Veterans and addiction
Veterans and addiction is a significant issue, as military veterans and active-duty service members face a heightened risk of developing substance use disorders (SUDs) due to the high-stress environments associated with their roles. Combat-related traumas, including depression, anxiety, and post-traumatic stress disorder (PTSD), often contribute to substance misuse as individuals attempt to cope with their mental health challenges. Research indicates that a notable percentage of veterans experience PTSD, with some estimates suggesting that between 6 and 20 percent are affected annually. Concurrently, many veterans diagnosed with PTSD also struggle with SUDs, highlighting the need for integrated treatment approaches.
Historically, stigma surrounding mental health issues has led to underdiagnosis and inadequate treatment, although awareness and resources have improved over the years. As of recent years, many veterans have turned to community-based treatment options due to distrust in government services, prompting the establishment of partnerships between the Veterans Administration and community resources. Effective recovery strategies typically involve comprehensive therapies that address both the psychological and social aspects of addiction. Research continues to inform strategies aimed at better understanding and supporting the mental health and addiction needs of veterans, emphasizing the importance of concurrent treatment for PTSD and SUDs.
Veterans and addiction
DEFINITION: Military veterans and active-duty service members are at an increased risk of developing substance use disorders (SUDs) compared to civilians because of the high-stress nature of their jobs. Combat-related stresses and traumas often result in depression, anxiety, or post-traumatic stress disorder (PTSD), which further increases the risk of substance abuse. Military and civilian mental health specialists continue seeking the best practices and implementing programs to support the mental health and SUD needs of veterans.
Combat-Related Stress Disorders
Substance abuse resulting from combat trauma or PTSD is not unique to veterans of twenty-first-century wars and conflicts like Operation Iraqi Freedom (OEF) and Operation Iraqi Freedom (OIF). Veterans of World Wars I and II, the Vietnam War, and earlier campaigns also presented classic symptoms of PTSD, though it was poorly understood. Researchers have studied the disorder for decades, and twenty-first-century data increasingly guides treatment and prevention programs and policies toward success.
Estimates vary, but between 6 and 20 percent of US veterans experience some form of PTSD in a given year. In a 2009 Social Work journal article, specialists pointed out that 25 percent of the more than 100,000 veterans treated by US Veterans Administration (VA) health services received a mental health disorder diagnosis. More than one-half of these veterans were diagnosed with both PTSD and a substance use disorder. In addition, an estimated 70 percent of homeless veterans have a substance addiction. As the stigma surrounding mental health treatment decreased, if minimally, veteran mental health treatment increased drastically after 2009. The VA treated nearly 1.1 million veterans in 2016 and 1.7 million veterans in 2023 for mental health needs, primarily PTSD and SUDs.
In their 2008 book After the War Zone: A Practical Guide for Returning Troops and Their Families, Laurie B. Slone and Matthew J. Friedman recommend that military personnel with PTSD and substance abuse disorders be treated for both conditions concurrently. PTSD and substance abuse disorders were grossly underdiagnosed among military service members in the early 2000s, largely because both disorders carry a heavy stigma in the military. If either condition was reported on one’s medical record, the person faced restrictions from military school opportunities, their mission readiness was impacted, and they could be excluded from pursuing a future defense or law enforcement career. Further research confirmed Slone and Friedman's assertion that treating SUDs in combination with underlying mental health conditions is the most effective treatment option. Though the stigmas and barriers to mental health care continued to exist in the military decades later, services, education, and prevention measures improved exponentially.
Research indicates that between 14 and 30 percent of military personnel who deployed to Afghanistan and Iraq developed a mental health condition, such as PTSD or major depression, requiring treatment. Yet, less than 50 percent of veterans returning from combat received mental health treatment. According to a 2017 article published in the American Journal on Addictions, past-month heavy episodic drinking, along with daily cigarette smoking, were the most prevalent types of substance misuse.
Substance Abuse Treatment
Service members who experience trauma, which may or may not lead to PTSD, often experience anxiety, anger, depression, and chronic nightmares. In an attempt to self-medicate, many soldiers and veterans begin or increase their use of alcohol, cigarettes, chewing tobacco, or illicit drugs.
In the first decades of the twenty-first century, mental health medicine researchers became increasingly convinced that addiction among veterans was directly related to the stresses of deployment and combat and that the treatment of substance abuse disorders among war veterans must occur in tandem with treatment for combat-related stress disorders like PTSD. Furthermore, specialists found that recovery strategies should involve psychological therapy, should address spiritual issues, and should focus on relaxation techniques and anger management. Because PTSD and substance abuse are chronic and dangerous disorders that are extremely difficult to treat, veterans, their family members, and care specialists should expect follow-up therapies, such as twelve-step programs and other support groups, to continue for several years following initial treatment.
In the 2010s, more veterans sought treatment at the community level rather than receiving services through the VA. Many service members and veterans experience a degree of distrust in relying on the government to treat their conditions, so knowing that military personnel and veterans are more inclined to seek help outside the military structure, the VA began partnering with community resources to create Veteran Community Partnerships (VCPs)., like the Veterans Community Care Program. Resources include support groups, impulse-control programs, and soldiers-helping-soldiers programs, in which soldiers are trained to help their peers handle combat-related stress.
Outlook
Through the first decades of the twenty-first century, research continued to emerge concerning the prevalence of SUDs in the military population. This research guided education and training, program development, and policy changes that increased and improved mental health and SUD treatment options for veterans and military members. In 2006, the Substance Abuse and Mental Health Services Administration (SAMHSA) and Treatment Communities of America held the National Behavioral Health Conference on Returning Veterans and Their Families to facilitate the partnership of government VA services with mental health practitioners and specialists in the private sector. In July 2010, the US National Institutes of Health (NIH) announced the approval of $6 million in federal funding to support research by institutions in eleven US states specializing in substance abuse among military personnel, veterans, and their families. The National Institute on Drug Abuse (NIDA) partnered with the VA to award grants earmarked for investigating the links between deployment and combat-related trauma with the prevalence of substance abuse, mainly among veterans returning from Iraq and Afghanistan.
Further research in the private and public sectors indicated the most vulnerable individuals in the military community. Younger female soldiers were most likely to be diagnosed with PTSD, while young male soldiers were more likely to be diagnosed with SUDs. However, one in three veterans who sought help for SUD in the late 2010s and early 2020s were diagnosed with PTSD upon examination. Similarly, one in five veterans who sought help for PTSD were diagnosed with a SUD upon examination. This data highlights the link between PTSD, SUDs, and military service and provides support for the combined treatment of these conditions.
Bibliography
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