Thank you to guest blogger, Charles Watson!
Serving Those Who Serve:
Addressing Substance Abuse and PTSD in Veterans
by Guest Blogger, Charles L. Watson
Addiction, Health & Tech Blogger
Throughout the United States, the increasing rate of alcohol, prescription drug, and illicit drug abuse has garnered national attention. While substance abuse and overdose deaths have touched nearly every population in the U.S., members of the United States military and veterans have been especially hard hit.
While the rate of prescription and illicit drug use is low before enlistment, research has shown that substance use and abuse increases sharply during deployment, with the issue continuing following return to civilian life.
Drug and Alcohol Abuse During Active Military Duty
The U.S. military currently has a zero-tolerance policy regarding illicit drug use during active duty. Random drug tests are conducted on active military personnel, with those in violation of the policy subject to dishonorable discharge and criminal prosecution. As a result, the rate of illicit drug use in the military is less than 3%, which is significantly lower than the 12% that occurs in the general population.
While that is good news, that doesn’t mean that substance abuse isn’t a major issue during active duty. Although the rate of illicit drug use is low, the rates of tobacco, alcohol, and prescription drug abuse are steadily increasing. In fact, access to opioid pain medication, which is often prescribed for combat-related injuries or work-related pain, has led to an increase in prescription drug abuse during active duty from just 2% in 2002 to 11% in 2008.
Additionally, binge drinking is also a major concern, with 47% of active military men and women admitting to binge drinking behaviors. This is, in large part, due to barrack parties and easy access to discounted liquor on bases, combined with the stress, isolation, loneliness, and fatigue that is common amongst members of the military. The highest rates of binge drinking are found amongst those participating in high levels of combat or those that have experienced multiple deployments.
Returning to Civilian Life: A Sobering Reality
The return to civilian life is anything but an easy transition for many service members. Besides trauma and stress related to their service, coming home often involves complex economic, health, and social challenges.
A significant number of veterans are young adults who enlisted straight out of high school before developing strong community roots and a social support system. Coming home can have them struggling to find a sense of belonging, also securing needed employment, housing, and healthcare.
Years of combat and stress can also take a significant psychological toll. Recent statistics show that around 20% of the veterans who served in Afghanistan or Iraq developed post-traumatic stress disorder or major depression. A quarter of Afghanistan or Iraq war veterans developed substance abuse disorders.
This is a significant number of our service men and women who need mental health treatment. However, tragically, only about half receive the help they need. This lack of support and mental health treatment can lead to catastrophic results, including worsening mental health, drug and alcohol overdoses, homelessness, and unemployment.
In addition, a lack of mental health treatment contributes to the staggering rate of suicides among veterans. Recent statistics show that over 6,000 veterans die each year from suicide, a rate that is 1.5 times higher compared to non-veterans. This amounts to just over 30.1 suicides per 100,000 veterans.
Dual Diagnosis: Substance Abuse Disorders and PTSD
Post-traumatic stress disorder is a mental health condition that is relatively common in veterans who experienced combat or other significant trauma. It is a mental illness that can cause changes in how the brain processes thoughts and stimuli. It is currently estimated that PTSD occurs at a rate of 31% among Vietnam war veterans, 10% for Desert Storm veterans, 11% for Afghanistan veterans, and 20% for Iraqi war veterans.
Unfortunately, PTSD is closely linked with substance abuse problems. Among those seeking treatment for PTSD, 2 in 10 also have a substance use disorder, and among those that seek treatment for substance abuse, a third have PTSD.
While binge drinking is a common form of substance abuse in veterans with PTSD, more recently, opioid use has become more frequent. Most often, the opioids are first prescribed to deal with chronic pain associated with overuse injuries, combat injuries, or traumatic brain injuries. However, use of these drugs can continue beyond the original prescription, sometimes as a way to self-medicate and cope with symptoms of PTSD and other mental health disorders, difficulty transitioning back to civilian life, and substance abuse habits during active service.
What Can We Do?
Clearly as a society, we need to do more to help our veterans and service men and women address their mental health needs both during active duty and after returning to civilian life. Despite increasing awareness about the need for mental healthcare in this population, there are still several barriers, including:
- Shame, embarrassment, and stigma related to seeking mental health and addictions treatment
- Accessibility and affordability of treatment
- Concerns over quality of care offered by the VA
- Confusion over eligibility and applying for coverage
- Long wait times
- Homelessness, unemployment, or other life challenges
Taking a Whole-Person Approach
To address these barriers, a whole-person approach needs to be taken. For example, a veteran experiencing mental health issues or substance abuse often cannot concentrate on healing and recovery if they do not have secure housing or stable employment to go back to. Likewise, if only the substance abuse is addressed, but not the underlying PTSD, the individual is likely going to turn back to drugs or alcohol as a way to cope with flashbacks, nightmares, or panic attacks.
Helping veterans access mental health and substance abuse treatment requires us to look at the barriers to treatment first and then to remove them. This can only be accomplished if we look at the whole person and address each of these barriers, not only at the moment of returning to civilian life, but throughout the veteran’s life.
Substance Abuse and Mental Health Treatment Access
One of the most important steps is to make veterans’ substance abuse and mental health treatment affordable and accessible. Too often, long wait times and confusion about benefits eligibility stand in the way of a person receiving help. Additionally, treatment facilities without knowledge of the complex relationship between the trauma and culture associated with the veteran’s service and their current mental health and substance abuse treatment needs can make it difficult for treatment to be successful.
There is a significant need to provide additional training for current mental health and addictions professionals that is specific to the veteran population. Additionally, there must be an increased number of professionals in the field to make treatment more easily accessible and to cut down on wait times.
Substance abuse and mental illness, and especially post-traumatic stress disorder, are urgent concerns among veterans and active duty military. This population is especially vulnerable to developing these conditions, while at the same time, the system set up to address these issues is not currently able to meet demand. However, with increased numbers of trained professionals, as well as a society that is willing to support our service men and women upon their returning home, we can help to address these urgent concerns faced by those who risk their lives serving our nation.