SUD-related Psychiatric Diagnoses: 1) Amphetamine; 2) Cocaine; 3) Opioid; 4) Alcohol

11 Significant Results (3) Homeless Services: • Demographics: 1) Younger age; 2) Minority race • Felony status history • Higher total % Service Connection • Psychiatric Diagnoses: 1) PTSD; 2) MDD; 3) Bipolar Disorder; 4) Psychotic Disorder • SUD-related Psychiatric Diagnoses: 1) Amphetamine; 2) Cocaine; 3) Opioid

12 Conclusions

13 Questions