Veterans and Substance Abuse: The Many Sides of the Problem

Veterans of the United States military have protected Americans from dangers we could not see, dangers we did not hear, and dangers we did not know existed. They have been on the front lines during combat. They have made decisions that most of us could not make. These men and women deserve our respect and our help when dealing with physical wounds, mental illness, and substance abuse.

Veterans and Drug Addition

The National Veterans Foundation (NVF) reports that veteran substance abuse is a growing problem. Today, there are more instances of debilitating physical and mental health issues in veterans than there were 50 years ago. Substance abuse has increased as veterans try to cope with their own physical disabilities, mental issues, and the challenges of returning to civilian life.


Veterans and Substance Abuse – The Numbers That Reveal the Reality

veteran drug abuse

The following statistics illustrate the magnitude of the problem of substance abuse among veterans in the United States:

  • 7.1% of veterans developed substance use disorder (SUD) during the period from 2004 to 2006, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
  • 2 out of 10 veterans who suffer from post-traumatic stress disorder go on to develop SUD, according to the National Center for PTSD.
  • 1 in 6 veterans of the Iraq and Afghanistan campaigns experiences symptoms of PTSD, according to the National Institute on Drug Abuse (NIDA)
  • 20% of female veterans who have served in Iraq and Afghanistan have been diagnosed with PTSD.
  • 1 out of 4 veterans of the Iraq and Afghanistan campaigns reports experiencing the symptoms of a mental health disorder, according to the U.S. Department of Health and Human Services.
  • 25% of young veterans aged between 18 and 25 years exhibited the symptoms of SUD or other mental health disorders between 2004 and 2006, according to the National Institute on Drug Abuse. This is double the instance reported by veterans aged 26-54 years and 5 times more than for veterans aged 55 years or older.

The Department of Defense (DoD) enforces a strict zero-tolerance policy for drug use among active military personnel. But according to the NIDA, veterans still have higher rates of tobacco addiction, alcoholism, and prescription drug misuse than civilians. Substance abuse among veterans is steadily increasing.

The following statistics from NIDA demonstrate the high rates of alcohol, tobacco, and prescription drug use among military service members:

The following numbers from NIDA show the high rates of alcohol, tobacco, and prescription drug use among military service members:

  • 47% of military service personnel reported binge drinking in 2008.
  • 20% of active-duty personnel reported binge drinking every week during the past month in 2008.
  • 30% of all active-duty military personnel smoke cigarettes.
  • 7% of veterans reported misusing prescription drugs in 2008, according to the DoD Survey of Health Related Behaviors Among Active Duty Military Personnel. This is more than 2.5 times the civilian rate. Opioid painkillers were the most misused prescription drugs.
  • From 2001 to 2009, the instances of pain medications prescribed by military physicians quadrupled, according to the National Council on Alcoholism and Drug Dependence.

What causes veteran substance abuse disorders?

  • High incidence of PTSD
  • High incidence of mental health disorders
  • Combat exposure
  • Traumatic brain injuries
  • High incidence of substance misuse during active service
  • Chronic pain
  • Altered mechanisms of coping with stress
  • Being a woman
  • Inability to recognize or acknowledge that there is a problem
  • Reluctance to seek help
It was a few years ago. I was playing with some Syrian kids during one of my missions, while my colleagues stood guard. While playing with the kids, I noticed a man out of the corner of my eye. He was standing next to the building in the area we played in. He was wearing a jacket, which was strange ‘cause it was really hot outside, so I took a second look and noticed some wires under the jacket. He was a suicide terrorist, so in five seconds I had to gather the kids and get them as far away from the danger as I could. No more than a minute later the whole building was gone. After it all happened, it came to my mind that I could’ve been dead. It took a while to sink in ‘cause I was too busy with the most important thing – saving the kids.Sean (age: 28)

Mental Disorders

veteran help

Post-traumatic stress disorder is a mood disorder that can result from witnessing or experiencing intense trauma. In some instances, the symptoms of post-traumatic stress may be similar to those of other mood disorders, as they can include anxiety and depression. Additional symptoms often include:

  • Flashbacks to the traumatic event(s)
  • Nightmares
  • Intrusive memories, often triggered by current events, places, and odors
  • Lashing out
  • Bizarre behavior
  • Sudden rage or violent outbursts

Re-experiencing traumatic events is stressful, so people with PTSD may act as if they are always on edge or may lash out at others for no apparent reason or over trivial issues. These experiences can be debilitating and may negatively impact an individual’s daily life and relationships. Veterans suffering from PTSD may avoid people, places, and situations that remind them of their traumatic experiences. Chronic anxiety can disrupt sleep which can affect a person’s mood and cognitive abilities.

Witnessing or experiencing traumatic events also increases the chances of developing other mental disorders. For instance, according to a study on more than 675,000 military personnel on active duty, the rate of depression has increased in recent years among this segment of the population.

Mental Health Issues

The instances of mental disorders, especially PTSD, are higher among veterans who have experienced combat or who have had life-threatening experiences. The incidence of substance abuse among PTSD sufferers is disproportionally high. According to the findings of a study published in the Journal of the American Medical Association, 12-15% of 88,235 combat veterans who were deployed in Iraq reported abusing alcohol. In another study, 53% of veterans, who had experienced combat reported frequent binge drinking.

It can be difficult for civilians and veterans who have never been in combat to understand many of the causes of PTSD. Common experiences that may lead to PTSD include:

  • Witnessing the death of a colleague on a battlefield and being unable to prevent it
  • Witnessing the death of civilians and children
  • Going for long periods without sleep – either due to maneuvers or stress
  • Being away from home and loved ones for months or years at a time
  • Being in danger all the time, never knowing what is going to happen or when
  • Witnessing or having near death experiences
We were in one of the buildings where we were sleeping. I heard some noise outside, so I took my gun and went outside to see what is going on. I carefully looked around and noticed nothing happening, so I turned around to walk back in. At the same moment I felt a sudden pain in my back. I passed out. It turned out that there was a sniper on the roof of one of the buildings. I’m lucky I had a bulletproof vest.Robert (age: 23)

Altered Coping Mechanisms

PTSD and other mental health issues are stressful. Veterans may turn to alcohol, illicit drugs, or prescription drugs to cope with stress. Veterans who suffer PTSD or traumatic brain injuries may be at higher risk of developing SUD because their neuronal circuitry and stress responses may have been altered by the traumatic events that they have experienced, according to Psychiatric Times.

Much military personnel is exposed to addictive substances abuse while on active duty. Many develop chemical dependencies long before they return to civilian life. Their stress responses may be altered by the time they are discharged from military service. Battle injuries often leave veterans in chronic pain. A person who has been used to managing chronic pain with opioid painkillers does not have any other tools or coping mechanisms. Opioid painkillers become their first line of defence when they experience physical pain.

Being a Woman

woman veteran

Being a female veteran increases the chances of developing SUD. Some unique factors work against female veterans to make them more vulnerable:

  • Due to genetics, women have more intense fear responses than men, according to research carried out at the University of California San Francisco. They are twice as likely as men to experience the symptoms of PTSD.
  • 10% of active-duty female service members report being raped by another soldier, and 13% are targets of unwanted sexual contact, according to a Pentagon report. This may be a contributing factor to higher stress levels in female service members.
  • Female veterans are four times more likely to abuse prescription medicines than the civilian population.
  • Fewer women seek treatment for their chemical dependencies than men.
We were best friends for 15 years. We were also in love with each other. I watched him dying. One of my so-called friends took my gun, shot him and later said that I did it. My friend betrayed me. I lost my best friend and the love of my life, and I lost the opportunity to continue serving my country.Paul (age: 22)

Smoking Among Pilots

Two pilots in a cabin of a civil plane

While the Federal Aviation Administration forbids alcohol use within a minimum of 8 hours of flight (known as “bottle to throttle”), this is only a guideline. A pilot is prohibited from flying with any blood alcohol level above 0.0%. Many airlines use the rule of 12 hours rather than 8. There is also a list of prescription drugs that pilots may take for genuine medical conditions. Smoking is permitted, and this can be an issue.

Many pilots smoke as a result of the pressures of the job. Every time a commercial pilot (or a military pilot) takes off, they bear the responsibility for their own personal safety and the safety and lives of all of their passengers and crew, not to mention the responsibility of millions of dollars worth of equipment.

Smoking is not allowed on commercial or military flights. This can be an issue on long-haul flights because nicotine withdrawal symptoms have been shown to affect pilot judgment within 12 hours of cessation. This may not have been an issue in the days when smoking was allowed on flights, but that is no longer the case.

Smoking and substance abuse among pilots, both military and civilian, has some interesting ramifications. Smokers have a higher level of carbon monoxide in their systems (up to 15% in heavy smokers, as compared to less than 0.5% in non-smokers), making their respiratory system much less efficient at carrying oxygen. With such a high level of carbon monoxide, pilots are more susceptible to hypoxia (lack of oxygen to the brain) that can cause poor judgment, poor coordination, and in extreme cases, loss of consciousness. The effects of hypoxia are magnified at higher altitudes.

As well, the eyes need a tremendous amount of oxygen to function properly at night, and it has been demonstrated that the night vision of heavy smokers can be reduced by 40% when compared to that of nonsmokers.

As with the general population, smoking cessation among pilots reduces the risk of stroke and heart attack, COPD, cancer, and a host of other chronic (and not so chronic) illness. It can also cause many illnesses that can disqualify a pilot from flying. Smoking cessation has also been demonstrated to improve sleep and improve mental function, certainly an asset for any pilot.

Yes, I smoke. There’s no worse feeling than knowing that you can’t save all the civilians. That there are kids dying on your watch, and you can’t do everything. Kids are brainwashed, and they pretend to listen to you, and then they kill you, thinking that it will take them to heaven. I lost my friend like that. You never know if the decision you make isn’t the last decision in your life. You try to slowly come closer to a kid with wires around him, knowing that either the kid or the terrorist behind him will blow him up. You try to persuade the kid to trust you. If you’re too late, it will haunt you for the rest of your life. You doubt yourself; you feel worse than horrible. I feel horrible for not being able to save everyone who needs it.Richard (age: 31)

Attitudes and Beliefs

Heavy drinking is a part of the military culture, and tobacco is a legal and available to both the military and civilian populations. Prescription drugs are prescribed by doctors, so it is natural for many people to believe there is no harm in using (or abusing) these substances. Many people who view themselves as “strong,” as many veterans do, may believe they can get away with anything and are not at risk of suffering from addiction. Many veterans may not acknowledge that they have a problem or that it needs to be treated.

Such self-image also makes them view SUD as a weakness or a moral flaw. Feelings of shame and guilt keep many veterans from seeking treatment.

What are the symptoms of veteran substance abuse?

An equipped soldier smoking a cigarette

  • Decreased interest in personal hygiene and appearance
  • Abnormal behavioral responses
  • Abnormal mood swings
  • Unexplained weight loss
  • Lethargy and excessive sleepiness
  • Sores on the face or mouth
  • Watery or red eyes
  • Giving up cherished activities
  • Withdrawing from company
  • Secretive behavior
  • Spending money without being able to account for the expenses

Alcohol and illicit drugs produce temporary feelings of euphoria. It is this euphoric “high” that users crave. But as the effects of the substance wear off, so do the pleasant feelings. Users may experience depression, apathy, and listlessness. Chronic substance abuse alters brain chemistry and functionality, so long-time users may exhibit lasting behavioral and mood changes.

Addicts are often preoccupied with procuring the substances that they are addicted to. They spend a large part of the day consuming these substance and then dealing with the withdrawal symptoms and then getting another high. This is a vicious cycle. The addict has no inclination, interest, or energy left to engage in hobbies or interact with friends and family members.

Secretive behavior such as lying about consumption habits, hiding away the substance of abuse, or spending money without being able to provide a satisfactory explanation for the expenses are tell-tale signs of substance abuse.

However, symptoms like weight loss, insomnia, lethargy, or sores on the face or mouth can also be caused by some underlying physical disorder. So it always makes sense to investigate.

Not everybody will exhibit all the classic symptoms of drug abuse. Nor will the signs appear simultaneously. Be proactive in trying to help those in your life.

Where to Find Help for Veteran Substance Abuse

thank you veterans

A veteran with SUD has multiple treatment options and avenues to explore, including the U.S. Department of Veterans Affairs Medical Centers, private addiction treatment and rehabilitation centers, addiction counselors, and mental health counselors.

  • The Department of Veterans Affairs (VA) Medical Center: Every VA medical center has health officers who can diagnose SUD and suggest an appropriate course of treatment. In addition, SUD-PTSD specialist who is trained to recognize and treat the symptoms of both these conditions are available to help find the best treatment options. Here treatment is provided under the Veterans Alcohol and Drug Dependence Rehabilitation Program. However, a veteran must be enrolled in the VA health care system in order to benefit from this program.
  • Private Addiction Treatment and Rehabilitation Centers: Many veterans choose to seek treatment at private inpatient or outpatient facilities that offer anonymity and guarantee confidentiality.
  • Addiction Counselor: An addiction counselor can help identify the best course of treatment. Some veterans may need to undergo detoxification before they can enter a rehabilitation center. The presence of co-occurring mental and substance abuse disorders may necessitate more specialized treatment, and an addiction counselor can help identify the proper course of treatment as well as a rehabilitation facility that is properly equipped to deal with both issues.
  • Mental Health Counselor: The presence of a mental disorder in veterans increases their risk of developing SUD. Proper treatment of PTSD and other mental health issues can help avoid SUD.

Ongoing counseling for post-traumatic stress disorder is also typically needed for those with symptoms of this disorder. Treatment usually includes therapy with a trained counselor with experience in treating post-traumatic stress, and sometimes medications to help alleviate anxiety.

If you or a loved one are trying to cope with a substance abuse problem, help is available. Learn about the Veteran Substance Abuse Problem.