Veterans and Substance Abuse

Substance Abuse and Addiction Among Veterans

Collectively, we owe our country’s veterans a debt of gratitude for their dedication and service. Our nation’s veterans sacrificed and committed wholly in service to our country. Many risked their lives, willing to make the ultimate sacrifice to protect our freedom and safety. For their sacrifice, they asked nothing in return.

A veteran’s service does not end when they return home or end their careers with the military. Veterans at the end of their service often face many challenges as they return to civilian life. For too many, overcoming addiction is one of these challenges.

While there is more research to be done about the connection between veterans and substance abuse, we have some understanding of the role addiction plays in the lives of our country’s service members and veterans. Understanding why substance abuse and addiction are so common among veterans can help clinical providers develop better treatment programs for our nation’s heroes.

Veterans and Substance Abuse: The Numbers

Recent research shows that veterans have a slightly higher rate of substance abuse, especially alcohol abuse, than the general population. While some rates of substance use are falling, several have shown dramatic increases in the last two decades.

To explore the problematic relationship between veterans and substance abuse, researchers surveyed vast numbers of people who had completed their military service. During their research, they discovered that marijuana use among veterans rose by 50% between 2002 and 2009.[1] This increase could result from the rising popularity of marijuana as states have begun to legalize or decriminalize it. This significant increase may also suggest that more veterans are turning to substances to cope with the effects of their service or to fit into the military culture.

Because it is widely available, alcohol is one of the most commonly abused substances among veterans. Although rehab can be highly effective in helping veterans overcome addiction, researchers estimate that 84% of veterans struggling with alcoholism have not received the treatment they need.[2]

Of all veterans who entered treatment for a substance use disorder, 10% were in treatment for heroin abuse. About 6% were in treatment for cocaine abuse.

Research tells us that about 1 in 10 veterans lived with a substance use disorder. This percentage is higher than the general population, suggesting a link between prior military service and substance use.

Understanding the Connection Between Veterans and Addiction

When trying to figure out the best way to treat addiction in any population, it is essential to understand the unique factors that affect the group and how these issues might lead to substance abuse. Veterans have various problems that may contribute to their increased likelihood of developing an addiction to drugs or alcohol.

Pain

In the general population, about 6% of people report regularly experiencing moderate to severe pain. Among veterans, this number is 9%.[3] Veterans may have more pain due to injuries they sustained during their service.  Between 2001 and 2009, the rate at which doctors prescribed opioid pain relievers increased by 8%. Higher numbers of veterans experiencing chronic pain may contribute to their likelihood of abusing prescription painkillers or other substances.

Traumatic Brain Injury (TBI)

The CDC reports more than 430,000 veterans have been diagnosed with traumatic brain injury.[4] Veterans who suffer a TBI are at an increased risk of developing a substance use disorder. Veterans whose TBI is unidentified or untreated face an even higher risk of becoming addicted to drugs or alcohol. Traumatic brain injury is also closely related to co-occurring health conditions like depression and Post Traumatic Stress Disorder (PTSD). Both of these conditions raise a person’s risk of substance abuse or addiction.

Homelessness

In 2017, veterans made up approximately 9% of the US homeless population, and on any given day, more than 40,000 veterans experience homelessness.[5] Veterans are often at an increased risk of homelessness due to various factors. While substance abuse can make it more likely for a person to experience homelessness, being unhoused makes it more likely that someone will abuse drugs and alcohol.

Stress

Considering the stress of being away from home, experiencing trauma, homelessness, or unemployment, veterans have high stress levels. Post-traumatic stress disorder is common in veterans–even those who do not see combat.  Without treatment, PTSD and chronic stress can lead to self-medication and addiction.

Easy Access to Alcohol

Alcohol is often readily available on or near army bases. Many countries where deployed troops are stationed do not have a minimum drinking age, meaning people can drink without supervision when they are 18 or older.

Culture

Many veterans report a culture of drinking and substance abuse among active military members. The culture is vital in this close-knit group. Deployed groups often develop a set of shared values and norms that may be almost impossible to ignore. Sometimes, these practices, including substance abuse, are destructive and interfere with a person’s ability to live a healthy lifestyle.

Difficulty Transitioning Back to Civilian Life

While it is impossible to narrow it down to one reason our veterans live with higher rates of substance abuse and addiction, it is clear that our military vets need more support when they return home from service. Many veterans find it challenging to integrate back into civilian life.

The stress of service and returning to civilian life, as well as the physical and mental injuries our veterans sustain, deserve more attention. Too many veterans return home without the support they need to succeed. The practical and emotional challenges that occur when readjusting to civilian life may contribute to higher levels of substance abuse and addiction among veterans.

The Role of Trauma and PTSD in Veterans with Addiction

A lot of research on PTSD has been done to help us develop effective treatment programs. Post-traumatic stress disorder is common among people who have experienced intense fear or chronic stress–and this includes veterans. Medical and mental health professionals understand that people who have untreated PTSD often develop substance use disorders at a rate that is higher than the general population.

PTSD used to be called “shell shock” or “battle fatigue.” For years, medical and mental health providers used these terms to describe the patterns or emotions and behaviors soldiers exhibited after returning home from war. We understand now that trauma is real, treatable, and can occur immediately after the traumatic event–or show up years later. Any traumatic event can result in lingering symptoms of PTSD. Soldiers who have seen combat frequently develop PTSD.

Even soldiers who are not actively involved in battle may still experience trauma from long periods of anxiety, uncertainty, or intense stress. Trauma can result from simply spending prolonged periods away from home and loved ones. Post-traumatic stress disorder is common after a sexual assault–something that is increasingly relevant as 23% of female soldiers report at least one incident of sexual violence during their time in military service.[5]

Post-traumatic stress disorder can prevent someone from having a healthy, fulfilling life. It can impair their ability to maintain steady work or develop good relationships with others. Left untreated, PTSD can also lead to substance abuse. The vast majority of research on the subject suggests a strong correlation between veterans with PTSD and drug or alcohol addiction.

Recognizing PTSD

The symptoms of PTSD can appear immediately after the traumatic event or may show up years later. The intensity and severity of the symptoms may change in the period after the trauma. Symptoms of PTSD can include:

• Experiencing flashbacks–emotionally re-living the trauma as though it is happening in real life
• Poor memory
• Low self-esteem
• Feelings of hopelessness and depression
• Poor sleep and nightmares
• Difficulty with forming and maintaining relationships
• New or increased aggressive behavior
• Poor concentration
• Destructive behaviors, including self-harm and substance abuse

When trauma is untreated, many people attempt to numb the pain or intensity of their emotions by any means necessary. For many people with trauma, this can involve abusing drugs or alcohol. Without treatment for their PTSD, many veterans depend on substances to help them cope with the symptoms of their trauma. Unfortunately, this often leads to addiction that requires treatment.

Treatment for Veterans and Substance Abuse

Addiction treatment is offered in many settings and several levels of care. A doctor or addiction specialist will perform an evaluation, including questions about a person’s mental health, physical health, and treatment history, to determine which type of program a person needs.

Comprehensive addiction treatment addresses the complex aspects of addiction by treating not just the physical aspects of addiction, but the emotional, behavioral, and environmental elements, too.

Some of these most commonly prescribed medications for pain or anxiety can lead to physical and emotional dependence. Some veterans receive prescription medications like Ativan or Xanax to help them manage their anxiety. They may also receive prescriptions for pain relievers such as Oxycontin or Vicodin to help them manage pain after an injury. Or, they may depend on drugs used to help them sleep, like Lunesta or Ambien.

Many of these prescription pain relievers and anti-anxiety medications are highly addictive. Because of the symptoms of trauma and the increased likelihood of experiencing chronic pain, veterans risk developing an addiction to recreational drugs or alcohol that they may use to dull the symptoms of untreated PTSD.

To have the best chance of recovery, someone struggling with addiction to any substance must receive substance abuse treatment. Some of the symptoms of addiction include:

• Spending a lot of time getting, using, or recovering from using the substance
• Financial problems related to substance abuse
• Using more of the substance than planned
• Using the substance despite adverse consequences
• Experiencing withdrawal symptoms when attempting to cut back or stop using the substance

Substance abuse treatment for veterans living with PTSD must include both addiction treatment and compassionate, knowledgeable care for their trauma symptoms. After an initial assessment, addiction treatment generally occurs in three distinct stages.

Detox

People receive medical observation and treatment for uncomfortable or dangerous withdrawal symptoms. They have a chance to experience complete detox because medical and support staff provide constant monitoring during the stage where their cravings are likely to be very intense.

Treatment

Addiction treatment programs consist of a combination of evidence-based and holistic therapies designed to support whole-person healing. During a treatment program, people receive education, medical treatment, and therapy–including individual, group, and family sessions–that help them learn how to live without substances.

Aftercare

Addiction is a lifelong condition that people with the condition must manage. People must have a plan to receive ongoing care and support to help them avoid relapse. An effective aftercare plan may involve participating in recovery support groups, individual counseling, and receiving all required medical and mental health care.

Many people with PTSD experience symptoms for an extended period, so aftercare planning is essential for veterans. Aftercare plans can include individual therapy, support groups, ongoing mental health treatment, and other activities that keep veterans engaged in their recovery for life.

Get Help Now

If you or a veteran in your life requires addiction treatment, reach out to the caring staff at Arise Treatment Center today.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614859/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587184/
3. https://academic.oup.com/painmedicine/article/20/5/869/5077453
4. https://www.cdc.gov/traumaticbraininjury/military/index.html
5. https://nchv.org/veteran-homelessness/
6. https://icasa.org/uploads/documents/Stats-and-Facts/Facts-and-Stats-for-Sexual-Assault-in-the-Military-2020.pdf