Veterans and Addiction

For the brave men and women who served in the military, transitioning back to civilian life can be challenging. While veterans contribute significantly to society, many face an increased risk of developing substance use disorders (SUDs).

Various factors of active military duty can easily become overwhelming. These factors include psychological trauma. Understanding this is critical in helping veterans find ways to cope and achieve long-term recovery.

This blog explores the unique challenges that veterans face when it comes to drug or alcohol addiction. It also provides resources for those seeking help or more information about veteran addiction services.

Key Takeaways

• The prevalence of substance abuse disorder in veterans is higher than in civilians, which comes with the risk of death due to overdose.
• Veterans should seek appropriate medical and mental health care to manage their addiction and mental health disorders.
• Veterans can learn about available resources through the Department of Veteran Affairs and local support groups.
• Veterans can also get specialized and comprehensive care for their substance abuse disorder through the aforementioned resources.
• If you're a veteran struggling with addiction, please seek help and break through the cycle of substance abuse.

Veteran Addiction Statistics

• 75% of Vietnam combat veterans with posttraumatic stress disorder (PTSD) met substance abuse or dependence criteria.
• A high percentage of Veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) screened positive for PTSD. The rate exceeds the 10.9% of non-deployed veterans who tested positive. 
• 0.2% of male veterans and 16.3% of female veterans showed signs of hazardous drinking.
• A study of 343 veterans found that 35% admitted to drug misuse to manage their pain. Specifically, 12% admitted using street drugs, while 16% admitted sharing prescription medications.
• According to a government report, over 10% of veterans seeking treatment for substance abuse were admitted for heroin use, with cocaine as the second most common substance at slightly above 6%.
• Marijuana dominates illicit drug use among veterans, with 3.5% admitting usage. Another 1.7% disclosed using other illegal drugs apart from marijuana within 1 month.
• The rate of opioid overdoses among veterans rose to 21% in 2016, up from 14% in 2010. Heroin and synthetic opioids rather than those prescribed for pain management primarily fueled this increase.
• Nearly two-thirds of veterans in treatment programs admit to misusing alcohol, twice as high as the general population’s substance abuse rate.
• In one month, veterans had a higher rate of alcohol use compared to non-veterans (56.6% vs 50.8%). Additionally, they were more likely to report heavy alcohol consumption (7.5% vs 6.5%).
• Tobacco use among military veterans has taken a toll on the Veterans Health Administration’s (VHA) finances, resulting in a hefty cost of approximately $2.7 billion. 

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Addiction and Mental Health Disorders in Veterans

Veterans with chronic pain are at a higher risk of developing an addiction to opioids. The link between chronic pain, opioid use, and other mental health disorders is also evident.

Psychological comorbidities of PTSD, depression, other mental illnesses, or cognitive disabilities increase the risk of SUDs. Those dealing with this condition need special attention regarding opioid use and pain management.

The prevalence of alcohol abuse is higher among veterans than civilians. Alcohol use and AUD were stable among veterans from 2018 to 2019. Alcohol use declined slightly in 2018, but AUD slightly increased in 2019.

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Veterans and the Use of Painkillers

Around 66% of veterans experience pain, while 9% report severe pain. More than half of veterans receiving care at the Department of Veterans Affairs (VA) experience musculoskeletal pain.

A survey conducted among them also revealed a significant occurrence of:

• Headaches (54%)
• Joint pain (45%)
• Back pain (44%)
• Muscle pain (33%)
• Abdominal pain (23%)

The number of veterans in the VHA system receiving opioid pain reliever prescriptions increased over the past two decades. This puts them at a much higher risk of developing an SUD. 

Veterans are also at higher risk for overdose deaths. It's estimated that SUDs account for more than 10% of all deaths among the population.

The Correlation of PTSD and SUDs

There's a strong correlation between PTSD and SUDs⁠—over 20% of veterans with PTSD experience SUD. Nearly 30% of veterans seeking SUD treatment also grapple with PTSD.

The prevalence of smoking among veterans with PTSD (60%) is nearly twice that of those without a PTSD diagnosis (30%). After the Iraq and Afghanistan wars, 10% of veterans seeking help at the VA experienced issues related to alcohol or substance abuse.

Veterans who suffer from both PTSD and alcohol problems are also prone to engaging in binge drinking. This involves consuming significant amounts of alcohol (4-5 drinks or more) within 1 to 2 hours.

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Why are Veterans at Risk for Substance Abuse?

Thousands of veterans turn to substances to cope with the various challenges they face after their service in the military. These challenges include: 

• Anxiety
• Co-occurring disorders (e.g. Post Traumatic Stress Disorder)
• Depression
• Difficulties with reintegration into civilian life
• Exposure to extreme trauma, including combat or military sexual trauma
• Traumatic brain injuries
• Stress from service and military duties
• Service-related physical injuries

These can lead to mental health issues that may increase the risk of developing an addiction. Prescription drug misuse is also a rising and significant problem among veterans.

Veterans and PTSD

Veterans are especially vulnerable to PTSD because of their exposure to dangerous and traumatic experiences while serving in the military. Exposure to a traumatic event causes this mental health disorder.

PTSD may result from exposure to death (actual or threatened), serious injury, or sexual violence. Exposure means you experienced, witnessed, or learned that the event happened to a loved one or close friend. 

The Manifestation and Impact of PTSD

PTSD can have long-lasting effects on a person's mental health. Symptoms vary from person to person and depend on various factors. Examples of these factors include trauma type and age.

PTSD symptoms usually begin early, within three months of the traumatic experience. However, they may also appear years later. Many people only experience short-term symptoms, while others develop chronic (long-term) PTSD.

Prevalence of PTSD Among Veterans

The prevalence of PTSD is higher among female veterans (13%) than male veterans (6%). Seven out of 10 veterans will experience it during their lifetime.

Mental Health, Substance Use Disorders, and Suicide 

Recent VHA enrollees have seen a significant increase in diagnoses of SUD and mental health issues. It rose from 27.9% to 41.9% from 2001 to 2020.

VHA members with mental health issues or SUDs have experienced a significant decrease in suicide rates. It dropped from 77.7 per 100,000 in 2001 to 55.5 per 100,000 in 2020. 

However, the suicide rate for recent veteran VHA users without documented mental health or SUD diagnoses has slightly increased. It rose from 25.6 per 100,000 in 2001 to 29.8 per 100,000 in 2020.

Many recent veteran VHA users who died from suicide were diagnosed with mental health issues or SUD. It totaled 56.1% in 2001 and 58.0% in 2020. 

Addiction and Suicide Rates Among Veterans

Veterans often use drugs and alcohol for self-medication. It happens when they rely on substances to cope without professional mental health treatment.

Veterans may use drugs or drink excessively to cope with difficult life circumstances. These include struggles with:

• PTSD
• Depression 
• Anxiety
• Other challenges with reintegrating into civilian life

In 2020, veteran suicide rates reached 6,146, averaging 16.8 lives lost daily. This figure represents a decrease of 343 suicides compared to 2019. The number of veteran suicides in 2020 was the lowest since 2006.

In 2020, a significant number of suicides were linked to various mental health problems:

• Depression (32.2%)
• Anxiety (25.6%)
• PTSD (24.4.%)
• Alcohol use disorder (19.6%)
• Cannabis use disorder (8.3%)
• Bipolar disorder (7.5%)
• Opioid use disorder (4.9%)
• Personality disorder (4.6%)
• Schizophrenia (4.5%)

Veteran Addiction Treatment Options

The U.S. Department of Veteran Affairs (VA) provides services for all eligible veterans, including:

• Therapy (individual or group)
• Medication
• Counseling sessions to help veterans improve mental health and behavior
• Seeking outside resources, such as Alcoholics Anonymous, for additional aid

These treatment options provide veterans the tools and resources to manage pain, SUDs, and mental health issues. The VA also offers specialized services for veterans with chronic pain or traumatic injuries. These include:

• Non-narcotic medications
• Physical therapy
• Occupational therapy
• Cognitive Behavioral Therapy (CBT) 

The Role of Family Members in Seeking Treatment

Family members are essential in supporting their loved ones struggling with PTSD, SUDs, or mental health issues. They can help by educating themselves on the signs and symptoms of these conditions.

They must be ready to intervene if necessary and encourage their loved ones to seek professional help. This support includes speaking openly about addiction, treatment options, and recovery.

It's also crucial that family members set clear boundaries and provide a supportive environment for their loved ones to get help. Some of their efforts can include:

• Avoid enabling behaviors
• Develop relapse prevention plans
• Find support services for families affected by addiction

Emotional and Practical Support for Veterans During Treatment

Family members should focus on providing emotional and practical support throughout the treatment process:

• Find the right treatment program
• Attend therapy sessions
• Provide positive reinforcement

If you or a veteran you love is struggling with addiction, call 1-800-827-1000, the VA's general information hotline, for help. You can also find a list of VAs and Vet Center facilities online at www.va.gov and www.vetcenter.va.gov.

The American Psychiatric Association and Veteran Addiction Treatment

The American Psychiatric Association (APA) released a practice guideline on treating veterans with PTSD and SUDs. The APA recommends a comprehensive, collaborative approach to treatment.

A comprehensive and collaborative approach includes:

• Medical care inclusive of mental health care and SUD treatment tailored to each person’s needs
• Psychotherapy for those with PTSD or SUD
• Close monitoring throughout the treatment process
• Screening for suicidal thoughts and behavior (especially for those with co-occurring disorders)

The Importance of Medication-Assisted Treatment in Veteran Addiction Care

The APA emphasizes the need to educate providers and veterans on the importance of medication-assisted treatment. It includes prescribing medications such as buprenorphine and naltrexone for opioid use disorder.

These medications can help manage withdrawal symptoms, reduce cravings, and prevent relapse. It should be combined with psychotherapy methods to provide comprehensive care for veterans suffering from SUDs or mental health issues. 

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