Hawkins Eric J, Grossbard Joel, Benbow Jim, Nacev Vladimir, Kivlahan Daniel R
VA Puget Sound Healthcare System, Center of Excellence in Substance Abuse Treatment and Education, Health Services Research & Development, 1660 S. Columbian Way, Seattle, WA 98108, USA.
Mil Med. 2012 Aug;177(8 Suppl):29-38. doi: 10.7205/milmed-d-12-00125.
Substance use disorders (SUDs) are among the most common and costly conditions in veterans and active duty military personnel, adversely affecting their health and occupational and personal functioning. The pervasive burden of SUD has been a continuing concern for the Department of Veterans Affairs (VA) and Department of Defense (DoD), particularly as large numbers of service members return from Operations Enduring and Iraqi Freedom. The VA and DoD have prioritized implementation of evidence-based practices and treatment services to enhance the recognition and management of SUD in general medical and SUD specialty-care settings. This article summarizes the clinical practice guidelines for identifying, diagnosing, and treating SUD in VA and DoD general medical and SUD specialty-care settings, highlights evidence-based pharmacotherapy and psychosocial interventions for managing SUD, and describes barriers to successful treatment of veterans and service members at risk for SUD in VA and DoD health care systems.
物质使用障碍（SUDs）是退伍军人和现役军人中最常见且代价高昂的疾病之一，对他们的健康、职业和个人功能产生不利影响。SUD的普遍负担一直是退伍军人事务部（VA）和国防部（DoD）持续关注的问题，特别是随着大量军人从持久自由行动和伊拉克自由行动中返回。VA和DoD已将实施循证实践和治疗服务作为优先事项，以加强在普通医疗和SUD专科护理环境中对SUD的识别和管理。本文总结了在VA和DoD普通医疗及SUD专科护理环境中识别、诊断和治疗SUD的临床实践指南，强调了用于管理SUD的循证药物治疗和心理社会干预措施，并描述了在VA和DoD医疗保健系统中，对有SUD风险的退伍军人和军人进行成功治疗的障碍。
