Severity Of Substance Use Research Articles

Validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale.

Stigma against people who have alcohol and drug problems severely affects their health and well-being. An instrument based on stigma theory assessing individual-level stigma is essential for a comprehensive understanding of their stigma. We evaluated the validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale (SU-SMS-J) among a population who had alcohol or drug use problems. Adults with experience in substance use disorders from psychiatry outpatient departments and rehabilitation facilities participated in the self-administered questionnaire survey. Confirmatory factor analysis was conducted to test the structural validity of the 5-factor model proposed in other language versions, and factor loadings and correlation between the subscales were confirmed. The correlations between the SU-SMS-J and psychometric properties related to substance use (e.g., severity of substance use, motivation to change) were investigated to assess concurrent validity. Internal consistency was assessed using Cronbach's alpha coefficients. Data from 126 participants were analyzed. The 5-factor model was acceptable with good or reasonable model fit indices. The correlations between subscales were weak to moderate, and this result suggested the SU-SMS-J assessed different but related components of stigma: enacted, anticipated, and internalized stigma from different stigma sources (family and healthcare workers). The SU-SMS-J and subscales showed moderate concurrent validity. Internal consistency was mostly sufficient, with Cronbach's alpha coefficients of 0.86 for all items and 0.66-0.93 for subscales. The SU-SMS-J is valid and reliable for use among populations with substance use problems in various settings in Japan.

Severity and Number of Substances Used are Independently Associated with Antiretroviral Therapy Adherence Over Time among People with HIV in the Current Treatment Era.

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care. Among 10,557 PWH (2010-2021) from 8 academic clinical sites nationally we examined longitudinal associations of substance use severity and number of substances used (measured using AUDIT-C and modified ASSIST) with patient-reported ART adherence (visual analog scale). Alcohol (68% any use, 18% unhealthy use [AUDIT-C > 4 men, > 3 women]), marijuana (33%), and methamphetamine (9%) use were most reported. Polysubstance use was common (32%). Both higher severity substance use and higher number of substances used were associated with lower ART adherence. Severity of methamphetamine use had the strongest dose-response association with ART adherence (low severity [ASSIST 1-3]: -3.05%, 95% CI: -4.23%, -1.87%; moderate [ASSIST 4-26]: -6.20%, 95% CI: -7.08%, -5.33%; high [ASSIST > 26]: -10.77%, 95% CI: -12.76%, -8.78%). Severe substance use, especially methamphetamine, and higher number of illicit drugs used were associated with declines in adherence at levels that were likely clinically meaningful in the modern era of ART. Findings support integrating substance use care with HIV care and potential benefits of harm reduction strategies for improving adherence such as encouraging lower levels of substance use and fewer number of substances used.

Profile of substance individual with substance use disorders: community-based project results

ABSTRACT Objective Substance use disorders have emerged as a remarkable public health problem worldwide in recent years. The present study aimed to determine the severity of substance use disorders of individuals who applied to the counseling unit within the scope of the project “Opening Doors to Hope, Holding on to Life,” and to examine the relationship between their sociodemographic, measured characteristics and the severity of substance use. Methods The data of this descriptive cross-sectional study were collected using the demographic information and substance use characteristics, and Addiction Profile Index-Clinical Form (BAPI-K) during the project implementation between February 2019 and December 2020. Results The findings revealed that 52.7% of the applicants had a low substance use level, while it was high among 23.3%. Significant relationships were detected between the severity of substance use and education level, previous counseling on addiction, level of depression, anxiety, poor anger management, and lack of safe behavior (p < .05). Conclusion This study revealed significant relationships between the severity of substance use disorders and level of depression, anxiety, anger management issues, and lack of safe behaviors. In this context, considering these factors in the substance use disorder treatment process could potentially enhance treatment success.

Assessment of Severity of Substance use for Outcomes Research and Treatment (ASSORT): A substance use severity scale developed and validated across six tertiary care centers in India.

Assessment of the severity of substance use disorders (SUDs) in a culture-sensitive manner can help gauge the current condition of the substance user and assess change with time. The present study aimed to develop a scale for the assessment of the severity of SUDs in the Indian clinical context. Based upon the review of literature on previously available instruments and a consultative meeting of experts, a clinician-rated scale was developed that finally comprised 41 items. A briefer 5-item scale with current and lifetime versions was also developed. The scales were applied to patients with SUDs at six different clinical sites. The instrument was applied to 720 patients (98.2% males, mean age: 34.6 years). The Cronbach's alpha of the full scale was 0.852. The inter-rater reliability Pearson correlation coefficient of the full-scale was r = 0.821 (P < 0.001), and the intra-class correlation coefficient single measure was 0.800 (95% confidence interval: 0.724-0.956). A four-factor solution was suggested to be the most tenable. The mean application duration of the full scale was 13.4 minutes, and that of the briefer version was 2 minutes. This validated scale could be a potentially useful assessment measure for the severity of SUDs in the Indian context. The utility lies in the simplicity of administration and scoring and the balance between brevity and thorough assessment.

Striatal brain volume linked to severity of substance use in high-risk incarcerated youth.

Substance use disorders among juveniles are a major public health concern and are often intertwined with other psychosocial risk factors including antisocial behavior. Identifying etiological risks and mechanisms promoting substance use disorders remains a high priority for informing more focused interventions in high-risk populations. The present study examined brain gray matter structure in relation to substance use severity among n = 152 high-risk, incarcerated boys (aged 14-20). Substance use severity was positively associated with gray matter volume across several frontal/striatal brain regions including amygdala, pallidum, putamen, insula, and orbitofrontal cortex. Effects were apparent when using voxel-based-morphometric analysis, as well as in whole-brain, data-driven, network-based approaches (source-based morphometry). These findings support the hypothesis that elevated gray matter volume in striatal reward circuits may be an endogenous marker for vulnerability to severe substance use behaviors among youth.

Reduced drug use as an alternative valid outcome in individuals with stimulant use disorders: Findings from 13 multisite randomized clinical trials.

Total abstinence has historically been the goal of treatment for substance use disorders; however, there is a growing recognition of the health benefits associated with reduced use as a harm reduction measure in stimulant use disorders treatment. We aimed to assess the validity of reduced stimulant use as an outcome measure in randomized controlled trials (RCTs) of pharmacological interventions for stimulant use disorder. We conducted a secondary analysis of a pooled dataset of 13 RCTs. Participants were individuals seeking treatment for cocaine or methamphetamine use disorders (N = 2062) in a wide range of treatment facilities in the United States. We validated reduced stimulant use against a set of clinical indicators drawn from harmonized measurements, including severity of problems caused by drug use, comorbid depression, global severity of substance use and improvement, severity of drug-seeking behavior, craving and high-risk behaviors, all assessed at the end of the trial, as well as follow-up urine toxicology. A series of mixed effect regression models was conducted to validate reduction in frequency of use against no reduction in use and abstinence. More participants reduced frequency of primary drug use than achieved abstinence (18.0% vs. 14.2%, respectively). Reduced use was significantly associated with decreases in craving for the primary drug [60.1%, 95% confidence interval (CI) = 54.3%-64.7%], drug seeking behaviors (41.0%, 95% CI = 36.6%-45.7%), depression severity (39.9%, 95% CI = 30.9%-48.3%), as well as multiple measures of global improvement in psychosocial functioning and severity of drug-related problems, albeit less strongly so than abstinence. Moreover, reduced use was associated with sustained clinical benefit at follow-up, as confirmed by negative urine tests (adjusted odds ratio compared with those with no reduction in use: 0.50, 95% CI = 0.35-0.71). Reduced frequency of stimulant use appears to be associated with meaningful improvement in various clinical indicators of recovery. Assessment of reduced use, in addition to abstinence, could broaden the scope of outcomes measured in randomized controlled trials of stimulant use disorders and facilitate the development of more diverse treatment approaches.

Predicting intimate partner violence perpetration by Latino/a/e/x men in residential substance misuse treatment

ABSTRACT Little is known about rates of IPV among Latino/a/e/x men in residential substance misuse treatment. Logistic regressions examined whether severity of substance use, mental health symptoms, and socioecological factors predicted IPV perpetration in 145 Latino/a/e/x men in treatment. Lifetime perpetration and victimization were 72.6% and 76.7%, respectively. Perpetration was negatively associated with self-esteem and positively associated with depression, PTSD, total lifetime types of drugs used, and victimization. More types of drugs used increased odds of lifetime perpetration and physical, psychological, and sexual perpetration; anxiety increased odds of lifetime perpetration; use of opioids, hallucinogens, and sedatives increased odds of physical and psychological perpetration only. Increased frequency of drug used in the past 6 months decreased odds of lifetime, physical, and psychological perpetration. Results highlight needs for concurrent/comprehensive assessments, and coordinated care for IPV/behavioral health in treatment facilities. Social work professionals are uniquely positioned to advocate for and provide holistic assessments and services.

Substance use and misuse among college students: Results of an online survey from three neighboring cities of North India.

We estimated prevalence and severity of substance use in college students from three cities in North India and explored demographic correlates of substance use. This was a cross-sectional online survey. We used Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). We contacted respondents through social groups. We performed analyses from the original sample, bootstrapped samples, and random subsamples. A total of 229 (58.3%) respondents reported any lifetime substance use. A third of substance-using respondents were female. Alcohol (54.7%), tobacco (40.2%), and cannabis (15%) use were most commonly reported. Prevalence estimates did not differ between original and subsample analyses. A significant proportion of respondents (alcohol 29.7% and amphetamines 66.7%) were at moderate risk level. Male gender, family history of substance use, and commerce stream correlated with substance use. There were positive correlations between tobacco and alcohol and licit and illicit substance use. The study highlights the need for a comprehensive college substance misuse prevention policy.

Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era

ABSTRACT Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence (p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) (p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized.

Can severity of substance use be measured across drug classes? Estimating differential item functioning by drug class in two general measures of substance use severity

BackgroundSubstance use severity is frequently measured using generic (i.e., non-drug specific) items. Yet, the measurement properties of these items must be evaluated for measurement invariance across inidividuals who use differing substances to ensure total scores can be compared across groups. MethodThis study used data from two independent samples (n1 = 474; n2 = 5183) and two measures of general substance use severity with generic items, the Patient Reported Outcomes Measurement Information System (PROMIS) Severity of Substance Use and DAST-10, to examine for differential item functioning (DIF) across substances (i.e., sedatives, opioids, amphetamines, cocaine, and cannabis). We utilized moderated nonlinear factor analysis to estimate DIF. Finally, we compared factor scores across estimation methods with and without accounting for DIF to examine the impact of DIF. ResultsA minority of items showed statistically significant DIF in each scale (Items with DIF: PROMIS Sample 1: 5/37; PROMIS Sample 2: 7/20; DAST-10 Sample 2: 3/10). Factor scores across scoring methods showed extremely high correlations (0.994 – 0.999), estimates of mean differences across substance groups did not vary considerably across scoring methods, but measurement differences were correlated with factor scores. DiscussionThese findings suggest that these two measures of substance use severity can be used across individuals using different substances. Factor scores appear similar across scoring methods and mean differences do not appear to be substantially biases. Measures with generic items may offer a parsimonious alternative to measures with drug specific items but more research is needed to evaluate the robustness of these findings.

Pathways to care for substance use treatment among tribal patients at a psychiatric hospital: A comparative study.

According to the national mental health survey, substance use disorders (SUDs) are prevalent in 22.4% of the population above 18 years, whereas the same is 26% among the tribal population. The treatment gap is also high in substance-addictive disorders. Our study aimed to compare the severity of substance use, pathways to psychiatric care, and treatment-seeking behavior among the tribal and non-tribal populations. The study was conducted at a tertiary psychiatric teaching institute in India. It was a cross-sectional comparative study. Patients fulfilling the International Classification of Disease 10 diagnostic criteria of mental and behavioral disorders due to substance use, with active dependence, were taken without comorbidity. Forty patients in tribal and non-tribal groups were recruited with consecutive sampling. The samples were assessed with a semi-structured interview schedule, addiction severity index, attitudes toward help-seeking, and pathways-to-care. Excessive substance use median was for 7.00 (± 5.00) years in tribal and 6.00 (± 4.00) years in non-tribal; in tribal, substance intake was younger than non-tribal (P = 0.167), and general health-care system more distance than the non-tribal (P < 0.001). Around 65% of the persons with SUD never consulted their general practitioner and primary health-care facilities. Alcohol severity was higher in the tribal population than in the non-tribal population. The cannabis and opioid severity was high in the non-tribal population. Help-seeking behavior was deficient in both groups. Most of the substance abuse tribal and non-tribal populations reach healthcare very late and do not consider it as a health issue initially. The major reason for the delayed pathway is a lack of awareness about mental health care facilities and stigma in both populations. The stigma is high in non-tribal communities compared to the tribal community. There is a need to improve the identification and treatment of alcohol morbidity in primary care.

Examining the risk and predictive factors for substance use and mental health among indigenous youth in out-of-home care

BackgroundYouth exposed to the child welfare system are among society’s most vulnerable citizens. Despite research highlighting the harms that typically follow child welfare placement, little is known regarding the factors that influence substance use and mental health among older Indigenous youth in out-of-home care. ObjectiveThe objective of this research are to provide a recent snapshot of the severity of substance use and mental health problems among older Indigenous youth in-care, identify factors driving the high prevalence of Indigenous youth in the child welfare system, and provide information on factors that could reduce health disparities among Indigenous youth. MethodUsing data from the 2016 Ontario Looking After Children project, this study examines the risk-predictive factors of substance use and positive mental health among 1173 youth between 16 and 17 years of age in out-of-home care. ResultsFindings reveal no significant difference in positive mental health between older Indigenous and non-Indigenous youth, but Indigenous youth are more likely to engage in substance use. Results also indicate that unstructured living arrangements, placement instability, low caregiver attachment, school suspensions, and deviant peer associations impact substance use and/or mental health among this population. ConclusionsThis study offers insight into how older Indigenous and non-Indigenous youth in the child welfare system fare with respect to substance use and mental health. While there are no differences in positive mental health, findings from this study warrant further investigation into the factors for substance use for older Indigenous youth.

Psychiatric symptoms in people living with HIV: prevalences, interactions and consequences

IntroductionPeople living with HIV (PLHIV) experience higher levels of mental health issues compared to the general population. Especially depression, anxiety, impulsivity and substance use occur frequently in PLHIV. This is thought to have important consequences for quality of life, sexual risk behaviour and antiretroviral treatment (ART) adherence. Both in PLHIV as well as in the general population, divergent psychiatric symptoms often co-occur, and influence one another.ObjectivesTo assess the interrelatedness of psychiatric symptoms and their potential consequences in PLHIV.MethodsData from 1615 outpatient PLHIV using suppressive ART from the 2000HIV study (NCT03994835) were analysed. Participants reported on the severity of substance use (MATE-Q), depression and anxiety (HADS), impulsivity (BIS-11), quality of life (EQ-5D-5L), ART adherence (MASS-8) and sexual risk behaviour. For these variables, prevalence rates and mean scores were calculated. After binarizing the data, an Ising network model was constructed. Using this network, interrelations between psychiatric symptoms were assessed, the centrality of symptoms was estimated and connections with clinical consequences were explored.ResultsIn our cohort of PLHIV, the increased prevalence of substance use was most pronounced, as shown by a prevalence rate of 28.7% for smoking, 13.6% for cannabis use, 11.1% for heavy alcohol drinking and 9.2% for ecstasy use in the past month. The network analysis revealed that symptoms of depression and anxiety were most strongly interrelated. The depressive symptom “feeling slowed down” was one of the most central symptoms, and was most strongly connected with quality of life. Substance use was associated with a higher occurrence of sexually transmitted diseases, and this relationship was mediated by a higher number of sexual partners. Notably, ART adherence did not display any connections with depression, anxiety, impulsivity or substance use.Image:ConclusionsThe high occurrence of substance use and its link with sexual risk behaviour, emphasizes it’s role as a potential target for prevention of HIV transmission. Contrary to general assumption, psychiatric symptoms are not associated with lower levels of ART adherence in our cohort. Treatment of depression in PLHIV might be improved by focussing on the symptom of feeling slowed down, since this symptom was most strongly connected with quality of life.Disclosure of InterestE. Meeder Grant / Research support from: ViiV Healthcare, M. Blaauw: None Declared, L. van Eekeren: None Declared, A. Groenendijk: None Declared, W. Vos: None Declared, Q. de Mast: None Declared, W. Blok: None Declared, A. Verbon: None Declared, M. Berrevoets: None Declared, J. van Lunzen Employee of: ViiV Healthcare, L. Joosten: None Declared, M. Netea: None Declared, V. Matzaraki: None Declared, A. van der Ven: None Declared, A. Schellekens: None Declared

Compulsory care of individuals with severe substance use disorders and alcohol- and drug-related mortality: A Swedish registry study.

This study used 17 year of Swedish registry data (2003-2019) for 25,125 adults assessed for their severity of substance use to identify the baseline factors predicting the risk of being court-ordered into compulsory care and examine the association between admission to compulsory care and mortality risks due to alcohol- or drug-related causes. Addiction Severity Index (ASI) assessment data were linked to register data on demographic characteristics, compulsory care, and alcohol- and drug-related mortality. Cox regression models were used to identify baseline factors predictive of post-assessment admission to compulsory care in the 5 years post-substance use assessment. Discrete-time random-effect logistic regression models were used to examine the association between compulsory care duration and alcohol or drug-related mortality risks. Propensity score matching was used for validation. The first models identified that younger age, female gender, and ASI composite scores for drug use, mental health and employment were significantly associated with the risk of placement in compulsory care for drugs other than alcohol. Female gender and ASI composite scores for alcohol, drug use and employment were significantly associated with compulsory care treatment for alcohol use. The second models showed that older individuals and men were more likely to die due to alcohol-related causes, while younger individuals and men were more likely to die due to drug-related causes. Length of stay in compulsory care institutions significantly increased the likelihood of dying due to substance use-related causes. Propensity scores analyses confirmed the results. In Sweden, a significant concern is the higher likelihood of women and young individuals to be court-ordered to compulsory care. Although compulsory care is often advocated as a life-saving intervention, our findings do not provide strong support for this claim. On the contrary, our findings show that admission to compulsory care is associated with a higher risk of substance use-related mortality. Factors such as compulsory care often not including any medical or psychological therapy, together with relapse and overdose after discharge, may be possible contributing factors to these findings.

Pattern and severity of substance use in help-seeking adolescents of North-East Part of India

Pattern and severity of substance use in help-seeking adolescents of North-East Part of India

Drug Deaths Among Older Adults Rising

Drug Deaths Among Older Adults Rising

Madde Kullanım Bozukluğu olan Hastalarda Diyalektik Davranış Terapisi Grup Becerileri Eğitimi Pilot Çalışması: Madde Kullanım Şiddeti, Duygudurum ve İlişki Becerilerindeki Değişiklikler

Objective: This pilot study aimed to investigate effects of Dialectical Behavior Therapy Group Skills Training (DBT-ST) on patients’ severity of substance use status, mood and other psychological symptoms, difficulties in emotion regulation, interpersonal problem solving skills, and social competence. Method: Nine outpatient males with substance use disorders were administered the DBT-ST for 20 weeks. Age ranged between 17 and 34. Average years of substance use was 1.61 (SD=.29). DBT-ST modules (mindfulness, emotion regulation, interpersonal skills, and distress tolerance) were administered for 20 weeks. Urine toxicology screenings, the Addiction Profile Index (API), the Symptom Check List-90-Revised (SCL-90-R), the Beck Depression Inventory (BDI), the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Problem Solving Inventory, and the Perceived Social Competence Scale were administered at pre and post-treatment. Results: There were significant decreases in the severity of substance use with decreased number of positive drug screening test results and an increase in emotion regulation; decreases in the API total score, dependency diagnosis, and the effects of substance use on the user sub-scale scores; depression, hostility, and phobic anxiety sub-scale scores on the SCL-90-R; the BDI total score; and nonacceptance, strategies, clarity and impulsivity sub-scale scores of the DERS. Conclusion: The findings indicated a 20 week DBT-ST helped participants increase their days of abstinence, regulate emotional regulation, decrease depressive and anxiety symptoms, and substance related difficulties.

Community Treatment Orders use Among Persons With a First Episode of Psychosis in Quebec.

Specialized early intervention for psychosis can reduce the duration of untreated psychosis and improve clinical and functional outcomes. However, poor adherence to treatment is frequent. The literature on community treatment orders (CTOs) use in first-episode psychosis (FEP) as a means to improve treatment adherence is limited. In the context of early intervention for psychosis services (EIS), this study aims to describe (1) the frequency of CTOs utilisation, (2) the trend of CTOs use over time, (3) the timing and reasons for requesting CTOs and (4) the baseline characteristics of FEP patients on CTOs compared to those who were not. A 5-year prospective longitudinal study describing the use of CTOs among persons with FEP admitted to two urban EIS in Montreal, Quebec, from 2005 to 2013. At admission, and then annually for 5 years, CTOs data were collected through chart review. Baseline characteristics, assessed by patient interviews, standardized questionnaires and chart review, included socio-demographic data, illness severity, functioning and alcohol and substance use. Descriptive analyses were performed, and FEP patients on CTOs during follow-up and those who were not were compared using analyses of variance, chi-square test and multivariate logistic regression. Among 567 FEP patients, 19.2% were placed on CTOs. The main reasons for requesting CTOs were to prevent further deterioration in mental state, social functioning, harmful behaviours to self and others and homelessness. FEP patients on CTOs had poorer premorbid and baseline functioning, more severe symptoms and social dysfunction at admission, including legal problems and homelessness. CTOs can be a tool to improve adherence to treatment, which is crucial for relapse prevention in FEP. However, since it is a coercive method that limits a person's fundamental rights, further research is warranted to assess its impact on patients' lives, clinical and functional outcomes, as well as patients' and carers' perception.

Utilizing SBIRT as a Framework for Transforming How We Think About Prevention and Early Intervention for Youth and Young Adults

Utilizing SBIRT as a Framework for Transforming How We Think About Prevention and Early Intervention for Youth and Young Adults

Addiction and Mental Health Treatment Experiences in Veterans During the First Year of the COVID-19 Pandemic: Nationwide Cross-sectional Survey

Background Addiction treatment evolved quickly during the first year of the COVID-19 pandemic in the United States, with changes likely increasing access to some forms of care (eg, medications for opioid use disorder) and reducing access to others (eg, inpatient treatments). Efforts to continue providing quality addiction treatment to veterans may have benefitted from the Veteran’s Healthcare Administration’s existing telehealth infrastructure. Veterans’ experiences of care during this time are key to evaluating these efforts. Objective This study aimed to examine veterans’ experiences of mental health and addiction treatment during the first year of the COVID-19 pandemic. Methods Cross-sectional self-report data were collected over 3 months starting in April 2021, using Qualtrics panels. Participants were 401 veterans who (1) endorsed one or more substance use–related problems and (2) reported attending one or more mental health or addiction treatment appointments since April 1, 2020. The survey included standardized assessments of the risk severity of substance use and treatment satisfaction, as well as study-specific questions assessing care in the past year, including the proportion of care received in person versus telehealth appointments and perceptions of treatment quality and access relative to before the pandemic. Results Overall, 22% of the participants were women and 67% were White and non-Hispanic, with an average age of 41.7 (SD 9.4) years. The majority were combat veterans (85%), and the army was the most commonly represented branch (61%). Most of them (98%) endorsed items consistent with a moderate to severe risk for one or more substance use disorders, with alcohol being the most common one (91%), and most (74%) met the risk criteria for 2 or more substances. One-fifth of participants (20%) reported that their past year appointments were evenly split between in-person and telehealth consultations, while 43% of them received care primarily via telehealth, and 37% of them attended mostly in person. The average satisfaction with mental health and addiction treatment was comparable with that reported in previous addiction treatment studies (mean 25.4, SD 4.1) and did not differ as a function of the proportion of care received via telehealth (F2,398=2.77; P=.06). Most participants rated treatment as much better (27%), slightly better (38%), or the same (26%), and overall health care access as better (51%) or the same (30%) relative to before the pandemic. The distribution of satisfaction, quality, and access did not differ as a function of treatment modalities accessed in the past year (eg, medications and inpatient care). Conclusions Veterans rated their treatment satisfaction, perceived quality of care, and overall health care access as largely better or the same relative to prepandemic care. These data should be interpreted in the context of web-based administration of care and the cross-sectional study design. Nevertheless, our findings align with those of recent work suggesting that veterans with substance use disorders are particularly open to telehealth treatment options. These results also suggest that health care providers’ efforts to continue providing care during the first year of the COVID-19 pandemic were well received. Conflicts of Interest None declared.