Veterans and Substance Abuse
Service members in the U.S. Armed Forces sacrifice a lot to serve their country. Sometimes, those sacrifices leave them with mental health disorders like alcohol or drug abuse.
Post-traumatic stress disorder (PTSD), physical pain, and traumatic brain injury (TBI) from theaters of war can contribute to high stress. This stress can increase the use of drugs or alcohol among military veterans.1
Continue reading to learn more about:
- Addiction among military veterans.
- The substances veterans abuse.
- Available evidence-based treatment.
Addiction Among U.S. Service Members
Addiction is a chronic brain disease involving compulsive drug-seeking and drug-consuming behaviors despite the harmful physical, emotional, and social consequences.2
Veterans and current service members smoke and abuse other drugs at higher rates than civilians, largely due to more intense career stresses. These stresses can also contribute other mental disorders such as post-traumatic stress disorder (PTSD), depression, and anxiety.1 When diagnosed in the same person, multiple mental disorders are called co-existing disorders.
Often, service members who develop a substance use disorder will also have PTSD. It has been found that in those diagnosed with a substance use disorder by the U.S. Department of Veterans Affairs, 74% of Vietnam veterans3 and 63% of Iraq and Afghanistan war veterans4 also had a PTSD diagnosis.
Our page on treatment for PTSD provides information on the different approaches to treating this mental health disorder.
Commonly Abused Substances
As of a 2015 report, 1 in 15 veterans had a substance abuse disorder that year.5 A few substances military veterans commonly abuse are below.
Although strict policies are in place for active-duty military members, the National Institute on Drug Abuse found that service members consume more alcohol than those not in the service.6
In all 4 branches of the military—Navy, Marines, Army, and Air Force—heavy drinking among men is 4 times that of women.7
Like stated above, being in combat, witnessing death, or other traumatic events may lead to higher rates of alcohol abuse among military veterans. It’s the most common substance use disorder among service members.8
Recovery First’s veterans and alcohol abuse page provides an in-depth look at why this population may abuse it and options for treatment.
The goal of opioids, when used as prescribed, is relief from pain. This is a big deal among service members, who can suffer from chronic pain from heavy gear or injuries from warzones. Opioids are very addictive: Even when used correctly according to a doctor’s prescription, opioids can be become addictive.
The number of prescriptions military doctors wrote for opioids quadrupled between 2001 and 2009, the onset of the Iraq and Afghanistan wars.9 The opioids that the U.S. Department of Veteran Affairs most often prescribes include:9
- Oxycodone: 46.9%.
- Hydrocodone: 39.5%.
- Codeine: 6.8%.
It may not be a surprise that older veterans as a whole suffer more from chronic pain. However, younger veterans are the most at risk to develop an opioid use disorder. In just 4 years, between 2003 and 2007, opioid abuse among young veterans rose from 3% to 4.5%.9
Learn more about why veterans may develop opioid use disorder.
As of 2008, about 30% of U.S. Armed Forces members were cigarette smokers.6 Another survey of over 48,000 service members found that deployment was a major risk factor determining if former smokers might start smoking again.1
One study revealed that among deployed troops who smoked cigarettes:1
- 7% smoked out of stress.
- 1% smoked out of boredom.
- 7% blamed smoking on an existing addiction.
Of the veterans who had used VA health services in 2011, 15% were diagnosed as physically dependent on nicotine.10
Our page on veterans and cigarette use has more in-depth information.
Military veterans are at a high risk for co-occurring disorders—also known as dual diagnosis or comorbidity. Post-traumatic stress disorder is a leading mental disorder that also co-occurs with a number of substance use disorders among service members.
Nearly 30% of veterans returning from the Iraq and Afghanistan wars report PTSD symptoms.11 Between 11 and 20% of service members returning from deployment struggle with PTSD and depression; these two disorders often occur together for veterans.12
Abusing drugs or alcohol is known to increase symptoms associated with mental health conditions, like depression, anxiety, bipolar disorder, and PTSD. It is also associated with increased risk of suicidal thoughts, suicide attempts, and death by suicide.
Recovery First’s page on military veterans and co-occurring disorders has more information for what they are, common co-occurring disorders among veterans, and evidence-based treatment. You can also learn more about veteran suicide—including how to notice the warning signs.
Evidence-Based Treatment Approaches
Veterans seeking treatment from the U.S. Department of Veteran Affairs (VA) for substance abuse are screened for PTSD, traumatic brain injury, depression, and suicidal thoughts.12 The risk of these co-occurring with substance abuse is extremely high among veterans in particular.
As with other approaches to co-occurring disorders, evidence-based psychotherapy is the foundation of treatment. Cognitive behavioral therapy (CBT) and specific, trauma-focused counseling approaches can help veterans with PTSD or depression understand these issues as triggers for their substance abuse problems and learn better ways to cope with stress that do not involve drugs or alcohol.12
The VA offers several different resources for veterans struggling with mental health disorders, including a:
- General information hotline that can be reached at 1-800-827-1000.
- Map of PTSD programs.
- Map of locations offering treatment services for a substance use disorder.
- A crisis line that can be reached at 1-800-273-8255.
Not all veterans want to use the VA for addiction treatment, or they may not have easy access to their nearest VA hospital. In this case, a veteran’s insurance may provide some options outside the VA system. Recovery First has a dedicated veterans’ program for military service members suffering from a substance use disorder or co-occurring disorders.
We have a few more resources for veterans online, including articles about:
- Veteran insurance for addiction treatment.
- Female veteran PTSD and substance abuse information.
- Resources for families and loved ones.
- Community Care Providers for Veterans
- Coast Guard Substance Abuse Trends and Resources
- Substance Abuse in the National Guard & Reserves
- Saxon, A.J. (2011). Returning veterans with addictions. Psychiatric Times, 28(7).
- National Institute on Drug Abuse. (2018). What is drug addiction?
- Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). The National Vietnam Veterans Readjustment Study: Tables of findings and technical appendices.
- Seal, K.H., Cohen, G., Waldrop, A., Cohen, B.E., Maguen, S., & Ren, L. (2011). Substance use disorders in Iraq and Afghanistan veterans in VA healthcare: 2001-2010: implications for screening, diagnosis and treatment. Drug and Alcohol Dependence, 116(1-3), 93-101.
- Substance Abuse and Mental Health Services Administration. (2015). 1 in 15 veterans had a substance use disorder in the past year.
- National Institute on Drug Abuse. (2019). Substance use and military life: general risk of substance use disorders.
- Ames, G., Conrad, C., National Institute on Alcohol Abuse and Alcoholism. Alcohol use and preventing alcohol-related problems among young adults in the military.
- U.S. Department of Veterans Affairs. (2019). PTSD and substance abuse in veterans.
- Teeters, J.B., Lancaster, C.L., Brown, D.G., & Back, Sudie, E. (2017). Substance use disorders in military veterans: prevalence and treatment challenges. Substance Abuse and Rehabilitation, 8, 69-77.
- Tsai, J., Edens, E.L., & Rosenheck, R.A. (2011). Nicotine dependence and its risk factors among users of veterans health services, 2008-2009. Preventing Chronic Disease, 8(6), A127.
- Tanielian, T., Jaycox, L.H., Schell, T.L., Marshall, G.N., Burnam, M.A., Eiber, C., Karney, B., Meredith, L.S., Ringel, J.S., & Vaiana, M.E. (2008). Invisible wounds: mental health and cognitive care needs of America’s returning veterans. Santa Monica, CA: RAND Corporation.
- U.S. Department of Veterans Affairs. (2018). How common is PTSD in veterans?