Traumatic brain injuries occur when the brain is forced against the skull during a violent blow to the head. As a result, the neurotransmitters in the brain that regulate feelings of pleasure can become damaged—which can cause people to turn to drugs and alcohol to feel good again.
EXPERTS
Clay Walters
View Bio- Signs a Veteran May Have an Addiction Problem
- How Military Service May Contribute to Substance Abuse
- PTSD and Substance Abuse
- By the Numbers: Addiction in Veterans
- Service, Depression, Substance Abuse, and Suicide: The Link
- The Veterans Alcohol and Drug Dependence Rehabilitation Program
- Military Families Suffer, Too
- Q&A With Substance Abuse Expert Clay Walters
- FAQs About Veterans and Substance Abuse
Members of the military make great sacrifices in order to serve our country—and sometimes those sacrifices can take an extreme toll on servicemembers’ health. As a result of this mentally, physically, and emotionally taxing career, some veterans turn to alcohol or drugs in order to cope with their experiences. This guide discusses substance abuse in the veteran community, including information on what triggers addiction, the consequences of abusing drugs and alcohol, and what kind of help is available to those who need treatment.
Signs a Veteran May Have an Addiction Problem
It sometimes can be difficult to differentiate whether someone has a drug or alcohol problem or is just using them to have a good time. When recreational use has crossed the line to addiction, however, there are signs that will manifest themselves. The following are some ways to tell that a veteran may have an addiction problem.
- Treating other people badly until relationships with friends, family members, and coworkers suffer
- Lying and stealing in order to get drugs and alcohol
- Drinking and taking drugs interferes with daily activities, such as going to work or school
- Making unsuccessful attempts to cut down or stop using drugs or alcohol
- Using drugs or alcohol to cope with problems or bad memories from military service
- Isolating from other people in order to use alcohol and drugs without being questioned or criticized
- Experiencing wild mood swings
- Having sudden financial or legal problems
- Using more drugs and alcohol than intended and feeling the inability to stop
- Feeling physically ill when not taking drugs or alcohol
- Ignoring hygiene and appearance
- Losing interest in hobbies, intimacy, and other enjoyable activities
- Blacking out after using drugs and alcohol
- Hearing from family and friends that they’re worried about substance use
- Experiencing changes in sleeping and eating habits
How Military Service May Contribute to Substance Abuse
A substance abuse addiction is often linked to other issues. There are several problems that can contribute to veterans using alcohol and drugs, including the following triggers.
Other Painful Injuries
Servicemembers who have sustained injuries on the battlefield live with unimaginable pain and often are prescribed powerful pharmaceuticals, like opioids, to help them manage it. Unfortunately, these medications can be highly addictive and often lead to veterans coming home with both chronic pain and a dependency on painkillers.
Transitioning to Civilian Life
Military jobs are extremely regimented and servicemembers become accustomed to strict rules. When they finish their military careers, they may find it stressful transitioning back into a lifestyle that requires them to make daily decisions about scheduling, housing, and even wardrobe. Also, dealing with jobs where roles may not be clearly defined can be difficult. As a result, some veterans alleviate the stress of civilian life by using alcohol and drugs.
Homelessness
Data from the Substance Abuse and Mental Health Services Administration indicates that 70 percent of homeless veterans have an addiction problem. Homelessness often precludes veterans from seeking substance abuse treatment, so they continue to use drugs and alcohol to deal with the daily emotional and physical stresses of living on the street.
Military Culture
During their downtime, servicemembers often drink heavily to unwind and bond with their peers. Since drinking regularly is a part of military culture, some people may develop an addiction and bring these habits back home after they’ve finished their service.
Public Perception
The public perception of servicemembers is that they’re strong, resilient, and always in control. This can make it difficult for veterans who are suffering from anxiety, depression, and PTSD to admit that there’s something wrong and they need help. This, coupled with the fact that mental illness already carries a stigma of its own, can cause veterans to suffer in silence and seek solace in the form of substance abuse.
PTSD and Substance Abuse
Post-traumatic stress disorder (PTSD) is often the result of servicemembers witnessing horrific events in the military. In fact, the U.S. Department of Veterans Affairs reports the following statistics of diagnosed PTSD among the veterans the agency serves:
12%
of Gulf War (Desert Storm) veterans
11% to 12%
of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) veterans
15%
of Vietnam War veterans
Many people who do not get treatment for their PTSD end up self-medicating with alcohol and drugs. In fact, the connection between substance abuse and PTSD is so strong that according to the VA, one in three veterans that seek treatment for substance use disorder (SUD) are also suffering from PTSD.
PTSD Among Women
While being a female servicemember does not automatically make someone vulnerable to addiction, it does increase the likelihood of experiencing PTSD. Additionally, ten percent of female active duty soldiers report being raped by a colleague and 13 percent report being subject to unwanted sexual contact—facts that exacerbate an already stressful environment and contributes to the likelihood of drug and alcohol use.
By the Numbers: Addiction in Veterans
More than two out of ten veterans with post-traumatic stress disorder also have an addiction.
(Source: U.S. Department of Veterans Affairs)
About 70 percent of homeless veterans are addicted to drugs or alcohol.
(Source: Substance Abuse and Mental Health Services Administration)
Between 2004 and 2006, about seven percent of veterans had substance use disorder.
(Source: Substance Abuse and Mental Health Services Administration)
Veterans are twice as likely to accidentally overdose on opioids as nonveterans.
(Source: U.S. Department of Veterans Affairs)
29 percent of active duty Army suicides that occurred between 2005 and 2009 involved alcohol and drug use.
(Source: National Institute on Drug Abuse)
More than two out of ten veterans with post-traumatic stress disorder also have an addiction.
(Source: U.S. Department of Veterans Affairs)
About 70 percent of homeless veterans are addicted to drugs or alcohol.
(Source: Substance Abuse and Mental Health Services Administration)
Between 2004 and 2006, about seven percent of veterans had substance use disorder.
(Source: Substance Abuse and Mental Health Services Administration)
Veterans are twice as likely to accidentally overdose on opioids as nonveterans.
(Source: U.S. Department of Veterans Affairs)
29 percent of active duty Army suicides that occurred between 2005 and 2009 involved alcohol and drug use.
(Source: National Institute on Drug Abuse)
Service, Depression, Substance Abuse, and Suicide: The Link
Substance abuse among veterans does not occur in a vacuum. Just as an addiction can be linked to causes beyond the excessive use of drugs or alcohol, its consequences can also be far-reaching—and tragic.
Many veterans who struggle with addiction also have co-occurring clinical depression—which manifests itself in strong feelings of sadness, worthlessness and despair, as well as irritable moods and changes in sleep or eating patterns. In fact, according to the National Alliance on Mental Illness, about 14 percent of people who suffer from depression are veterans. Like PTSD, when depression goes untreated, people may begin abusing alcohol or drugs to self-medicate and end up developing an addiction.
Another reason that untreated depression is so serious is because people who suffer from the condition may also have suicidal ideation. Being addicted to drugs and alcohol can aggravate the feelings of helplessness and hopelessness that people with depression tend to feel, which can put those struggling with addictions at higher risk of actually acting on their suicidal thoughts.
Among veterans, the rate of those dying from suicide is actually higher than the number of soldiers killed in combat, according to the Department of Defense Suicide Event Report for 2014. Also, the report found that the most common method of suicide among veterans involved the use of drugs or alcohol.
VA Addiction Treatment Programs
Whether veterans are addicted to prescription medications, street drugs, alcohol or even tobacco, the VA has treatment programs to help them get clean. The programs are built on evidence-based practices—which may include medicinal or nonmedicinal methods, or a combination of both—that have been proven to be effective and tailored to the individual needs of each patient.
In medication-based treatments, pharmaceuticals are chosen based on the nature of the patient’s addiction. For example, veterans who are addicted to opioids like oxycodone and heroin are given methadone, buprenorphine, naloxone, or naltrexone. Similarly, treatment for nicotine addiction may include bupropion, varenicline, or a nicotine replacement system like skin patches, lozenges, or gums. Each type of medication used during treatment is designed to manage withdrawal symptoms and reduce cravings.
VA treatments that do not involve medications are designed to help patients gain the skills needed to live an addiction-free lifestyle through counseling. During therapy sessions, patients may address family and other relationship issues, ways to cope with problems without turning to drugs and alcohol, and how to identify triggers that cause them to use.
In some cases, patients may need to be treated for a coexisting disorder, such as PTSD or depression. When treating these patients, the VA may use medications, individual or group therapy, and psychological treatments—like cognitive processing therapy or prolonged exposure—that are specifically designed to address trauma.
The Veterans Alcohol and Drug Dependence Rehabilitation Program
The Veterans Health Administration (VHA) offers the Alcohol and Drug Dependence Rehabilitation Program to provide holistic care for veterans who need help overcoming an addiction. In addition to offering detoxification to get the drugs and alcohol out of patients’ system, the program provides psychiatric help and assistance with social and vocational issues.
Military Families Suffer, Too
The stresses of military life can take a toll on servicemembers—but they’re not the only ones who can be affected. Marriage is challenging for any couple, but military spouses have tests to their relationship that can be especially difficult to deal with. Loneliness caused by long periods of separation during deployments, coupled with the stress of running a household and raising children without the help of their significant other, can cause military spouses to become depressed—which can put them at risk for drug or alcohol addiction. In fact, according to a report by the Substance Abuse and Mental Health Services Administration, military wives are more likely than their civilian counterparts to binge drink and abuse prescription medications.
And the children in military families are also at risk. Not only are military children more likely to have problems in school and with their peers, they are also at increased risk of binge drinking and having lifetime problems with alcohol abuse.
Q&A With Substance Abuse Expert Clay Walters
About Clay Walters, MMIS, BA, BS, NCAC II, CADC III, KCGC, CPP (Ret.)
Clay Walters is a former NCAC II and a CADC III. He has a marketing degree from Fort Hays State University, an honors clinical psychology degree from Kansas State University, his A/D Counseling certificate from Washburn University, and his MMIS from Friends University. He was also a KCGC and a CPP (Certified Prevention Professional). Mr. Walters worked in the field from 1995-2014. Experience includes education to residential treatment, youth to older adult, indigent to wealthy, mental health facility dual dx program to incarcerated women. Mr. Walters presently coordinates benefits at a call center for Department of Veterans Affairs.
Note: Mr. Walters spoke with Rehab Advisors as a substance abuse expert and is in no way acting as a representative of the VA. All views expressed here are his own. To learn more about addiction treatment programs for veterans, please contact the VA directly.
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What factors make veterans likely to become addicted to drugs or alcohol? Do they need to have been in theater to be vulnerable?
My experience with the disease of addiction is that anyone can develop the illness if they use enough for long enough. Some substances appear to increase the speed of illness development. Risk factors for veterans include being a human being, using substances, stress, violence, violation of values, away from families and support people, poor sleep, long hours, rigid cultural behavioral norms, physical and emotional pain, substance availability and normalization, etc. A veteran’s risk is increased even though they may not be in a combat situation or in theater.
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Why do many veterans with PTSD turn to alcohol and drugs?
For the same reasons’ non-veterans without PTSD use substances (I’m a non-veteran with PTSD). Addictive drugs aggravate PTSD and make it worse.
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What can a veteran’s family do to help their loved one with an addiction?
Practice ongoing healthy self-care individually and as a family; don’t be an enabler to the illness. This could mean that you may have to educate yourselves with new information to be able to detach from the illness in another person and go on with your lives while giving love, support, and empathy to the addict.
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What are the most important things that readers should know about veterans and addiction?
You didn’t cause it, and you can’t cure or control it. The disease of addiction is very democratic, it treats everybody the same. A person doesn’t have several addictions just like they don’t have several brains. They have one illness that displays itself in multiple ways. The illness is treatable and its development can be arrested with appropriate daily actions, just like a diabetic must take daily insulin. There is support and assistance for both addicts and families. You are not alone.
FAQs About Veterans and Substance Abuse
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What are the signs of addiction?
Addiction can manifest itself in physical, emotional, and behavioral ways. Some of the signs that someone is addicted to drugs and alcohol include having conflict in relationships with friends and family, suffering from mood swings, having different eating habits, and feeling that using a drug or drinking is necessary to get through the day.
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What triggers addiction in veterans?
The rigors of military life can trigger addiction in several ways. Some of the triggers for addiction that veterans may experience include suffering from painful physical injuries—such as traumatic brain injury—heavy drinking in military culture, post-traumatic stress syndrome, and the difficulties of transitioning back into civilian life.
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Does the military lifestyle increase the risk of addiction for the family of servicemembers?
The stress of military life can also put spouses and children at risk of abusing drugs or alcohol, especially when a deployment is involved.
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What is the relationship between addiction and suicide?
Addiction is often co-occurring with depression and PTSD. As a result, veterans may feel hopeless and helpless, which can lead to suicidal thoughts. If these challenges are not addressed, veterans may eventually commit suicide.
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Does the VA provide treatment to veterans with addiction issues? How does treatment for addiction work?
The VA provides treatment for veterans with addiction issues that includes medicinal intervention, therapy, or a combination of both.
Helpful Resources
- AddictionResource – Veterans and Substance Abuse: The Many Sides of the Problem
- National Center for PTSD
- Operation Homefront
- Substance Abuse and Mental Health Services Administration (SAMHSA): Publications and Resources on Veterans and Military Families
- VA Caregiver Support
- VA Suicide Hotline
- Vet Center Combat Call Center
- Veterans Alcohol and Drug Dependence Rehabilitation Program
- Veterans Crisis Line
- Women Veterans Call Center
What factors make veterans likely to become addicted to drugs or alcohol? Do they need to have been in theater to be vulnerable?
You didn’t cause it, and you can’t cure or control it. The disease of addiction is very democratic, it treats everybody the same. A person doesn’t have several addictions just like they don’t have several brains. They have one illness that displays itself in multiple ways. The illness is treatable and its development can be arrested with appropriate daily actions, just like a diabetic must take daily insulin. There is support and assistance for both addicts and families. You are not alone.