Veterans have been there for our country, protecting us from dangers we could not see, dangers we did not hear, and dangers we did not know existed. Veterans have stood on the frontline during combat. They have made decisions that most could not make. They have withstood pressures that would crumble many. These men and women deserve our undivided attention and our help when it comes to a dependence on any substances.
The National Veterans Foundation (NVF) acknowledges that veteran substance abuse is a growing problem. The war on terror has magnified the physical and mental trauma on soldiers. Today, there are more instances of debilitating physical and mental health issues in veterans than 50 years ago. Substance abuse has increased as veterans try to cope with their own physical disabilities, mental issues, and the challenges of a civilian life.
If you or a loved one are trying to cope with a substance abuse problem, know that help is available. Also, learn about the various facets of the veteran substance abuse problem. If you are grappling with the problem, this knowledge will help you get rid of feelings of helplessness, despair, and frustration. If a loved one has a substance abuse disorder, this knowledge will help you understand his or her side of the story and be more empathetic.
Veterans and Substance Abuse: The Numbers That Reveal the Reality
The following statistics reveal the extent of the problem of veteran substance abuse in the United States:
- About 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).
- About 2 out of 10 veterans who suffer from post-traumatic stress disorder (PTSD) go on to develop SUD, according to the National Center for PTSD.
- About 1 in 6 veterans of the Iraq and Afghanistan campaigns experiences symptoms of PTSD, according to the National Institute on Drug Abuse (NIDA)
- About 20% of female veterans of Iraq and Afghanistan have been diagnosed with PTSD.
- About 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.
- In 2004-2006, 25 percent of young veterans aged between 18 and 25 years exhibited the symptoms of SUD or other mental health disorders in the past year, according to the NIDA. This is double the instance reported by veterans aged 26-54 years and 5 times what it is for veterans aged 55 years or more.
The Department of Defense (DoD) enforces a strict zero-tolerance policy for drug use. This has decreased the instances of illicit drug use among veterans compared to what it is for civilians. But according to the NIDA, veterans still have higher rates of tobacco addiction, alcoholism, and prescription drug misuse than civilians. What is alarming is that these numbers are steadily increasing.
The following numbers from NIDA show the high rates of alcohol, tobacco, and prescription drug use among military service members:
- About 47% of military service personnel reported binge drinking in 2008.
- About 20% of active-duty personnel reported binge drinking every week during the past month in 2008.
- About 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. Most of these drugs were opioid painkillers.
- The instances of pain medications prescribed by military physicians quadrupled from 2001 to 2009, according to the National Council on Alcoholism and Drug Dependence, Inc.
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
PTSD is a mood disorder that is the result of witnessing or experiencing intense trauma. The symptoms for post-traumatic stress are similar to those of other mood disorders in some cases, as they can include anxiety and depression. Additional symptoms can include:
- Flashbacks to the traumatic event
- Intrusive memories, often triggered by current events or places
- Lashing out
- Bizarre behavior
- Sudden rage or violent outbursts
Re-experiencing the traumatic experience 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 at times and may affect an individual’s daily life and relationships negatively. Veterans suffering from PTSD may avoid people, places, and situations that bring back memories or churn up visions of their traumatic experiences. Chronic anxiety can disrupt sleep that in turn, can affect a person’s mood and cognitive abilities.
The instances of mental disorders, especially PTSD, are higher among veterans who have been through combat experiences or were exposed to life-threatening scenarios. The incidence of substance abuse is also high among this group. For instance, according to the findings of a study published in the Journal of the American Medical Association, about 12-15% of 88,235 combat veterans who were deployed to Iraq reported abusing alcohol. In another study, 53% of veterans,who had experienced combat situations, reported binge drinking often.
Altered Coping Mechanisms
PTSD and mental disorders are stressful. Veterans may turn to alcohol or illicit drugs to cope with stress. On the other hand, PTSD and other mental disorders and traumatic brain injuries increase the risk of a person developing SUD by tweaking their neuronal circuitry and altering their stress responses, according to Psychiatric Times.
It doesn’t help that military personnel are exposed to substances of abuse while on active duty. Many develop chemical dependencies long before they return to civilian life. Their stress responses are already altered by the time they are discharged. For instance, battle injuries often leave veterans with chronic pain issues. A person who has been used to managing physical pain with opioid painkillers does not know any other coping mechanism. So he or she is bound to reach out for these medicines when in pain.
Being a Woman
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 percent of active-duty female service members report being raped by another soldier, and 13 percent are targets of unwanted sexual contact, according to a Pentagon report. This adds to the emotional trauma and stress levels of 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. Women may feel stressed by their childcare duties or other familial obligations and choose not to undergo treatment or rehab.
Attitudes and Beliefs
Heavy drinking is a part of the military culture. Tobacco is not a banned substance. Prescription drugs are, after all, “prescribed” by doctors. It is natural for a person to believe there is no harm in using too much of these substances. On the other hand, people who perceive themselves as being “strong”—as many veterans do—may believe they can get away with anything. Often veterans may not acknowledge that they have a problem that needs to be treated.
On the other hand, people who perceive themselves as being “strong”—as many veterans do—may believe they can get away with anything. Often veterans may not acknowledge that they have a problem that needs to be treated.
Chemical dependency and addiction bring on feelings of helplessness, despair, and frustration. These feelings tend to be acute in veterans who perceive themselves as “strong” individuals who are supposed to protect others.
What are the symptoms of veteran substance abuse?
- Decreased interest in personal hygiene and appearance
- Abnormal behavioral responses
- Abnormal mood swings
- Unexplained weight loss
- Lethargy and/or 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 may bring on feelings of euphoria. It is this euphoric “high” that users crave. But after the effects of the substance wear off, the pleasant feelings too disappear, and users experience depression, apathy, and listlessness. Chronic substance abuse tweaks brain chemistry and functionality, so users may exhibit lasting behavioral and mood changes.
Addicted people are often preoccupied with procuring the substances of abuse. They spend a large part of the day consuming the substance and then battling with the withdrawal symptoms. He or she has no inclination, interest, and energy left to engage in hobbies or interact with friends and family members. So if a loved one is exhibiting reclusive behavior, be on guard.
After being away from loved ones for months on end, it is natural for a veteran to want to catch up on the good times he or she has missed. What is unnatural is a tendency to sneak up to his or her room to be alone (and drink) or stay away from friends and family members (to avoid questions or criticism about his or her habits).
Secretive behavior like lying about consumption habits and hiding away the substance of abuse (bottles of vodka in the basement or strips of painkillers in the closet) or spending money without being able to provide a satisfactory explanation for the expenses are tell-tale signs of substance abuse.
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
A veteran with SUD has multiple treatment options and avenues to explore, including U.S. Department of Veterans Affairs Medical Centers; private addiction treatment and rehabilitation centers; addiction counselors; and mental health counselors.
- S. 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. Every medical center also has an SUD-PTSD specialist who is trained to recognize and treat the symptoms of both these conditions to ensure the most optimal health outcome. Here treatment is provided under the Veterans Alcohol and Drug Dependence Rehabilitation Program. However, a vet must be enrolled in the VA health care system for him or her to obtain the benefits of 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 a person choose the best course of treatment. Some veterans may need to undergo detoxification before they can enter rehab. Dual diagnosis or the presence of co-occurring mental and substance abuse disorders necessitates simultaneous treatment, so a veteran needs to seek treatment at a facility where specialists from both the disciplines are available.
- Mental Health Counselor: The presence of a mental disorder in veterans increases their risk of developing SUD. So even if a person is not exhibiting the symptoms of SUD, it is imperative that his or her mental health is examined by a specialist and treated.
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.