Veterans' views on alcohol use and experience of alcohol withdrawal syndrome treatment and subsequent alcohol use disorder care at two highly rural-serving VA hospitals: a qualitative study.

Authors

Tony Pomales, Daniel Ball, Jeydith Gutierrez, James C Willey

Published in

Journal of behavioral medicine. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

Alcohol use disorder (AUD) is a significant cause of morbidity that disproportionately affects veterans and rural-serving hospitals. As part of a larger quality improvement project to improve care for veterans with AUD admitted to rural-serving Veterans Affairs (VA) hospitals, we conducted a qualitative study using a phenomenological research approach to incorporate the veteran perspective. Participants were n = 16 veterans with AUD and recent admissions to two highly rural-serving hospitals. Veteran views and experience were elicited by conducting 30-60 min sessions of semi-structured interviews and assessed using thematic content analysis. Two themes relating to participants' views on alcohol use were identified: perceived unmet need, resulting in the use of alcohol to treat pain and cope with trauma and co-occurring mental health symptoms, often related to military service, and factors influencing hospital admission and need for additional treatment services. Themes relating to participants' experience of AWS treatment and subsequent AUD care were identified and divided into barriers and facilitators. Barriers included: limited, uneven distribution of hospitals; perceived premature discharge from inpatient AWS treatment; perceived discriminatory treatment and stigma about AUD; and a shortage of VA residential rehabilitation treatment programs. Veterans' geographic location and the uneven distribution of RRTPs within large catchment areas restricted access and increased travel burden. Preference and excess demand for VA RRTPs and limited service capacity contributed to long wait times. Facilitators included clinician support and spousal/family and veteran/peer support. Our findings suggest that a non-judgmental treatment environment and improved access to specialized services are essential to receiving effective AUD treatment, particularly for veterans in rural areas who have been repeatedly admitted for AWS. The VA should examine options to reduce stigma, align treatment with patient goals, leverage peer-led programs, and promote comprehensive care that addresses co-occurring conditions and underlying causes of alcohol misuse.

PMID:
42426355
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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