Substance Abuse Resources for Veterans

Returning to civilian life after active duty can be especially difficult. The military provides a highly structured environment, which can be difficult to reconcile with more traditional jobs where titles, roles and duties are not as clearly defined. These challenges can be heightened for those who have been in high-risk, life-threatening situations, particularly when these experiences have resulted in trauma-based reactions that can impact daily functioning.

The U.S. Department of Veteran Affairs highlights several difficulties that veterans face while transitioning into civilian life:

• Finding community and camaraderie outside of the military
• Returning to or finding a civilian job (some may need additional training and education)
• Adjusting to new, overwhelming choices and decisions in everyday life
• Navigating services and benefits previously provided by the military, including medical and dental care
• Finding housing, especially for families

Adjusting back to civilian life from a predetermined daily routine in the military can be difficult.  The sudden influx of decisions and stressors, major life changes in housing, employment, daily routine and identity can overwhelm veterans. These factors can contribute to substance use as a coping mechanism.

The most commonly abused substance by veterans (and active duty service members) is alcohol. In a survey of 1,120 recently deployed soldiers, 25% had abused alcohol, while a separate survey indicated that 53% of recently deployed personnel with combat exposure admitted to binge drinking. Prescription abuse is a growing problem among veterans who have experienced physical injury. A 2008 survey of 26,546 active duty military members indicated that 11.1% reported prescription abuse.

These unhealthy relationships with substances are often the result of not knowing how to cope with the difficult experiences faced during active duty. This is exacerbated when a veteran transitions back into civilian life and is faced with daunting choices and uncertainty, all while still managing the emotional and psychological effects of their military service.

The most important step in treating veteran alcohol abuse and addiction is prevention. Ensuring that service members have the resources they need to securely transition into civilian life is key. It’s also important for many to have access to trauma-informed counseling for the mental and emotional hardships that can come from military service. But for those who are already struggling with alcohol or other substances, there are many resources available, including VA alcohol rehab and private treatment centers like The Recovery Village, a nation-wide network of rehabilitation facilities. The Recovery Village has several locations throughout the United States and is dedicated to helping patients of all backgrounds overcome substance use disorder and any co-occurring mental health disorders, which is especially important for veterans.

According to a 2013 SAMHSA report, 65.4% of veterans in substance abuse treatment suffered from alcohol addiction, compared to 37.4% of non-veterans in treatment.

Nearly 60% of veterans previously deployed in the Middle East and 50% of older veterans experience chronic pain, compared to 30% of the general population. With traumatic injuries and extreme circumstances, it’s no wonder that veterans experience pain at a higher rate than the general population. But treating this pain has become a problem in recent years. For many, pain management and treatment involves opioids, powerful painkillers only available with a prescription. When taken as directed, these medications can be effective in treating a variety of ailments, including back pain, surgical recovery and other injuries. However, opioids have the potential to contribute to drug abuse, as these medications are highly addictive.

Until recently, opioid prescriptions were routinely given to those with chronic pain. This trend led to an increase in painkiller addiction among veterans. Between 2010 and 2015, opiate addiction among veterans rose to approximately 68,000; that statistic represents 13% of veterans who are prescribed opioids.

The Veteran’s Administration and other organizations are beginning to recognize and address the issue. Even with proactive measures, substance use disorder is still a problem for many veterans who originally sought treatment for chronic pain and ended up with an addiction.

Opioids and other medications can be effective treatment options for many, however, there are also other ways to safely control and reduce long-term pain. Some VA centers are even incorporating alternative methods like yoga, acupuncture, mindfulness and physical therapy. These alternative programs are slowly beginning to spread to help mitigate the addictive potential of opioid painkillers.

According to a 2011 study, veterans who currently struggle with opioid addiction are twice as likely to accidentally overdose on opioids than other Americans. Substance abuse can be a struggle for many former service members, but it doesn’t have to be the end of their story. VA drug rehab programs are available throughout the country, along with other centers dedicated to helping veterans. The Recovery Village has a network of treatment centers across the United States and offers a full range of addiction treatment services to help veterans address substance use disorders. With the right help, veterans can overcome addiction, manage pain and work toward a substance-free future in the nation they served.

• Mentally and emotionally reliving the traumatic event through flashbacks and nightmares
• Avoiding people, places or situations that serve as a reminder of the traumatic event
• Intense feelings of anxiety and helplessness
• Sudden bouts of anger, adrenaline or hypervigilance
• Difficulty sleeping, concentrating or controlling emotions
• Partaking in impulsive or self-destructive behaviors
• Suicidal thoughts

The number of veterans affected by PTSD varies by service era. According to the U.S. Department of Veterans Affairs:

• An estimated 30% of Vietnam veterans experienced PTSD in their lifetime.
• An estimated 12% of Gulf War (Desert Storm) veterans experienced PTSD in their lifetime.
• An estimated 11–20% of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) veterans experienced PTSD in their lifetime.

Studies show that there is a strong relationship between PTSD and substance use disorders in veterans. The following are some veterans and substance abuse statistics, according to the U.S. Department of Veterans Affairs:

• 1 in 10 soldiers returning from the wars in Iraq and Afghanistan abused drugs or alcohol
• Nearly 1 in 3 veterans seeking treatment for a substance use disorder also have PTSD
• The number of veterans who smoke is nearly double for those with PTSD (6 in 10) than those without it (3 in 10)

If left unaddressed, PTSD and substance use disorders wreak havoc on the affected individual’s mental and physical health, causing:

• Sleeping problems
• Trouble concentrating
• Increased stress levels
• Isolation from family and friends

Alcohol affects brain chemistry. In small amounts, it acts as a stimulant, resulting in an alteration of excitatory neurotransmitters. Feelings of euphoria typically ensue, which cause people to want to drink more. Moderate amounts may also provide certain health benefits, such as how red wine potentially decreases the risks of heart disease and diabetes. However, it’s important for veterans and others who drink to keep in mind that these benefits are not guaranteed for everyone.

In larger amounts, alcohol acts as a depressant, which means it depresses the central nervous system and alters inhibitory neurotransmitters (chemical messengers). Brain electrical activity decreases as a result, leading to slurred speech, sluggish movements, and poor balance, among other symptoms. It can also lead to drowsiness, respiratory depression or worse, if large amounts are consumed in a short amount of time. This is known as binge drinking (consuming four to five drinks on one occasion), which tends to be more common with military personnel with high combat exposure than those without it.

Alcohol is the substance of choice for many veterans as a means of coping with PTSD and other behavioral disorders to drown out the scarring recollections of war. PTSD and substance abuse — specifically alcohol abuse — often go hand in hand for veterans.

• Sixty to 80 percent of Vietnam veterans seeking PTSD treatment have alcohol use problems.
• War veterans with PTSD and alcohol problems tend to be binge drinkers.
• Veterans over the age of 65 with PTSD are at higher risk for a suicide attempt if they also have drinking problems or depression.

Alcohol abuse among veterans is a serious matter, one that can affect more than just the veterans. Family members, friends and other loved ones can all be impacted. This is why it’s so important to seek help if you’re a veteran struggling with alcoholism.

There are hundreds of thousands of disabled veterans in the country, according to the U.S. Department of Veterans Affairs. Injured service members are treated for traumatic injuries such as lost limbs, back pain or chronic headaches to name a few. With the many war-related ailments that exist among veterans, there are various types of opioids that are prescribed to treat them. Opioids are synthetic (man-made) substances derived from naturally-occurring opiates which are used as painkillers. Unfortunately, the abuse of these drugs has become an increasing problem in the U.S. since the late ‘90s, with the number of opioid-related deaths steadily climbing.

Some of the most popular opioid brands include Lortab, Vicodin and Oxycontin — all of which are successful in treating varying levels of pain. However, these medications can all become very addictive for veterans and anyone else to whom they’re prescribed. Dr. Gavin West, who heads the Opioid Safety Initiative at the Department of Veterans Affairs, stated in a recent NPR article that prescriptions for narcotics to treat pain are worse for combat veterans than other veterans or civilians. They “have more pain to deal with than most,” he said.

In many cases, opioid abuse begins while troops are still in the field. Veteran Mike McDonel witnessed this firsthand, which he shared on NPR in July 2014. “The troops, if they got hurt, they’d just shove you a bag of pills,” he said. “You never got a bottle and knew what was in it; you always got a baggie.” He also claimed that there were numerous medications prescribed for virtually any type of pain, and additional drugs for the side effects. This led many military personnel to become dependent.

Two other prevalent ailments of veterans are anxiety disorders and insomnia. This is why benzodiazepines and sedatives have been commonly prescribed. Benzodiazepines (also called “benzos”) are a group of psychoactive drugs that affect GABA receptors, which inhibit or reduce brain activity. Some popular benzodiazepine brands include Ativan, Valium and Xanax. These drugs are often prescribed for anxiety, seizures and panic disorder, among other disorders.

For veterans struggling with insomnia, a sedative like Ambien or Lunesta is often prescribed. These sedatives are also called hypnotics, and they affect brain chemicals that may be unbalanced in people with sleeping problems. As a result of this effect, they induce a state of relaxation by reducing excitement or irritability. Benzos can also be used as hypnotics to induce sleep when used in higher amounts than what’s prescribed for anxiety.

Contrary to popular belief, one of the conditions that benzos and sedatives should not be used for is PTSD. The reason is that there is currently insufficient data on their effectiveness. There is also growing evidence for the potential health risks of using these drugs for PTSD. Prescriptions for opioids has declined in recent years, as their use for PTSD is unfounded and compounds the risk of addiction for veterans.

Struggling with a mental health disorder or addiction can make a veteran feel lonely, angry, isolated, useless and hopeless. In a society that still largely views mental health issues through the lens of stigma, it can seem impossible to speak up about struggles with depression, anxiety or PTSD. That’s why it’s so important for veterans to have a support network of friends and family who are willing to listen and be there for them whenever they need a shoulder to lean on. Even though many veterans find it difficult to open up about the trauma they experienced during deployment, knowing they have emotional support from others can make a big difference.

Learn about veteran substance abuse and PTSD — from those who have been there. While you may never know exactly what your loved one is going through, you can learn about PTSD and substance abuse in veterans from a variety of trusted resources.

For too many veterans, PTSD and substance abuse go hand in hand. And the hardest part of being a friend or family member of a veteran with an addiction or mental health issue is watching them suffer. Left untreated, mental health and substance use disorders can ruin a veteran’s life, and oftentimes self-medicating and home-detoxing can do more harm than good. It may be up to you as a loved one to guide your veteran to the treatment they need before it’s too late. The good news is that veteran substance abuse programs exist, and they are more widespread than you might think.

• More than 20% of veterans with PTSD also have a substance use disorder.
• War veterans with PTSD and alcohol problems tend to be binge drinkers.
• Almost 33% of veterans seeking treatment for SUD also have PTSD.
• In the wars in Iraq and Afghanistan, about 1 in 10 returning soldiers seen in the VA have a problem with alcohol or other drugs.
• There was a 52.7% increase in the number of veterans outpatient clients who were treated for substance use disorders from 1995 to 2013.

• First-time screening for alcohol or tobacco use in all care locations
• Short outpatient counseling, including focus on motivation
• Intensive outpatient treatment
• Residential (live-in) care
• Medically managed detoxification (stopping substance use safely) and services
• Continuing care and relapse prevention
• Marriage and family counseling
• Self-help groups
• Drug substitution therapies and newer medicines to reduce cravings
• Evening and weekend programs
• Programs for patients with special concerns, such as women, veterans of Operation Iraqi Freedom and Operation Enduring Freedom, and homeless patients

In addition to treatment programs that use medication, the VA offers treatments that do not involve any drugs. These include:

• Explaining the correlation between PTSD and substance use problems
• Strengthening the veteran’s motivation for change
• Helping veterans better identify and deal with triggers and relapse risks
• Counseling couples together on how to recover from substance abuse
• Recommending outside support for recovery, including groups like Alcoholics Anonymous (AA)

Locating your closest VA hospital or medical center is simple with this list of healthcare providers in major cities from the U.S. Department of Veterans Affairs.

This interactive U.S. map allows you to find VA substance abuse treatment by program type (opioid treatment, inpatient or outpatient care) and state. The same style of map exists to find VA PTSD programs in your state.

The U.S. Department of Veterans Affairs offers a free hotline and chat function specifically for female veterans. This resource allows you to discuss issues unique to women and is completely confidential. Visit the site or call 1-855-VA-WOMEN. (855-829-6636)

If you or a loved one is in a crisis situation and need to talk to someone immediately, call 1.800.273.8255 and press 1 to speak with a caring responder who can talk you through what you’re dealing with. You can also send a text to 838255 or start a live chat instantaneously.  View a full list of VA programs and services for mental health and substance use disorders on the U.S. Department of Veterans Affairs’ website.