Criminal Typology of Veterans Entering Substance Abuse Treatment

• We examined criminal histories and clinical characteristics of veterans.
• Mild or moderate (92.5%), rather than severe (7.5%), criminal histories were common.
• The severe criminal history group was least involved in mutual-help groups.
• Severe groups' more severe clinical problems were not present at follow-ups.
• Treatment and mutual-help group use improve outcomes among criminally involved.

Criminal justice involvement among veterans is a critical and timely concern, yet little is known about criminal histories and clinical characteristics among veterans seeking treatment for substance use disorders (SUDs). The present study examined criminal typology, clinical characteristics, treatment utilization, and 12-step mutual-help group (MHG) participation among veterans (N = 332) at intake to SUD treatment at the Department of Veterans Affairs (VA), and 6 months and 1 year post-intake. Cluster analysis yielded three types of criminal histories mild—(78.9%), moderate (13.6%), and severe (7.5%)—distinguished by type of offense, number of convictions, and number of months incarcerated. At intake, participants with mild criminal histories reported more alcohol problems and fewer legal and employment problems than participants with moderate and severe criminal histories. Participants with severe criminal histories were most likely to attend a 12-step MHG meeting in the year post-intake, but all groups had high attendance. When only participants who had attended at least one meeting in the year post-intake were compared, participants with mild criminal histories worked more steps and were more involved in 12-step practices. All groups improved between baseline and follow-up and did not differ at follow-ups on substance use or other clinical outcomes. Multiple regressions identified treatment utilization and MHG attendance, but not baseline criminal history, as significant predictors of improved substance use problem severity at follow-up. Outpatient treatment and 12-step MHG attendance appear to be important components of recovery for veterans with varying criminal histories. Clinicians in SUD treatment programs should screen for criminal histories at treatment intake to ensure appropriate treatment planning.