I would like to welcome everyone to our subcommittee hearing.  We are here today to talk about treatment for substance abuse and comorbid conditions in the Department of Veterans Affairs. 

Substance use disorders are among the most common diagnoses made by the Veterans Health Administration.  According to the 2007 National Survey on Drug Use and Health, 7.1% of veterans met the criteria in the past year for a substance use disorder and 1.5% of veterans had a co-occurring substance use disorder.  Of the approximately 300,000 veterans from Operations Enduring and Iraqi Freedom who have accessed VA health care, nearly 50,000 have been diagnosed with a substance use disorder.

Additionally, more than 70% of homeless veterans suffer from alcohol and other drug abuse problems. 

Over the past several years, Congress has increased funding for substance use treatment programs within the Department of Veterans Affairs to $428 million in Fiscal Year 2008.  I believe that continued adequate funding is imperative for the health and well being of our veterans and their families.

Substance use frequently co-occurs with other mental health conditions.  VA needs to continue to dedicate itself to providing services that can address both substance use and other mental health conditions such as PTSD simultaneously.

I also was pleased to learn that Dr. Kussman, VA’s Undersecretary for Health recently released a directive on the management of substance use disorders.  This directive states, among other things, that VA facilities must not deny care to any enrolled veteran because they are using substances and that all VA medical facilities must provide services to meet the needs of veterans with substance use disorders and PTSD.  I think that this is a step in the right direction and I commend VA for it’s proactive leadership on this issue.

Last week, Mr. Miller and I introduced the Veterans Substance Use Disorder Prevention and Treatment Act of 2008.  This legislation will require the VA to provide the full continuum of care for substance use disorders, and it will require this full spectrum of care to be available at every VA medical center.  This legislation also directs the VA to conduct a pilot program for internet-based substance use disorder treatment for veterans of Operations Enduring Freedom and Iraqi Freedom.  This will enable our newest generation of veterans to overcome the stigma associated with seeking treatment and receive the necessary care in a comfortable and secure setting. 

The committee realizes that substance use and comorbid conditions are complex issues.  But we also recognize that it is an important one that deserves serious thought and consideration.  I look forward to hearing from our panels today about ways that VA can effectively address these critical issues.