Making the changes to better your health

Big or small can lead to positive growth    

Recognizing the stigma that often surrounds substance use and mental health, VA is committed to removing barriers so that every Veteran who seeks help has access to a wide range of evidence-based services. These include harm reduction strategies, medications for addiction treatment and other proven approaches tailored to individual needs.

“Our approach right now is very much a ‘come as you are’ approach,” said Dr. Jesse Barglow, psychologist and section chief for the downtown Substance Use Disorder (SUD) Clinic at the Los Angeles VA Medical Center. “We really want to work with anyone who is dealing with substance use issues and wants to make a change, no matter how big or how small.”

Research supports this flexible “meet-them-where-they-are” philosophy. The National Institute on Drug Abuse highlights that patient-centered care, use of effective medications, and reducing barriers and stigma are associated with better outcomes for Veterans living with substance use disorders.

Dr. David Lawrence, the clinic’s medical director, emphasized the breadth of services available: “We offer all FDA-approved treatments for substance use disorders, including methadone and buprenorphine for opioid addiction, as well as medications for alcohol and stimulant use. In addition to medication, we provide trauma-informed therapy, peer support, harm reduction tools such as fentanyl test strips, and contingency management programs that reward progress.”

Additionally, Veterans are not required to be abstinent to receive care, and they will not be turned away for continued use. Instead, the team meets each Veteran where they are, helping them define their own goals, whether that means complete sobriety or simply reducing harm.

“We’re trying to undo a lot of the rigidity and judgment that has historically been part of addiction treatment,” said Barglow. “We don’t require urine tests. We don’t punish people for relapsing. We want to build relationships based on trust and support.”

Matthew Ayala, a 37-year-old Navy Veteran, struggled with alcohol use, which began after he left the military due to the stress he carried and a sense of identity loss while transitioning into civilian life. Like many Veterans, Ayala’s substance use was a kind of self-medication he developed to cope with underlying pain and distress. 

“I had the realization that my coping was really costing my health, my sanity, my peace and my presence, mainly my presence as a father and a husband. I was a new father at the time and I decided, for me, recovering is not about quitting something, it’s more about building something better,” said Ayala.

A network of support

With the help of his family, friends and VA, he turned his life around and embraced sobriety. In the span of approximately six months, he completed the Intensive Outpatient Program (IOP) at VA where he took classes in mindfulness, anger management, PTSD and courses focused specifically on alcohol use. He got a new job that he loves—building emergency vehicles such as police cars—and was able to rent a larger home more suitable for his family. 

“I opened my mind and my heart up to VA because they opened theirs to mine… I felt valued, I felt cared about, and so I gave it a shot,” said Ayala.

Ayala encourages other Veterans who may be hesitant to seek help to consider giving it a try.

“You can jump into a class and not say anything to anybody, and they don’t care if you have anything to say or not. You just get to look and listen and see if you like it,” he added.

It’s never too late to apply for VA health care you’ve earned. If you are a Veteran or know a Veteran who has not yet applied for their VA health care benefits, learn how to get started.

This article was originally published on the VA Greater Los Angeles Health care System site and has been edited for style and clarity.