Substance Use Disorders QUERI

Over the past year, important policy issues related to access and safety for veterans with Substance Use Disorders (SUDs) have been the focus of the Health Systems Committee of the National Leadership Board. SUDs are prevalent, debilitating, costly, and can be lethal. During FY06, almost 355,000 veterans seen in VHA had SUD diagnoses other than nicotine dependence; and over 450,000 additional patients had nicotine dependence diagnoses without other SUDs. In collaboration with multiple partners, the SUD QUERI seeks to implement best practices for improving the detection and treatment of VHA patients who misuse psychoactive substances. We focus on patients whose substance use meets diagnostic criteria for abuse or dependence, but we also address patients' harmful drinking and use of tobacco (primarily cigarettes). SUD QUERI's purview also encompasses co-occurring infectious diseases and/or psychiatric disorders with the highest prevalence and disease burden as the co-morbidities of SUDs.

SUD QUERI Goals

The SUD QUERI has four goals:

1. Improve Detection and Management of Alcohol Misuse in Primary Care
2. Promoting Evidence-Based Specialty Care for Patients with SUD
   • A. Improving Continuity of Care
   • B. Implementing Opioid Agonist Therapy (OAT)
   • (i) Methadone Quality Improvement Project
   • (ii) Implement Buprenorphine
3. Enhancing Effective Treatment for Tobacco Use/Nicotine Dependence
4. Improve Services for Patients with SUDs and Co-occurring Conditions
   • (i) Liver Health Initiative for Patients with SUDs and Viral Hepatitis
   • (ii) Patients with SUDs and HIV
   • (iii) Patients with SUDs and Depressive Disorders
   • (iv) Patients with SUDs and PTSD