America’s veterans are not strangers to addiction. While rates of drug and alcohol dependency are startlingly high across the country, veterans face this issue at nearly 1.5 times the rate of the civilian population.
According to the U.S. Department of Veterans Affairs, one in ten soldiers returning from the wars in Afghanistan and Iraq were seen for a substance abuse issue — however, those numbers miss soldiers who never sought treatment. The Substance Abuse and Mental Health Services Administration puts the overall rate of substance abuse among post-9/11 veterans at 12.7 percent, compared to 8.6 percent for the general population.
The largest factor contributing to the substance abuse endemic among veterans is post-traumatic stress disorder (PTSD). PTSD affects 18.5 percent of veterans returning from Iraq and Afghanistan, and two in ten veterans with PTSD also live with addiction. Large-scale studies found that nearly half of all people with PTSD meet the criteria for a substance use disorder. It’s postulated that the main driver behind the co-occurrence of substance abuse and PTSD is avoidance. Avoidance of trauma-related thoughts, feelings, and reminders is a criterion for diagnosing PTSD, and drugs and alcohol provide a way to escape negative thoughts.
In addition to PTSD, veterans may have a traumatic brain injury or chronic pain, both of which can spur a substance use disorder. Veterans may struggle with a loss of identity after leaving their military career, especially if it was due to disability, and turn to drugs or alcohol to cope with depression symptoms. Sometimes, substance abuse is a leftover habit from a military career, where alcohol can play a big role in the social sphere or be used to deal with a high-stress job.
The high rate of substance use disorders among veterans has even bigger implications: Substance abuse is a leading risk factor for suicide. The unfortunate reality of this link is already revealing itself in the veteran suicide rate: 20 veterans commit suicide every day, and veterans account for approximately 20 percent of all U.S. suicides despite representing less than 10 percent of the population.
While treatment for substance abuse disorders is available, veterans don’t always receive help. In 2014, only 30 percent of veteran suicide victims were receiving services from the VA healthcare system. While their closest VA Medical Center is where many veterans turn first when they need medical care, it isn’t the only option for substance abuse treatment. Veterans with additional health insurance can apply it to care received at a private rehabilitation facility. Private treatment centers can let veterans circumvent the long wait times that often plague VA services and receive treatment exactly when they need it.
When the substance use disorder co-occurs with post-traumatic stress disorder, mental health care becomes an essential piece of the recovery puzzle. There are numerous treatment options that veterans with PTSD can benefit from. Trauma-focused psychotherapy is a popular and effective approach to treatment that helps veterans unpack and reframe their trauma. Trauma-focused psychotherapies include prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing. Veterans with PTSD may also benefit from selective serotonin reuptake inhibitors and norepinephrine reuptake inhibitors, medications traditionally used to treat anxiety and depression, or from other medications and therapies that relieve PTSD symptoms.
It’s clear that addiction is a serious problem facing veterans today. Substance abuse impacts everything from the high rate of veteran suicide to the high rates of veteran homelessness, unemployment, and poverty. The only way to protect veterans is by refusing to sweep drug and alcohol abuse under the rug. Healthcare providers, as well as the VA, must instead focus on helping every veteran who needs addiction treatment to receive it.
Note: Constance Ray started Recoverywell.org with the goal of creating a safe place for people to share how addiction has affected them, whether they are combating it themselves or watching someone they care about work to overcome it.