The opioid epidemic is a crucial issue for the United States. As such, the numbers of Veterans from Ethnic Minorities receiving opioid misuse treatment continue to increase (SAMHSA, 2018). The purpose of the current Specialization Plan was to conduct an extensive search of available treatment strategies, support policies, and recent scholarly studies in the minority Veteran research. The analyzed information suggests that minority Veterans are less likely to receive proper medical and psychological support when dealing with the effects of the opioid epidemic. This knowledge is significant for military social work, illustrating that Ethnic Minority Veterans should receive additional assistance in light of the opioid epidemic.
Veterans are forced to rely on opioid medication to battle the negative consequences of military service. A tendency to manifest a higher likelihood of opioid misuse, lower levels of welfare, anxiety, and depression are reported by scientific research (Doran et al., 2017). Of special concern are the minority Veterans, who are more adversely influenced by opioid treatment. For example, Burgess et al. (2014) suggest that decreased support from social and policy institutions reduces the likelihood of alleviating the opioid misuse effects. As a result, there is a significantly higher prevalence of opioid misuse among Veterans from Ethnic Minorities (Herbert et al., 2018).
Theories Addressing Veteran Opioid Misuse
For the current Specialization Plan, I have reviewed three opioid misuse theories. The psychosocial theory is suggested as a prominent theoretical basis for understanding the harmful effects of the opioid epidemic (Todd et al., 2004). In this framework, opioid misuse is regarded as a maladaptive mechanism that develops due to the availability of opioid treatment and its believed efficacy (Todd et al., 2004). Another well-recognized approach is the cognitive-behavioral theory, which suggests that negative emotions might contribute to the development of harmful behaviors, namely opioid misuse (Morland et al., 2014). Finally, the post-traumatic growth theory directly addresses the psychological trauma at the core of opioid misuse.
Opioid Misuse Intervention Approaches
Based on the literature, I reviewed three opioid misuse intervention approaches: medication-based treatment, Cognitive-Behavioral Therapy (CBT), and Post-Traumatic Growth (PTG) strategy. Medication-based treatment aims to reduce the number of opiate drugs prescribed to Veterans, administering naloxone and closely monitoring the patients’ reactions to the new medicine (Bennett et al., 2013). The cognitive-behavioral therapy and the post-traumatic growth framework involve a psychological approach to opioid misuse (Morland et al., 2014). Cognitive-behavioral therapy focuses on identifying maladaptive behaviors that cause opioid misuse in Veterans, attempting to replace these tendencies with more beneficial practices (Morland et al., 2014). The post-traumatic growth strategy is directed towards assessing the Veterans’ traumatic experiences and initiating personal growth, eliminating the factors causing opioid misuse.
Policies battling the opioid epidemic
The policies addressing the opioid epidemic in Veteran populations that I reviewed are the SUPPORT Act, the Affordable Care Act, and the opioid safety initiative. The SUPPORT Act includes several provisions aimed specifically at American Veterans to improve access to opioid treatment, medicine and services (US Congress, 2018). Another useful legislation, the Affordable Care Act, expands access to opioid treatment and ensures that Veterans from numerous communities can receive the necessary assistance (US Congress, 2010). Finally, the Opioid Safety Initiative is aimed explicitly at the Veteran communities and enforces preventative, educational, and treatment interventions to decrease the devastating effects of the opioid epidemic.
I analyzed 24 articles, of which 5 included qualitative studies, 16 utilized the quantitative approach, and the remaining 3 used the Delphi study method. The quantitative methodology appears to be especially prominent among scholars. 11 out of 16 quantitative studies used large pools of information for conducting statistical analysis. In contrast, the qualitative strategy was used to perform individual interviews and outline the main themes discussed by minority Veterans. The Delphi study was implemented to gain information about Veteran opioid treatment from experts in this sphere (Merlin et al., 2018). Overall, the results of the studies demonstrate that Ethnic Minority Veterans might be more susceptible to developing opioid misuse, and they are also highly likely to be deprived of high-quality opioid misuse treatment. The main factors listed include cultural disparities, absence of policy support, and negative attitudes towards treatment.
Social Work Relevance
Military experience is a unique characteristic of this social group, and research suggests that this aspect is important to consider during social work (Nichter et al., 2019). Smith (2021) has also shown that culturally appropriate treatment methods are significantly more effective for social interventions. Military social work can combine these aspects and improve the well-being of Veteran populations, but it requires insights from scholarly research to enhance its methods. The current Specialization Plan analyzed the academic evidence on opioid misuse interventions and contributed to the understanding of the problems encountered by minority Veterans during opioid treatment.
In conclusion, minority Veterans encounter adverse effects of the opioid epidemic in their everyday lives, struggling to overcome the consequences of opioid misuse. Some of the scholarly articles reviewed in this Specialization Plan suggest that psychological treatment might be exceptionally efficient when battling the outcomes of opioid misuse. I have also observed that qualitative, quantitative, and Delphi study methodologies can be highly useful for extracting and analyzing the data regarding this issue. In the long term, this research can improve minority Veterans’ well-being, allowing them to identify and mitigate the factors preventing the success of opioid misuse treatment.
Bennett, A. S., Watford, J. A., Elliott, L., Wolfson-Stofko, B., & Guarino, H. (2019). Military Veterans’ overdose risk behavior: Demographics and biopsychosocial influences. Addictive Behaviors, 99.
Birtles, C. M. B. (2017). An interdisciplinary conceptualization of posttraumatic growth: A modified Delphi study (Publication No. 10269765) [Doctoral dissertation, North Dakota State University]. ProQuest Dissertations & Theses Global.
Burgess, D. J., Nelson, D. B., Gravely, A. A., Bair, M. J., Kerns, R. D., Higgins, D. M., van Ryn, M., Farmer, M., & Partin, M. R. (2014). Racial differences in prescription of opioid analgesics for chronic noncancer pain in a national sample of Veterans. The Journal of Pain, 15(4), 447–455.
Coleman, J. A., Lynch, J. R., Ingram, K. M., Sheerin, C. M., Rappaport, L. M., & Trapp, S. K. (2018). Examination of racial differences in a posttraumatic stress disorder group therapy program for Veterans. Group Dynamics: Theory, Research, and Practice, 22(3), 129–142.
Doran, J. M., Pietrzak, R. H., Hoff, R., & Harpaz-Rotem, I. (2017). Psychotherapy utilization and retention in a national sample of Veterans with PTSD. Journal of Clinical Psychology, 73(10), 1259–1279.
Herbert, M. S., Leung, D. W., Pittman, J. O. E., Floto, E., & Afari, N. (2018). Race/ethnicity, psychological resilience, and social support among OEF/OIF combat Veterans. Psychiatry Research, 265, 265–270.
Merlin, J. S., Young, S. R., Starrels, J. L., Azari, S., Edelman, E. J., Pomeranz, J., Roy, P., Saini, S., Becker, W. C., & Liebschutz, J. M. (2018). Managing concerning behaviors in patients prescribed opioids for chronic pain: A Delphi study. Journal of General Internal Medicine, 33(2), 166–176.
Morland, L. A., Mackintosh, M.-A., Greene, C. J., Rosen, C. S., Chard, K. M., Resick, P., & Frueh, B. C. (2014). Cognitive processing therapy for posttraumatic stress disorder delivered to rural Veterans via telemental health: A randomized noninferiority clinical trial. The Journal of Clinical Psychiatry, 75(5), 470–476.
Nichter, B., Norman, S., Haller, M., & Pietrzak, R. H. (2019). The psychological burden of PTSD, depression, and their comorbidity in the U.S. Veteran population: Suicidality, functioning, and service utilization. Journal of Affective Disorders, 256, 633–640.
Rubin, A., & Barnes, W. G. (Eds.) (2013). Assessing, preventing, and treating substance use disorders in active duty military settings. In Handbook of military social work (pp. 191-208). John Wiley & Sons.
Smith, A. J. (2021). Towards a trauma-informed existential career development group for Veterans-in-transition: A conceptual exploration. The Journal for Specialists in Group Work, 46(2), 187–201.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2018). 2018 National survey on drug use and health: Veterans.
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US Congress. (2010). Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111–148 124 Stat. 119.
US Congress. (2018). Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018, Pub. L. No. 115-271.