{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:50:34Z","timestamp":1784256634535,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Department of Veterans Affairs Office of Rural Health"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The recent opioid crisis is characterized by a relatively greater increase in opioid use disorder and related mortality in rural populations when compared with urban populations.<jats:sup>1\u20105<\/jats:sup> As almost a quarter of our nation's veterans reside in rural settings, the United States Veterans Health Administration (VHA) is interested in the impact of this epidemic on rural veterans. This study aims to develop a comprehensive understanding of the trends in substance use disorders (SUD) in veterans seeking treatment from community, non\u2010VHA providers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using Substance Abuse and Mental Health Services Administration (SAMHSA)\u2019s Treatment Episode Data Set (TEDS), this study presents the prevalence of treatment for veterans seeking initial admission into publicly funded non\u2010VHA SUD treatment centers for years 2011\u20102016. Comparisons were made for all SUD types. Multivariate trend analysis based on annual data from 2011 to 2016 compared urban and rural veterans for opioid use disorder treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Both urban and rural veterans had comparable rates of treatment for SUD, though rural veterans had slightly higher rates of injectable (11.2% vs 8.7%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and opiate drug use disorder admissions (20.7% vs 18.1%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014). Both urban and rural showed an increase in admissions for opioid, heroin, and injectable drug use disorders between 2011 and 2016 (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Comprehensive understanding of veteran SUD and treatment should include national\u2010level data on community non\u2010VHA treatment. SAMHSA's TEDS for years 2011\u20102016 provides clinical information for more than 90,000 veterans and indicates continued increase in treatment seeking for opioid use disorders, particularly for rural veterans.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12406","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T13:00:58Z","timestamp":1575637258000},"page":"167-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Community Treatment for Opioid Use Disorders in Urban and Rural Veterans"],"prefix":"10.1111","volume":"36","author":[{"given":"Carolyn L.","family":"Turvey","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs Office of Rural Health Rural Resource Center  Iowa City Iowa"},{"name":"Iowa City VA Health Care System Comprehensive Access and Delivery Research and Evaluation Center  Iowa City Iowa"},{"name":"Department of Psychiatry University of Iowa Roy J. and Lucille A. Carver College of Medicine  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Lund","sequence":"additional","affiliation":[{"name":"Iowa City VA Health Care System Comprehensive Access and Delivery Research and Evaluation Center  Iowa City Iowa"},{"name":"Department of Epidemiology University of Iowa College of Public Health  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DeShauna","family":"Jones","sequence":"additional","affiliation":[{"name":"Iowa Consortium for Substance Abuse Research and Evaluation University of Iowa  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0783-8204","authenticated-orcid":false,"given":"Stephan","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Iowa Roy J. and Lucille A. Carver College of Medicine  Iowa City Iowa"},{"name":"Department of Biostatistics University of Iowa Roy J. and Lucille A. Carver College of Medicine  Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990601175078"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301709"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1276"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1626"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2793"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.12319"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.796988"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13491"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.796991"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2018.79.853"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2013.06.020"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-017-4283-8"},{"issue":"8","key":"e_1_2_7_14_1","first-page":"e265","article-title":"Reducing coprescriptions of benzodiazepines and opioids in a veteran population","volume":"24","author":"Shayegani R","year":"2018","journal-title":"Am J Manag Care"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S116720"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usz104"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.08.010"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx014"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxu014"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/21635781.2015.1077179"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03052.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.06.003"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2013.816859"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-12-00131"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2016.06.022"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.12534"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000874"},{"key":"e_1_2_7_28_1","unstructured":"Substance Abuse and Mental Health Services Administration. 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