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

DALT Fellowship Works In Progress:

Exploration of Substance Use Patterns in Previously Incarcerated Veterans

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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
• n service utilization to inform future intervention

development efforts.

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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)

Project Overview

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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

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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

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Inpatient Psychiatric Services

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B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper

AGE

• .027

.003 .000 .973 .968 .979

RACE

• .350

.068 .000 .704 .616 .805

GENDER

• .036

.128 .779 .965 .751 1.239

FELON STATUS

.345 .138 .012 1.411 1.078 1.848

• SERV. CONNECT %

.002 .001 .017 1.002 1.000 1.004

PTSD Dx.

.133 .072 .065 1.142 .992 1.316

MDD Dx.

.629 .065 .000 1.877 1.652 2.132

BIPOLAR Dx.

.887 .071 .000 2.429 2.115 2.789

PSYCHOTIC Dx.

.981 .077 .000 2.666 2.293 3.101

AMPHETAMINE Dx.

.131 .107 .218 1.141 .925 1.406

COCAINE Dx.

.760 .070 .000 2.138 1.866 2.451

OPIOID Dx.

.570 .081 .000 1.768 1.509. 2.072

ALCOHOL Dx.

.259 .086 .003 1.296 1.094 1.535

SUD Residential Services

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B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper

AGE

• .017

.004 .000 .983 .976 .991

RACE

• .094

.076 .217 .910 .784 1.057

GENDER

• .095

.166 .565 .909 .657 1.258

FELON STATUS

.376 .137 .006 1.456 1.114 1.904

• SERV. CONNECT %
• .002

.001 .138 .998 .996 1.000

PTSD Dx.

.150 .083 .070 1.162 .988 1.367

MDD Dx.

.244 .074 .001 1.276 1.104 1.474

BIPOLAR Dx.

.167 .085 .049 1.182 1.001 1.397

PSYCHOTIC Dx.

.321 .092 .000 1.378 1.151 1.650

AMPHETAMINE Dx.

.545 .105 .000 1.724 1.403 2.119

COCAINE Dx.

2.602 .095 .000 13.484 11.197 16.238

OPIOID Dx.

.621 .083 .000 1.862 1.583. 2.189

ALCOHOL Dx.

1.906 .146 .000 6.724 5.047 8.958

Homeless Services

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B S.E. Sig. Exp(B). 95% Confidence Interval Exp(B) Lower Upper

AGE

• .016

.002 .00 .000 .984 .980 .987

RACE RACE

• .112

.043 .00 .009 .894 .822 .972

GENDER

.024 .091 .788 1.025 .857 1.225

FELON STATUS

1.035 .102 .00 .000 2.815 2.307 3.436

• SERV. CONNECT %

.002 .001 .000 1.002 1.001 1.003

PTSD Dx.

.558 .048 .000 1.747 1.589 1.921

MDD Dx.

.579 .044 .000 1.784 1.638 1.943

BIPOLAR Dx.

.277 .056 .000 1.319 1.183 1.471

PSYCHOTIC Dx.

.260 .063 .000 1.297 1.146 1.469

AMPHETAMINE Dx.

.214 .081 .008 1.239 1.057 1.452

COCAIN INE Dx.

.283 .046 .000 1.327 1.212 1.453

OPIOID Dx.

.297 .061 .000 1.346 1.195 1.516

ALCOHOL Dx.

.098 .055 .074 1.103 .991 1.229

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

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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

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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

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Conclusions

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Questions

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