Substance Abuse Resources for Veterans

We’ve all heard the horror stories from Iraq, the Afghanistan war, the Kosovo war, and other wars which have taken place around the world. Young, vibrant men and women volunteer to go overseas and fight for their country. They sacrifice their peace of mind, time, and comfort.

However, when they come back, some of these individuals are not the same. They come back emotionless and empty vessels too horrified to talk about what they witnessed.

They just keep quiet. It’s not long before these veterans start engaging in substance abuse to get rid of the war thoughts.

Perhaps a veteran friend or relative came back from the war, turned to alcohol or drugs, and you’re wondering how you can help them.

Or, you may be the veteran suffering from substance abuse.

Read on to know the various aspects of substance abuse in veterans and how they can get help.

Why Do Veterans End Up in Substance Abuse?

Below, we discuss four common reasons why veterans may turn to drugs, alcohol and other outlets that are addictive:

1. To deal with the tough transition back to normal life

The various changes or transitions in life can be challenging for many people. However, for veterans, transitioning to normal life can be particularly challenging. While in the military, they work in a highly-structured environment. This may not be the case in regular jobs where duties and roles aren’t clearly defined.

Other challenges they come across are coping with new and overwhelming decisions in daily life, navigating the benefits offered to veterans, getting a military-like community outside, getting the best housing, potential unemployment, etc.

To deal with the stress and problems associated with the transition back a normal life, some veterans get into substance abuse. In a study conducted on recently-deployed 1,120 servicepeople, 25% had abused alcohol [1]. A separate study showed that 53% were into binge drinking [2].

This alcohol misuse is often as a result of troubles with managing and coping with difficult experiences outside the military.

2. To cope with the symptoms of post-traumatic stress disorder (PTSD)

During war times, military personnel experience life-threatening and traumatic events. After they’ve left combat, these events such as death, shooting, torture, and others lead to the development of PTSD, a severe mental health condition.

Veterans struggling with this condition turn to alcohol and drugs to self-medicate, which often doesn’t help and ends up worsening their symptoms.

Here are some of the PTSD symptoms you should look out for in your veteran friend or relative:

• Isolation from places, people, and conversations that may trigger war events
• Relationship issues
• Reliving the war times by having nightmares, flashbacks, distress, sweating, etc
• Reckless driving and other risky behaviours
• Smoking, drinking and doing drugs
• Feelings of hyperarousal such as anger, irritability, aggression, trouble sleeping, and jitteriness
• Uncontrollable negative feelings and thoughts of anxiety, despair, shame, and hopelessness
• Trouble concentrating and increased stress levels
• Sleeping problems
• Self-harm tendencies like suicide

Is PTSD a common condition among veterans? Even though we’re all at risk of suffering from post-traumatic stress disorder, veterans are at a higher risk of developing this condition than the general population.

The reason for this is that military life exposes servicepeople to frequent and potentially traumatic events, which leave them in a sad state of health both physically and mentally. For servicewomen, military sexual assaults also contribute to high PTSD rates in veterans.

Are PSTD-affected veterans at a greater risk of developing substance abuse disorders? The symptoms of PTSD can take both a physical and emotional toll on the victim. That’s why many people with this condition turn to alcohol and drugs as a way of numbing their pain.

n a comorbidity study conducted in 1995, 52% of men and 28% of women struggling with PTSD were found to have alcohol misuse or dependence. Also, 35% of men and 27% of women met the criteria for drug misuse and dependence [3].

Sadly, veterans with PTSD are also in this trend, with statistics indicating that nearly 1 in 3 veterans getting treatment for a SUD (substance use disorder) also have PTSD. The number of smoking veterans with PTSD is almost double that of smoking veterans without PTSD.

Is PTSD a permanent condition? If left untreated, its symptoms may go for even a lifetime. Even though substances may offer relief in the short-term, they may worsen the condition over time. SUD and PTSD can destroy a person’s relationship with his/her friends, relatives, and coworkers.

If you’re a veteran and have PTSD, reaching out for help isn’t a sign of weakness; it’s a sign of strength. With professional help and care, you can work through your PTSD and lead a fulfilling life without turning to harmful substances.

3. To numb chronic pain from war injuries

Chronic pain is another reason why many veterans fall into substance abuse. While some of us may suffer from some kind of long-term pain, veterans are at a greater risk of developing chronic pain because of the extreme circumstances and traumatic injuries experienced in war.

To manage their pain, they may use opioids. These are strong painkillers available only with a prescription. If taken as prescribed, these medications can be very effective in handling various issues such as surgery recovery, back pain, and other problems. However, since they’re also addictive, veterans may abuse them.

In the recent past, there has been a sharp rise in opioid prescriptions, which has led to addictions. A study conducted by the Center for Investigative Reporting in 2013 indicated that in 12 years, there was a 270% increase in veteran opioid prescriptions in the US [4].

This increase resulted in twice the amount of overdose and addiction deaths among veterans as compared to the average.

For people struggling with opioid addictions, their situation may be faced in various challenges. A study conducted in 2011 indicated that veterans are twice as likely to overdose on opioids than the general population [5].

Although substance abuse can be a real struggle for ex-service members, it doesn’t mean they can’t beat it. They can enrol in a suitable rehab program where they can get help to overcome their addiction, manage their pain through other ways, and go on to live successful lives.

4. To deal with the symptoms of traumatic brain injuries

Other than chronic pain from physical injuries sustained during war times, another reason that may lead veterans to substance abuse is a traumatic brain injury. This injury may result from a violent shake or blow to the head. As a result, the brain collides with the skull and suffers nerve damage.

The nerve damage goes on to interrupt the brain’s normal function of pleasure neurotransmitters and receptors, leading the victim to get pleasure from prescription pills, drugs, and alcohol. In a study conducted on traumatic brain injury victims, 10-20% of were found to have a substance abuse habit [6].

For people with mild traumatic brain injury, veterans showed a 2.6 times higher rate of drug and alcohol abuse than the general population with the same condition. For people with moderate traumatic brain injury, veterans were 5.4 times more likely to engage in drug and alcohol abuse than the general public [7].

One reason for these statistics is that they do not receive proper diagnosis and treatment for their brain injury. They turn to drugs and alcohol as a way of getting much-needed pleasure and numbing their pain.

If you or your loved one has just come out of service, here are some of the symptoms which may indicate an individual has a traumatic brain injury.

• Dizziness
• Nausea and vomiting
• Loss of balance and coordination
• Slow speech
• Memory loss
• Blurred vision and/or sensitivity to light
• Losing consciousness
• Persistent headaches
• Inability to fall asleep
• Disorientation, mood swings, and poor concentration

A study published in the Journal of the American Medical Association (JAMA) indicated that 30% of veterans deployed in Iraq and Afghanistan could have experienced a traumatic brain injury. There may be even more cases. And since individuals with traumatic brain injury are at risk of developing PTSD, a proper diagnosis and treatment are vital so that the affected person doesn’t fall into drug and substance abuse.

Substance Abuse and Active Military Service

A 2012 report titled ‘Substance Use Disorders in the U.S. Armed Forces’ indicates that alcohol, prescription drugs, and tobacco abuse are increasing in the military as compared to the rest of the population [8]. Why do active service people engage in substance abuse?

One reason is being deployed in regions with high rates of war. During their time here, they feel lonely, are away from their loved ones, they feel tired, and spend months in a very difficult environment. To ease the pressure on their minds, they turn to substance abuse.

They end up getting addicted to these substances. And due to the lack of confidentiality and stigma surrounding addiction, they often don’t get help.

Substance Abuse in Female Veterans

Substance abuse in veterans varies depending on a person’s gender. Even though military women show lower rates of heavy drinking than military men, the use of other illicit drugs is comparable for both genders.

But, women have to deal with the extra stress and challenges of being female in a male-dominated field, which increases their risk for substance abuse.

Other factors which increase the chances of military women developing substance use disorders are: their higher rates of depression than men, more women than men report PTSD even before entering military service, and females face sexual trauma, sexual assault, and fear of sexual harassment.

While only 1% of males report sexual assault or harassment, as much as 10-30% of females report these cases. Female veterans with substance use disorders are more likely to have experienced sexual abuse when they were kids, domestic violence, anxiety, depression, military sexual trauma, PTSD, and other mental health conditions. Additionally, female veterans with substance abuse are at a higher rate of death and suicide.

One interesting fact is that there are lots of similarities in both veteran and non-veteran when it comes to substance abuse, heavy drinking, and binge drinking. However, cases of drug dependence and alcohol abuse are generally higher in veteran men than veteran women.

Which Substances are Commonly Abused by Veterans?

Even though veteran life can be rewarding in one part, it may come with unwanted memories, suffering, and heartache in the other part. These unwanted feelings and experiences lead veterans to various substances, which are aimed at numbing the emotional pain, physical pain, or both. Let’s look at the commonly-abused prescription and non-prescription substances abused by veterans.

1. Alcohol

Alcohol can be categorised both as a stimulant and depressant depending on the amount consumed. If taken in small amounts, alcohol acts as a stimulant and alters excitatory neurotransmitters. The user feels euphoric, which may encourage further drinking. In huge amounts, it behaves like a depressant.

It depresses the user’s central nervous system and affects inhibitory neurotransmitters. Electrical activity in the brain reduces, and as a result, the user experiences slow speech, poor balance, sluggish movements, drowsiness, and other symptoms. This is referred to as binge drinking (taking 4-5 drinks on one occasion), and it occurs more commonly among military people than the general population.

Veterans choose alcohol to cope with PTSD and other disorders from the war. Alcohol abuse and PTSD go hand in hand. Statistics by the US Department of Veteran Affairs indicate that 68% of Vietnam veterans looking for PTSD treatment also have alcohol use issues. Also, these statistics show that veterans who have PTSD and take alcohol are binge drinkers.

Alcohol abuse is a severe condition that not only affects the user, but also his/her friends, family, and coworkers. If you’re a veteran and are struggling with it, seek help before everything falls out of hand.

2. Opioid (painkiller)

In the country, disabled veterans are in tens of thousands. Injuries are common results of war and can consist of things like back pain, chronic headaches, and lost limbs. Derived from opiates, opioids are man-made substances designed to work as painkillers.

Sadly, many people have started misusing these drugs, and NIH highlights them as a major concern for growing addiction. This has even lead to an increase in opioid-related deaths.

Oxycotin, Lortab, and Vicodin are some of the opioid brands which are the most popular. These are effective in dealing with different types of pain. However, they have a downside – they’re very addictive. In many cases, veterans start abusing opioid while still in active duty.

When they get hurt, they go for opioid pills to get some relief. Before they realise it, they have an addiction to these painkillers even after leaving the military.

3. Sedatives and anti-anxiety medications

Other than pain and injuries, there are conditions which veterans face such as anxiety and insomnia. That’s why those facing these conditions are prescribed sedatives and benzodiazepines. Benzodiazepines are psychoactive drugs which affect the gamma-aminobutyric acid (GABA) receptors.

These receptors are responsible for reducing or inhibiting brain activity. Benzodiazepines are often prescribed to tackle panic disorders, seizures, anxieties, and other disorders.

If a veteran is struggling with insomnia, a health professional may prescribe a sedative-like Lunesta or Ambien. Also known as hypnotics, these sedatives affect unbalanced brain chemicals in people with sleeping issues. They bring a state of relaxation by minimising irritability or excitement. Also, benzodiazepines can be used to induce sleep when used in higher amounts than those prescribed for anxiety.

Unlike what many people think, sedatives and benzodiazepines should not be used for PTSD. The reason for this is that there is little research and data on their effectiveness. Also, the evidence is emerging about the possible health risks of using these medications for PTSD.

Symptoms of Substance Abuse in Veterans

The use of alcohol or drugs brings a temporary feeling of happiness and excitement. This feeling is what users crave. However, once the substance effects have worn off, the euphoric feelings also wear off. The user goes on to experience apathy, listlessness, and depression.

Long-term drug abuse alters brain functionality, so chronic users may show lasting and behavioural changes such as:

• Mood swings
• Poor hygiene and appearance
• Unexplained weight loss
• Red or watery eyes
• Isolation from loved ones
• Extravagant spending, which leads to debts and other financial problems
• Secretive behaviour
• Excessive sleeping and lethargy
• Giving up favourite activities or hobbies

Addicts pre-occupy themselves with getting their substances. They spend most of their time taking these substances. After euphoric feelings have worn off, they try to get another high. It’s like a cycle, only that this leads to worsening of the condition.

The user has no energy or interests in spending time or interacting with his/her loved ones. They also develop secretive behaviours like lying about their substance use and hiding their drugs or alcohol.

If a friend or a family member has just left active military service, and you’ve noticed these symptoms, it’s always good to investigate. Early detection can make a huge difference in successful treatment.

The Risks of Substance Abuse in Veterans

Lack of employment – After leaving the military, an individual may want to get a job that will sustain him/her for the rest of their lives. However, having an addiction presents a significant challenge. No one wants a heavy drinker or drug abuser in their workplaces. Therefore, a veteran with a substance abuse problem will always be disadvantaged in this case.

1. Homelessness

What happens if these veterans can’t land a job? They can’t afford a home and thus, they end up on the streets. In the US, more than 10% of homeless people are veterans. Most of these homeless veterans suffer from drug and alcohol abuse.

2. Suicide

There is a relationship between war trauma and suicide. PTSD, a mental health condition commonly found in veterans, is linked to suicidal behaviours. When PTSD is coupled with substance abuse, the situation becomes worse, and the user may feel heightened suicidal thinking. Early diagnosis and treatment can help get rid of suicidal thoughts and prevent a sad occurrence from happening.

3. Illegal behaviours

If a veteran has a substance use addiction, then they may be tempted to get into crime. They become violent and can engage in unnecessary fights. Some turn to robbery, especially if they don’t have the money to buy drugs or alcohol.

How Can You Help a Veteran Struggling With Substance Abuse?

Below, we list ways you can assist a veteran who is struggling with substance abuse issues:

1. Listen to them

If a loved one has substance abuse, then he/she will feel lonely, hopeless, useless, isolated, and angry some times. In a world where mental health issues are still stigmatised, the individual may find it difficult to talk about their struggles with PTSD, anxiety, and depression. That’s why it’s vital to have a network of supportive friends and family. The emotional support offered to the victim can make a huge difference in his/her recovery.

2. Get information about PTSD and substance abuse from past victims

There are lots of information regarding substance abuse and PTSD, which a common condition among veterans. By getting as much information as you can on these issues, you will learn things you didn’t know about helping your loved one.

3. Encourage your loved one and help them get treatment

PTSD and substance abuse go hand in hand for many veterans. Watching your loved one go through these conditions can be tough for you. If left untreated, they may end up ruining his/her life. Don’t let them suffer as you watch; help them get suitable treatment. Veteran substance abuse programs are available, and by enrolling a friend or relative in one, you may have done the wisest thing for them.

Alcohol and Drug Rehab for Veterans in the UK

If you or your loved one is a veteran and is suffering from substance abuse, getting professional help is vital. While many people prefer going to the NHS in UK, this system isn’t well-equipped to offer the help needed. That’s why it’s recommended that you enrol yourself or a loved one in a suitable drug and alcohol rehab centre. Especially if it’s a fully residential clinic, it can work wonders to help a veteran get rid of their addiction and lead a fulfilling life.

Fully residential rehab centres are the recommended option due to several reasons. One, they a safe environment where a person can recover without temptations. Second, they ensure 24/7 care from qualified medical professionals.

Quitting a substance abuse addiction comes with various withdrawal symptoms, some of them which may be devastating. Being in a residential centre ensures that there is someone to care for you just in case of anything.

When you join a residential rehab centre, there are several stages you may go through. Three crucial stages are evaluation, detox, and therapy. The evaluation stage is aimed at determining a veteran’s severity of substance abuse, and whether they have other co-existing conditions such as PTSD, anxiety, or depression. Data from this assessment is then used to draw up a customised plan to help the victim.

From there, a detox may be recommended to get rid of substances from the victim’s body. The third stage, counselling and therapy, is also crucial. It is aimed at discovering why the veteran got into substance abuse and treating co-existing issues such as PTSD and anxiety disorders.

Some of the therapies used in the treatment are CBT, DBT, one to one counselling, group therapy, process therapy, trauma therapy, and holistic therapies such as Reiki, yoga, mindfulness meditation, relaxation, and music therapy.

You can be assured of the best possible treatment because these centres have teams that consist of doctors, nurses, counsellors, psychologists, psychiatrists, recovery support workers, fitness experts, nutritionists, and holistic therapists. After treatment, you or your loved one can enjoy an aftercare plan designed to help you stay in recovery.

Alcohol and Drug Rehab for Veterans in the US

Below, we list resources based in the US.

1. Crisis Line

If you are faced with a crisis, call 1.800.273.8255. Then you need to press 1 to talk with a helpline worker. You may also send a text to 838255 or initiate a live chat on their website.

Website: https://www.veteranscrisisline.net

2. Women Veterans helpline

The U.S. Department of Veterans Affairs maintains a helpline for female veterans. This helpline provides a platform for you to reach out and talk to other women veterans. This helpline is confidential.  You may call on: 1.855.VA.WOMEN

Website: https://www.womenshealth.va.gov/WOMENSHEALTH/ProgramOverview/wvcc.asp

3. VA medical centers

Find your nearest VA medical center or hospital using the list of healthcare providers contained in the below link. This is provided for by the U.S. Department of Veterans Affairs.

Website: https://www.va.gov/health/vamc/

Professional Help Works for Veterans Facing Substance Abuse Problems

If you or your loved one is a veteran struggling with substance abuse, there is no reason to hide anymore. With professional treatment, you can get rid of your alcohol and drug abuse problem, get rid of other co-existing issues such as PTSD, and go on to have a happier, healthier, and more fulfilling life.

Don’t let shame or substance addiction stigma deter you; make a decision to enrol in a treatment centre, and get the right help.

References:

[1] https://www.psychiatrictimes.com/military-mental-health/returning-veterans-addictions

[2] https://www.psychiatrictimes.com/military-mental-health/returning-veterans-addictions

[3] https://www.ncbi.nlm.nih.gov/pubmed/7492257

[4] https://www.revealnews.org/article/vas-opiate-overload-feeds-veterans-addictions-overdose-deaths/

[5] https://www.ncbi.nlm.nih.gov/pubmed/21407033

[6] https://www.brainline.org/article/substance-abuse-and-traumatic-brain-injury

[7] https://www.psychiatrictimes.com/military-mental-health/returning-veterans-addictions

[8] https://www.nap.edu/resource/13441/SUD_rb.pdf