How addiction affects our veterans is often an issue given less thought than it deserves. Veterans and substance abuse have gone hand-in-hand for decades, yet they often don’t manage to receive the help they need.
We hope today to shine a light on substance abuse in veterans, highlighting some reasons they are often pushed towards abuse and how they can be helped.
When talking about veterans and substance abuse, we have to be careful not to make generalizations too sweeping. The lives of veterans are as varied as the walks of life that join the military, after all. At the same time, the number of veterans with PTSD compared to other members of society can’t be ignored in the discussion of drug abuse.
The rate of PTSD among veterans varies by conflict but sits above 12% by most estimates.1
There are plenty of varying reasons connecting PTSD in veterans. But in short, the life one lives and the things one sees in the military can be quite traumatic — and unfortunately, many don’t seek help.
Post-Traumatic Stress Disorder (PTSD) first entered the public conversation as “shell shock” in WWI and “combat fatigue” after WWII.2
While it can affect anyone, it is so prevalent among those in the military as their work, by definition, often involves traumatic events. Many see close friends or innocent civilians perish or forced to go through extreme, perhaps painful, circumstances.
This is all putting aside the military’s long-standing history of the culture of sexual assault or harassment.3 These things can be as or more traumatic to those involved as any military operation.
As for how PTSD can affect a servicemember or veteran can at times be quite a debilitating condition.
For someone with PTSD, their trauma haunts them, often long after the event in question has passed. It is a condition characterized by intense, disturbing thoughts and feelings connected to the trauma in question.
This trauma is often relieved by those affected in the form of nightmares or intense, vivid flashbacks. At times, the event’s details may even become twisted, with disturbing details that were not true of the actual event also feeling real.
The symptoms of PTSD are often separated into a few distinct categories. A given person affected by PTSD often only experiences some of the symptoms in question and at varying intensity levels.
Experiencing intrusion means experiencing unwanted recall of trauma through dreams or intense memories. It is one of the most common and universal symptoms of PTSD.
Some people who experience PTSD may have intense flashbacks of the event that feel so real that they are reliving the moment. While a symptom stereotypical of PTSD, it should be noted not everyone experiences such flashbacks.
A person experiencing avoidance will feel driven to avoid things that may remind them of the trauma they underwent.
Exactly what a person avoids will depend on the trauma they experienced and how intense their symptoms are. To give an example, some veterans with PTSD may be unable to watch war movies or hate the sound of fireworks.
It isn’t that the person in question is afraid of the triggers themselves, although they might learn to be. Rather, these triggers can cause them to remember their trauma again, leading to an intrusion suddenly.
People who experience trauma often have their perception around that trauma warped. For example, many victims of sexual assault often feel guilt or shame despite the fact they did not choose to be attacked.
People with PTSD may view themselves as worthless or guilty. Others may grow depressed and find it very difficult to see joy even in things they used to do for fun.
Many people with PTSD start to feel detached from others and the world around them. They may grow quiet, rarely go out, and may even start ignoring responsibilities, often to their own detriment (like missing work or school).
“Arousal” in a medical sense does not mean the same thing as how we often use the word in everyday speech. In this instance, it can be thought of as “irritability” or “tension.”
People with PTSD often struggle with self-control, angering quickly. They also can feel a sense of paranoia and anxiety even when they ostensibly are safe, startling easily.
Altogether, this often makes it hard for those with PTSD to focus and can lead to sleeping difficulties. It also can damage their relationships with others and might lead to other self-destructive behaviors.
Given the nature of PTSD, it is not surprising that it often pushes people suffering from it towards drugs. It is estimated 20% or more of American veterans with PTSD also suffer from Substance Abuse Disorders (SUDs).4
That rate of drug abuse among veterans is even higher if one includes nicotine. About 6 of 10 veterans dealing with PTSD smoke, double the rate of the veteran population as a whole.
These aren’t the only veterans abusing drugs, but these numbers are high enough that they need to be highlighted. PTSD is a difficult condition to deal with and, without the right tools, it is easy for a veteran affected by it to fall to drug abuse.
It’s also worth noting that these are the estimates as the US government could make them. It is possible and even likely that the real rates of abuse are higher.
While the study did not focus on veterans, it’s also worth noting it’s been shown that binge drinking is more common among those affected by PTSD.5
That said, the study showed the correlation is stronger among women than men.
As mentioned, PTSD is not the sole factor that decides whether a veteran is at risk for drug abuse. On the contrary, several factors work against veterans regarding drugs, whether they have PTSD or not.
Substance Use Disorder (SUD) is a disease characterized by an inability to control one’s use of either an illegal or legal drug or medication.
Male veterans aged 18–25 years seem to have a higher prevalence of SUDs compared to civilians. Research is not asn clear how female veterans compare to the civilian population.
When veterans choose to use illicit drugs, the vast majority decide to use cannabis. While the debate around cannabis is ever-evolving, it should be noted that it tends not to be good for one’s physical health.
Perhaps more concerning is a government report that veteran admissions to substance use treatment centers saw 10.7% of veterans coming for heroin abuse and over 6% for cocaine.
While abuse rates are lower than those regarding veterans with PTSD, it’s clear the general veteran population has many factors that can push them towards abuse. Young male veterans specifically seem to be a vulnerable group.
It’d be difficult to discuss veterans’ relationship with drug abuse without discussing active service members and their relationship with drugs.
The military has a zero-tolerance policy on most drug abuse. Being caught abusing drugs could result in a dishonorable discharge and other legal consequences.
Moreover, the military also lacks confidentiality regarding soldiers’ behavior and mandatory random drug testing.
This means a few things for people within the military.
Illicit drug use among military members tends to be lower than in the general population. Illicit drugs are harder to get, and the consequences for their use can be quite severe. However, binge drinking is quite common compared to the general population, as the rules on drinking are far laxer than illicit drug use.
The use of prescription opioid pain relievers has historically been higher than average. And the use of sedatives was once quite common among servicemembers due to overprescribing. However, it has decreased since a big nationwide push for better prescribing practices.
As for smoking, it was once widespread in the military, although it has decreased over the years. Fewer service members smoke in proportion to the general population, although many who smoke started after they enlisted.
There is plenty to criticize about the US and its military’s approach to drug abuse. One of the biggest weaknesses of their approach lay in their zero-tolerance policy.
Assuming the goal is to prevent drug abuse and help those who suffer from addiction, a zero-tolerance policy has many weaknesses. It needs to be said that much of the most destructive drug abuse isn’t a choice; it’s a way to cope.
Drug abuse is not a healthy coping mechanism, but it is still how many people try to deal with trauma and pain. Moreover, as one abuses drugs, the odds they get addicted increase.
A zero-tolerance policy means someone who abuses drugs in the military and wants to stop may feel they have limited options. It can be hard to seek help if you may lose your position or even face legal repercussions.
This is also something of a “stick” approach rather than a carrot. If you feel pushed to do drugs but choose not to out of fear of repercussions, what stops you from abusing once the risk of those repercussions fades?
Zero-tolerance policies put veterans at risk in two ways, even if there are meant to be ways for service members and veterans to seek help when they need it.
First, if they were abusing drugs as service members, they might be reluctant to seek help while in the military. This means their abuse may take months or years to get worse before they can feel safe to seek help.
Second, if they felt compelled to abuse drugs but did not out of fear, they might fall to drug abuse once that fear is gone.
With all the above in mind, the US government has somewhat tried to evolve its stance on drug abuse. It has a long way to go, but there have been efforts to get service members and veterans the help they need.
Like the rest of the country, there has been a slow but steady march towards the understanding that drug abuse is a symptom of a larger issue, not a person’s fault.
The US Department of Veteran Affairs (VA) provides treatment to many veterans seeking to overcome problems with drug abuse. They often will help provide detoxing services as well as drug abuse counseling.7
The VA also has made an effort to help veterans with PTSD get treatment, helping to combat drug abuse indirectly by tackling one of its biggest causes among veterans.
Even if veterans don’t have VA health care benefits, they can often get these or similar services if they served in a combat zone or face homelessness.
Things aren’t perfect, but there are many more in-built ways for veterans to seek help than there were even a few decades ago.
In addition to some of the harder data, based on analysis and expert reporting, it is also worth looking at how veterans self-report.
For instance, 35% of veterans sought help for emotional issues of some kind, and about as many believe they suffer from post-traumatic stress, whether they sought help or not.8
Military life can harm the mental health of those who serve. Unfortunately, it is poor mental health that often drives a person to abuse drugs.
In addition, positive connotations with the military among veterans have fallen somewhat post-9/11, although most are still proud of their service.
We note this because post-9/11 veterans, on the whole, seem to have a harder time with their transition than pre-9/11 veterans.
For instance, while 78% of pre-9/11 veterans felt the transition to civilian life was easy, only 51% of post-9/11 veterans felt the same, according to a Pew Research Center survey.8
These numbers may not be abysmal, but they fit the narrative that many veterans may be primed towards drug abuse. If one is in poor mental health and has trouble transitioning to civilian life, drug abuse may be one way to try and cope.
Despite the unique circumstances that may lead veterans towards drug abuse, the specifics of how to get them to help remain, for the most part, unchanged.
One element many veterans and their loved ones may have to help them get past is the perception that admitting one needs help overcoming a problem with drugs is a sign of “weakness” or a reason to feel ashamed.
The medical reality of drugs is something that completely contradicts this idea. Addiction is a disease; the brain and body quite literally are rewired to make quitting drugs feel difficult or even impossible.
It isn’t weak to need the help of medical professionals when confronting drug abuse for the same reason it isn’t weak to need a cast for a broken leg.
Helping people struggling with drug addiction is often a matter of having an admittedly difficult conversation (or many conversations). One needs to be loving and empathetic without avoiding hard truths.
Solving addiction in veterans means getting them to admit they have a problem and need help for said problem. Try to avoid blaming them for their issues while also letting them dodge the issue; if they can’t stop using drugs, something is wrong.
As was touched on earlier, it is also important for a veteran to try and identify why they chose to abuse drugs in the first place.
When it comes to drug abuse, addiction comes later. The reason one first chooses to abuse drugs is going to guide how they recover.
For many, drugs are used as a coping mechanism. For instance, a veteran who has PTSD may try and use drugs to feel some relief from their anxiety and pain.
From the outside, this may seem strange as one might think short-term relief isn’t worth it; in the long term, things are getting worse. However, one needs to realize that mental health isn’t always about the most logical path.
Depression, paranoia, and intense emotional pain can drive us to do anything for relief, even if our choices seem unwise in retrospect. From those unwise choices, addiction can then occur, escaping even harder.
This is why getting help for those problems from mental health professionals is often so important to a full recovery from drug abuse. Without solving underlying issues driving you towards addiction, recovery is much harder.
Veterans struggling with drugs, like anyone else, will often be overwhelmed by what is, for many, the hardest part of kicking a drug habit: withdrawal.
While a whole article could be written on withdrawal, the short of it is that the brain and body often struggle when one tries to stop abusing a drug.
Due to the way drugs can rewire our brains and body, we may start to have a strong physical reaction as those drugs exit our system. In essence, the body panics, having grown so used to the chemical changes those drugs caused.
This is a critical part of kicking a drug habit but also one of the hardest parts. The body has to “detox.” It has to expel all the drugs in a person’s system and slowly recover from the absence of drugs. It may take a while before the person in recovery feels “normal.”
This process is uncomfortable and, at times, even dangerous if done at home. Many people find it all but impossible without help.
The good news is that centers like ours offer medically-assisted detox programs. This lets a person detox under the care of a doctor and psychiatrist who help monitor their health and guide them through this difficult step of the healing process.
After detoxing, the next few steps a veteran takes to combat their addiction are pretty critical. A person isn’t “cured” once a drug leaves their system.
There are many levels to addiction treatment a person may undergo, depending on the nature of their addiction and recommendations from mental health professionals.
Once a person has a drug out of their system, the goal is to equip them with the tools and support network they need to resist drugs in the future. The ideal is they will someday be able to resist drugs without any outside help.
Our own facility has a number of outpatient programs tailored to various drug addictions a person may be trying to recover from. The goal of an outpatient program is to be flexible, allowing for things like work and school.
The best ways for a veteran to combat an alcohol addiction may be similar to, for instance, opioids, but there are key differences worth learning about. Every drug offers unique challenges for those who once abused them to overcome.
Now your know a few more tips on how to make your relapse prevention plan. If you stick to your plan, you will stay strong and make it through the temptations.
Find your triggers and avoid them. Concentrate on your life and what’s going on around you. Are you slowly climbing those steps towards a relapse?
Find people you can talk to during every stage of your struggle. Learn new skills on how to prevent relapse from your new life.
Contact us today to enquire about programs we have to offer you or those you care about. Asking for help is not a weakness; it’s a cure.
 Torres, F., M.D., DFAPA, MBA. (2020, August). What Is Posttraumatic Stress Disorder? (American Psychiatric Association, Ed.).
 Myers, M. (2020, April 30). A culture that fosters sexual assaults and sexual harassment persists despite prevention efforts, a new Pentagon study shows. Retrieved from https://www.militarytimes.com/news/your-military/2020/04/30/a-culture-that-fosters-sexual-assaults-and-sexual-harassment-persists-despite-prevention-efforts-a-new-pentagon-study-shows/
 U.S. Department of Veterans Affairs. (n.d.). PTSD and Substance Abuse in Veterans. Retrieved from https://www.ptsd.va.gov/understand/related/substance_abuse_vet.asp
 Kachadourian, L. K., Pilver, C. E., & Potenza, M. N. (2014). Trauma, PTSD, and binge and hazardous drinking among women and men: findings from a national study. Journal of psychiatric research, 55, 35–43. https://doi.org/10.1016/j.jpsychires.2014.04.018
 NIDA. 2019, October 23. Substance Use and Military Life DrugFacts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/substance-use-military-life
 U.S. Department of Veteran Affairs. (2020, June 26). Substance use treatment for Veterans. Retrieved from https://www.va.gov/health-care/health-needs-conditions/substance-use-problems/
 Igielnik, R. (2019, November 17). Key findings about America’s military veterans. Retrieved from https://www.pewresearch.org/fact-tank/2019/11/07/key-findings-about-americas-military-veterans/
 The Nursing Home Abuse Center Team (2020, August 28). Key findings about Nursing Home Abuse and Veterans. Retrieved from https://www.nursinghomeabusecenter.com/resources/veterans/