{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:38:27Z","timestamp":1789767507821,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["IIR 18\u2010093"],"award-info":[{"award-number":["IIR 18\u2010093"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Substance use disorder (SUD) represents a substantial health burden to US Veterans. We aimed to quantify recent time trends in Veterans' substance\u2010specific disorders using Veterans Health Administration (VA) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified Veteran VA patients for fiscal years (FY) 2010\u20132019 (October 1, 2009\u2013September 9, 2019) and extracted patient demographics and diagnoses from electronic health records (~6 million annually). We defined alcohol, cannabis, cocaine, opioid, sedative, and stimulant use disorders with ICD\u20109 (FY10\u2013FY15) or ICD\u201010 (FY16\u2013FY19) codes and variables for polysubstance use disorder, drug use disorder (DUD), and SUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Diagnoses for substance\u2010specific disorders (excluding cocaine), polysubstance use disorder, DUD, and SUD increased 2%\u201313% annually for FY10\u2013FY15. Alcohol, cannabis, and stimulant use disorders increased 4%\u201318% annually for FY16\u2013FY19, while cocaine, opioid, and sedative use disorders changed by \u22641%. Stimulant and cannabis use disorder diagnoses increased most rapidly, and older Veterans had the largest increases across substances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Rapid increases in cannabis and stimulant use disorder present a treatment challenge and key subgroups (e.g., older adults) may require tailored screening and treatment options. Diagnoses for SUD are increasing among Veterans overall, but there is important heterogeneity by substance and subgroup. Efforts to ensure access to evidence\u2010based treatment for SUD may require greater focus on cannabis and stimulants, particularly for older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>These findings represent the first assessment of time trends in substance\u2010specific disorders among Veterans, overall and by age and sex. Notable findings include large increases in diagnoses for cannabis and stimulant use disorder and among older adults.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13413","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T08:12:19Z","timestamp":1678263139000},"page":"393-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Trends in substance use disorder diagnoses among Veterans, 2009\u20132019"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9431-5438","authenticated-orcid":false,"given":"Katherine J.","family":"Hoggatt","sequence":"first","affiliation":[{"name":"San Francisco VA Health Care System Research Division San Francisco California USA"},{"name":"Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neetu","family":"Chawla","sequence":"additional","affiliation":[{"name":"VA Health Services Research &amp; Development (HSR&amp;D) Center for the Study of Healthcare Innovation, Implementation, &amp; Policy, VA Greater Los Angeles Healthcare System Research Division Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna L.","family":"Washington","sequence":"additional","affiliation":[{"name":"VA Health Services Research &amp; Development (HSR&amp;D) Center for the Study of Healthcare Innovation, Implementation, &amp; Policy, VA Greater Los Angeles Healthcare System Research Division Los Angeles California USA"},{"name":"Division of General Internal Medicine and Health Services Research, Department of Medicine UCLA Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Yano","sequence":"additional","affiliation":[{"name":"VA Health Services Research &amp; Development (HSR&amp;D) Center for the Study of Healthcare Innovation, Implementation, &amp; Policy, VA Greater Los Angeles Healthcare System Research Division Los Angeles California USA"},{"name":"Department of Health Policy and Management UCLA Fielding School of Public Health  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12331"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31310-2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30231-2"},{"key":"e_1_2_8_6_1","unstructured":"Institute of Medicine.Substance Use Disorders in the U.S. Armed Forces. 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