Substance Abuse and Military Veterans: The Facts Behind the Epidemic

United States Military personnel do a lot for our country. They protect our freedom, assist in natural disasters, and protect our interests abroad. Unfortunately, once their military career ends, they face significant difficulties in the civilian world. This translates into a wide variety of issues, one of the most pressing of which is a substance abuse crisis amongst military veterans. For those who want to help their loved ones struggling with addiction after ending their military service, it is important to understand the facts behind this devastating epidemic.

Why Substance Abuse Amongst Veterans Is So Common

We often hear about substance abuse being common amongst veterans. What is lacking is a discussion about why this is. What is different for veterans when compared to civilians?

Approximately six percent of the United States population has or has had a struggle with substance abuse. Amongst veterans, that number is estimated to be as high as 27 percent, depending on the population being studied. This brings us to an important question: why is substance abuse more common amongst veterans than it is amongst civilians?

The first thing to understand is that substance abuse amongst military veterans is, to a certain degree, motivated by the same factors that contribute to addiction at large. These factors include:

  • A desire to escape negative feelings
  • The goal of feeling better
  • Wanting to enhance performance at work or in social situations
  • General curiosity about what various substance are like and how they might help them
Number of Army Substance Abuse Program pie diagram

However, there are some issues that, while not unique to military veterans, are more prevalent in that specific population, which therefore contributes to higher levels of substance abuse. These are:

Chronic pain can be the result of injuries sustained while in the military or overuse of painkillers meant to treat these injuries. As a result of this pain, the veteran is driven to abuse painkillers and possibly other drugs as substitutes when they are unable to obtain prescription opioids. This is considered to be a crisis, and it has been linked to veteran suicides.

The U.S. population in general is well aware that members of the military experience traumatic events, especially those who see active combat. This translates into various mental health issues, including the inability to properly cope with daily stressors. Approximately 17 percent of U.S. veterans suffer from Post-Traumatic Stress Disorder (PTSD).

Life inside the military is very different from life on the outside. Everything is highly structured, there are clear expectations to be met, and everything exists within a hierarchy. Leaving this environment for one that is less controlled, less predictable, and not fully designed for them can be a shock to veterans, making it hard to transition.

The U.S. Military has allowed female members in certain positions since the 20th century. Over the years, the military has expanded the roles available to women. However, the system is still male-centric, which can pose problems for female members. Exactly how this impacts women in the military varies by position and branch of service.

This is an issue that all addicts tend to face, but for those who have served in the military, this denial can be much stronger. Why this is the case is not clear. Some theorize it has to do with it contrasting with their self-discipline enforced in the military, while others believe it to come down to seeing addiction as a weakness.

Military veterans are generally limited in their ability to access care because they healthcare is through government programs strictly for those who served in the U.S. Military. While there are programs available for substance abuse treatment, getting to them and being enrolled in them is difficult. As a result, many veterans try to manage without care.

Currently, there are various efforts in place to address these issues. However, they remain significant for now. Those wishing to help a veteran with substance abuse must be prepared to address these factors.

Substance Abuse Rates Amongst Veterans

As we have noted above, the rate of substance abuse amongst military veterans is higher than that in the population at large. However, looking at overall statistics does not present the complete picture. It is important to break those statistics down in order to see where the greatest problems lie, making it easier to deliver the treatment veterans require.

Breaking it Down By Demographic

Given that substance abuse is prevalent amongst veterans, it is easy to assume that it must be common amongst active duty military members as well. In truth, illicit drug use is significantly less common amongst active duty military than it is amongst veterans or civilians. However, legal substances are more frequently abused in the military than by the general public. This includes alcohol and prescription drugs, as well as lesser addictive substances, such as tobacco products.

Does this mean that active duty military personnel are naturally less inclined to use these drugs? Not quite. This low use of illicit drugs could just come down to the lack of availability, especially for those stationed on military bases or involved in active combat. Once military personnel return home, rates of illegal drug use increase significantly, as do those of substance abuse disorders in general. It is estimated that only 25 percent of veterans who seek mental health services have access to adequate care, which makes it difficult to get the help needed to break the addiction cycle.

Another clear division when it comes to substance abuse and those who have served or are serving in the United States Military is that between those who are serving or have served in combat positions and those who aren’t or didn’t. This is likely because active combat situations contribute to the development of PTSD and PTSD often contributes to substance abuse. And as a result of this PTSD connection, women are more likely than men to develop an addiction, as women are twice as likely to develop PTSD. This indicates a clear need for programs that focus specifically on those who have been in combat.

The Most Commonly Abused Substances

Amongst both veterans and active duty military, alcohol and prescription drugs are the most frequently abused substances. This is due to both their availability and the fact that using these substances has a greater level of social acceptance. More than 10 percent of active duty military admit to misusing prescription medication, with the numbers being higher amongst veterans. Those who binge-drink on a weekly basis are as high as 27 percent. In some veteran communities, these behaviors are actively encouraged and are considered part of the subculture.

With that said, there are no substances that veterans as a whole steer clear of. There are veterans addicted to a wide variety of substances, including illicit drugs like cocaine, heroin, and methamphetamines. As such, any prevention or treatment programs for veterans must be equipped to address any addiction.

Substance Abuse and Co-Occurring Disorders in Veterans

Substance abuse is considered to be a behavioral disorder. However, it rarely occurs without other disorders or trauma being present; this is true in the population at large and amongst veterans specifically. Instead, substance abuse is largely fueled by underlying conditions and life-changing events. Some common co-occurring disorders are:

  • Depression
  • Bipolar disorder
  • Anxiety
  • Eating disorders
  • Other addictions, such as sex addiction and gambling addiction

PTSD is a mental health disorder that impacts those who have been part of or witnessed traumatic events. In general, it is not diagnosed immediately after an event, but several months later if symptoms persist. As such, many veterans are not diagnosed before their service ends, putting the onus on them to seek a diagnosis.

Sadly, many veterans do not seek a diagnosis or treatment. For those who do, oftentimes the care is significantly limited. As a result, it is common for veterans suffering from PTSD to self-medicate. Approximately 20 percent of veterans with PTSD are believed to also have a substance abuse problem, but one-third of veterans with a substance abuse problem have PTSD. It stands to reason that addressing PTSD will go a long way in addressing substance abuse amongst veterans.

TBI is a broad term that refers to any injury to the brain that is significant in nature. The trauma must be sudden, but the results can be mild, moderate, or severe in nature. Many TBIs go undiagnosed because they mimic the symptoms of other disorders or the symptoms are so mild that they are written off.

With that said, there is a strong link between TBIs and substance abuse disorders. However, studies focusing on this link are highly limited at this time. What is known is that TBIs can contribute to the development of various behavioral disorders, one of which may be substance abuse disorder, or the other disorders caused may play into the development of addiction.

Addiction Amongst Female Veterans

As has been noted above, women in the military face unique issues that can contribute to the development of substance abuse. Women have long been marginalized in the United States military, being limited to specific roles throughout the majority of the time they have been permitted to serve. Sex-based discrimination, harassment, and assault are not uncommon.

It is documented that women in the military experience psychological trauma at twice the rate of men. This plays into the development of PTSD and other behavioral disorders. As a result, substance abuse disorders are heavily present amongst female veterans.

Symptoms of Veteran Substance Abuse

The exact signs of symptoms of substance abuse will vary from person to person. Signs and symptoms that point to a veteran having a substance abuse issue are the same as those amongst the general population. In general, dramatic behavior changes, new social circles, and being controlled by access to the given substance are solid signs that an addiction is present. Other signs to watch for include:

  • Struggling to cope with problems without using the substance
  • Feeling or acting bolder while under the influence of the substance
  • Making efforts to hide the substance or hide the use of the substance
  • Minimizing how much the substance is actually used
  • Continuing to use the substance despite significant negative consequences physically, personally, or professionally
  • Exhibiting withdrawal symptoms when not using the substance
  • Experiencing greater levels of pain—usually when abusing opiates
  • Struggling to stop quitting use of the substance without help
  • Needing to take more of the substance in order to achieve the same effects
  • Acting out in ways that were uncommon prior to using the substance
  • Frequently experiencing problems with bosses, coworker, family, and friends
  • Paying less attention to personal appearance and cleanliness
  • Showing significant changes in sleep patterns
  • Having significant weight loss or weight gain
  • Presenting with bloodshot eyes or dilated pupils
  • Experiencing extreme mood swings
  • Having increased anxiety and anger
  • Choosing isolation over social situations
  • Abusing those around them, especially spouses or children
  • Starting unusual spending habits
  • Spending significant time talking or thinking about the substance
  • Struggling with self-limitation in general
  • Losing interest in things that were once loved
  • Disappearing medication or other substances are noticed after the person visits

If any of these signs are noticed, it is vital to seek help for the individual through counseling and rehabilitation.

Life After Active Duty

As noted previously, while there is substance abuse in the military, it significantly increases once the transition into civilian life begins. Once out of the military, there are numerous issues that veterans must face, and in many cases, they have minimal support in doing so. Even discounting underlying disorders such as PTSD, when veterans transition out of the military, they are at extremely high risk of developing substance abuse disorders for several reasons.

Having a job is critical to adult success. Not only does it provide the income needed to survive, but it also gives a sense of purpose. For veterans, the totality of their adult work experiences has usually been in the military, joining at 18 and leaving when either their service is complete or when discharged.

This means that upon exiting the military, veterans are unemployed. Many are able to find some form of employment. Those who received a college education as part of their military service tend to be highly employable, but for those who simply served, they must look for unskilled labor or find work that puts their military skills to use. Unskilled jobs are highly competitive while those using military skills are rare. As a result, unemployment amongst veterans hovers around 4 percent.

Homelessness is a problem that has plagued veterans since the Civil War. However, it did not become an epidemic until the 1980s. Veterans make up more than 12 percent of the entire homeless population in the United States despite being just 9.7 percent of the population.

Compared to the overall homeless population in the United States, veterans tend to present with fewer risk factors, which means that their overrepresentation of the homeless population comes down to just a few reasons: veteran homelessness is heavily tied to substance abuse and mental health disorders. Currently, there are federal efforts in place to reduce homelessness, which have made inroads, though it is still a significant problem.

Veterans face significant mental and physical health issues, some of which are not commonly found in civilian populations. As a result, finding experienced healthcare professionals can be a struggle. Many medical professionals struggle to understand the unique needs of veterans. Some common health problems veterans struggle with are:

  • Amputations as a result of injury in battle
  • Debilitating injuries sustained in battle or training
  • Chronic pain as a result of injuries or overprescribed painkillers
  • Exposure to toxic materials
  • Traumatic brain injuries
  • Post-traumatic stress disorder
  • Depression
  • Anxiety
  • Suicidal tendencies

Out of these health issues, suicidal tendencies have received the most coverage as of late. Roughly twenty veterans commit suicide each day. However, all of these problems are significant for the veterans dealing with them.

For however long they have been in the service, military personnel have been in a mostly isolated environment with its own unique culture, values, systems, and structures. While people tend to understand that veterans are likely dealing with trauma, there is less understanding regarding the adjustments they must make when returning to civilian life. It often results in something of an identity crisis.

The experience is similar to what immigrants experience when they move to another country. There are significant feelings of alienation, a desire to be around others they see as being the same as them, and feelings of upset when other people do not understand their perspectives. This identity crisis impacts all areas of their lives, including their interpersonal relationships. As a result, it is often a driving factor in substance abuse.

  • Amputations as a result of injury in battle
  • Debilitating injuries sustained in battle or training
  • Chronic pain as a result of injuries or overprescribed painkillers
  • Exposure to toxic materials
  • Traumatic brain injuries
  • Post-traumatic stress disorder
  • Depression
  • Anxiety
  • Suicidal tendencies

Out of these health issues, suicidal tendencies have received the most coverage as of late. Roughly twenty veterans commit suicide each day. However, all of these problems are significant for the veterans dealing with them.

Veteran and Civilian Suicide Rates chart

Getting Help for Addicted Veterans

For anyone suffering from addiction, getting help is often the hardest part. Getting to the point of seeking help is an extremely emotional process. Once there, it is still something of a journey to receive the help needed. Rather than tackle this task, many addicts find reasons to justify not getting the help they need. Some common reasons include:

  • Interference With Work: For those who are both addicted and employed, conflicts with work are often used as a reason to refuse to go to rehab. The reasoning itself isn’t bad; having a job is important and can help them steer clear of addictive substances once clean. However, there are rehab options that can be complementary to working and there are types of leave that allow people to get help without losing their job.
  • Interference With Family: If the addict has family, especially young children, they can often be a reason the individual is unwilling to enter rehab. They worry about not being there and not helping as needed. For veterans, this is even more powerful as they were separated while deployed. However, this neglects to understand that their family needs them sober and healthy, not just present while addicted.
  • Not the Right Time: This is a very generic reason, but it is one of the most common given by addicts who are adverse to getting help. Because it is so broad, many people find it difficult to argue with. It is important to realize that there is no such thing as the right time for going to rehab. Ultimately, the only time is now—before it is too late.
  • They Won’t Succeed Anyway: In most cases, addicts who are considering and then refusing help have tried to quit at least once in the past. Perhaps this was done on their own or maybe they did go to rehab without success. Again, this is a difficult position to argue with since their past experience serves as their evidence. They need to understand that trying again can deliver a different result.
  • They Are Ashamed of Their Addiction: Addiction is something that has been made shameful in society, and especially in the military. In fact, through the 1980s, addiction was a valid legal reason to deny paying benefits to veterans. Additionally, the military places significant emphasis on self-control and strength, and admitting addiction can make veterans feel out of control and weak.

Where Veterans Can Get Help

Rehabs that are open to civilians are also open to veterans. This means that veterans in need of rehabilitation can receive this at any addiction rehab center in the United States. However, there are also rehabilitation programs run by the Veterans’ Administration. These programs are free of cost for military veterans and tailored to the unique needs of those who have served in the armed forces. However, due to funding and staffing issues, many complain that these programs do not offer the quality of care needed.

Ultimately, the most important thing for veterans seeking care is to find a center that has experience treating veterans and co-occurring disorders. Whether a VA program or a private program, if they know how to work with veterans, there is a high chance of success.