It has become clear to Alexander Bennett, Ph.D., that veterans can be highly successful at helping other veterans readjust to civilian life. This makes sense, given their shared lived experiences. Many veterans also have a strong distrust of the VA, providers, and other groups who try to assist veterans. Alexander is conducting interviews and focus groups with recently separated Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans to understand how researchers and providers can help veterans connect with each other, give veterans a voice in shaping the social and public policies that impact them, and help veterans to understand the voices of people who are trying to reach out to them.
Alexander addresses these barriers through his work for the National Development Research Institute (NDRI). His path to NDRI started with 15 years in the drug and alcohol field and working with grassroots needle exchange and overdose prevention programs. He subsequently earned a Ph.D. from Carnegie Mellon with a focus on Substance Use and Misuse. He was awarded a Public Health Solutions/National Institute of Drug Abuse (NIDA) fellowship at NDRI and began to work on a veteran’s reintegration study run by Dr. Andrew Golub. This work led to a grant from the Peter J. McCanus Charitable Trust to explore drug and alcohol initiation and escalation among recent veterans emerging from the wars in Iraq and Afghanistan.
Alexander’s passion for vets grew out of a commitment to historically marginalized populations who face barriers to health, healing, and accessing or utilizing health services. In particular, his work has focused on those at risk for HIV/Hepatitis C, incarceration, and other drug-related harms, including overdose. This work generated a great deal of thought about the impact of public policy on minorities, people of color, women, and other socially and economically disadvantaged populations.
“These things came together and we started observing problematic relationships veterans have with opiates while they were deployed, in particular OxyContin. We examined the repercussions that resulted from the misuse of opioids,” explained Alexander. These were exacerbated by incidence of traumatic brain injury, posttraumatic stress disorder (PTSD), and sexual trauma. In order to understand these dynamics, Alexander combined his focus on the contemporary problems veterans face with the historical underpinnings, hoping to achieve an historical understanding of veterans and drug use and misuse.
Currently, Alexander is working on a small qualitative study with veterans experiencing homelessness and drug use who have been recently separated from military service, less than 24 months. In the larger veterans reintegration study, a method called Respondent Driven Sampling is used. Respondent Driven Sampling is a method that has been used to research hidden populations, including jazz musicians and injection drug users. “It relies on veterans’ social networks and is in part a social network method that allows researchers to obtain unbiased estimates for the target population,” says Alexander. “For example, I meet Joe. Joe refers me to Fred.”
These networks for some veterans are extensive and for some they are non-existent, indicating that the veterans are socially isolated. It has been hypothesized that the veterans without social networks fare the worst in terms of civilian reintegration. Respondent Driven Sampling is a method that goes beyond simply sampling for the study and encourages individuals who are often difficult to locate to connect to others and to researchers and to grow their networks one person at a time. With this system there is a mathematical model that weighs the sample to account for the non-random collection method.
Given that success is more prevalent among veterans who have larger community networks they can rely on, talk to, and relate to, Alexander sees hope for moving forward and building trust, and his research has had a lasting impact on the research subjects. For his team it is very much about creating a community of veterans. “We are trying to work with veterans to see how we can work to reach out,” says Alexander.
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