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Military veterans and active military personnel are susceptible to substance abuse and addiction just as much as the rest of the general population. Current and former members of the military sustain combat injuries, traumatic brain injuries (TBIs), as well as manage the physical and psychological experiences of military service. Rejoining civilian life also can bring on its own set of stresses.

Over time, all of this and more can take a mental and emotional toll, and can be deeply traumatizing. As a result, people in this population may turn to drugs, alcohol and other substances to cope with their experiences, possibly putting them on a path to alcohol or drug addiction. The US Department of Veteran Affairs (VA) has made it easier for veterans and active military personnel to get the help they need. Addiction treatment and recovery services can also be found at a private facility.

In either case, the VA advises talking with a healthcare professional for more information and treatment options for mental health disorders, including post-traumatic stress disorder and substance use disorder, which we will go into more detail about below.

What Is PTSD?

Post-Traumatic Stress Disorder, or PTSD, is a mental health disorder that can develop after a life-threatening event is experienced. For active and retired military personnel, that can include combat, sexual assault, a natural disaster, terrorist attacks, and serious accidents. PTSD can happen right after a traumatic event is experienced or it may happen over time and long after the event has passed.

“If thoughts and feelings from a life-threatening event are upsetting you or causing problems in your life, you may have PTSD,” writes the VA.

Signs and symptoms of PTSD include:

  • Unwanted memories of traumatic events
  • Avoiding anything that triggers unpleasant memories of a traumatic event
  • Flashbacks that include reliving an event to the point where the person loses touch with reality
  • Emotional numbness, detachment from family, friends
  • Nightmares
  • Scary thoughts
  • Extreme anxiety, heightened alertness or awareness for threats
  • Pain
  • Sleep problems
  • Anger issues
  • Distractions

People with PTSD can receive treatment for this disorder at any time, even if they have struggled with it for years. Treatment can alleviate all symptoms of PTSD or make them less severe. Success rates vary, but treatment is recommended to prevent symptoms from getting worse. The VA also recommends seeking treatment if troublesome, distracting thoughts continue for more than three months or if there are questions or concerns about drinking and drug use.

Veterans are twice as likely to die from accidental opioid overdoses than non-veterans, according to a 2011 analysis.


PTSD and substance abuse

According to the US Department of Veterans Affairs, there is a strong relationship between post-traumatic stress disorder and Substance Use Disorder (SUD) for both civilian and military populations. In one example, nearly 33 percent of veterans seeking treatment for SUD also have PTSD, and more than 25 percent of veterans with PTSD also have SUD.

People who are trying to manage and cope with their PTSD may:

  • Drink alcohol heavily
  • Smoke or use tobacco products (such as smokeless tobacco) excessively
  • Abuse illicit and legal drugs

Active and retired members of the military who use and/or abuse substances to manage PTSD are at risk of developing an SUD. The condition can range from mild or moderate to severe but the level of severity is determined according to the individual. Self-medicating numbs sufferers to their emotions, further worsening pre-existing symptoms of feeling cut off from others because of their PTSD. Using substances also allows PTSD sufferers to avoid their struggles.

While abusing substances allows them to focus on other things, they may find it hard to focus and live a productive life in the long run.

Signs and symptoms of a Substance Use Disorder include:

  • Difficulty concentrating
  • Easily distracted
  • Forgetfulness
  • Difficulty with decision-making
  • Difficulty speaking
  • Repetition when speaking
  • Easily angered or agitated
  • Impulsive

Overusing alcohol and drugs can open the door to dependence and addiction. For people who have co-occurring PTSD and SUD, the VA recommends entering a treatment program that address both disorders at the same time (dual diagnosis treatment).


active duty military

Past data shows substance use and abuse among the active military personnel population. According to this publication ”Substance Use Disorders in the US Armed Forces”, the use of alcohol, illicit drugs, and tobacco is common in military culture.

“Service members have engaged in illicit drug use (i.e., the use of illegal drugs such as cocaine, heroin, and marijuana and the nonmedical use of prescription drugs) since discovering that they reduced pain, lessened fatigue, or helped in coping with boredom or panic that accompany battle. In the modern U.S. military, drug use surfaced as a problem during the Vietnam War in the late 1960s and early 1970s,” it states.

In 2013, the National Institute on Drug Abuse (NIDA) reported that while illicit drug use was lower among US military personnel than among civilians, “heavy alcohol and tobacco use, and especially prescription drug abuse” were much more prevalent and on the rise in this population. Some of these differences have been attributed to the stresses of deployment during wartime as well as the unique culture of the military.

NIDA goes on to say, “Those with multiple deployments and combat exposure are at greatest risk of developing substance use problems. They are more apt to engage in new-onset heavy weekly drinking and binge drinking, to suffer alcohol- and other drug-related problems, and to have greater prescribed use of behavioral health medications. They are also more likely to start smoking or relapse to smoking.”


prescription misuse in the military

Concerns over the misuse and abuse of prescription medications among military personnel and civilians has grown in recent years. In military populations, prescription drug abuse is linked with increases in the number of prescriptions written out to people who are in chronic pain from injuries they have sustained.

In a 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, 11 percent of service members reported misusing prescription drugs, up from 2 percent in 2002 and 4 percent in 2005.

Data shows that most of the misused prescription drugs among service members were opioid pain medications, and that between 2001 and 2009, military physicians wrote almost 3.8 million pain reliever prescriptions, a quadruple increase.

“Combat-related injuries and the strains from carrying heavy equipment during multiple deployments likely play a role in this trend,” NIDA said.

Identifying and treating substance use problems among active military personnel has been difficult, NIDA says. Reasons for that include zero-tolerance policies, stigmas, and a lack of confidentiality that discourages people from seeking the treatment they need.

In 2012, the Institute of Medicine issued recommendations for addressing substance abuse in the military in a report it prepared for the Department of Defense. Recommendations include:

  • Increasing the use of evidence-based prevention and treatment interventions
  • Broadening insurance coverage to include effective outpatient treatments
  • Better equipping healthcare providers to recognize and screen for substance abuse problems so they can connect clients with the appropriate treatment
  • Increasing confidentiality, changing the cultural climate in which alcohol and drug problems are stigmatized
  • Limiting access to alcohol on military bases

TBI and substance abuse

Traumatic Brain Injury (TBI) occurs when sudden trauma injures the head and damages brain. Severity levels range from mild, moderate or severe and vary according to how serious the injury is. Mild TBI symptoms include headache, confusion, lightheadedness, dizziness, blurred vision and more.

Studies show that the alcohol use of people with traumatic brain injury worsens two to five years after the injury occurs and that they turn to their prior levels of substance use unless something prevents that from happening.

Due to certain cases involving brain traumatic injuries, some veterans develop a dependence on opioid medication that was originally prescribed to treat pain. According to an article published in The Minneapolis Tribune, nearly 60 percent of veterans returning from war during the past decade report that chronic pain is their common medical problem.

From 2002 to 2013, the number of prescription medication from the VA for oxycodone and morphine saw a 259 percent increase in the U.S.

A dependence on pain medication may include the following signs or symptoms:

  • High anxiety levels
  • Anxiety attacks
  • Feelings of euphoria
  • Depression
  • Irritability
  • Low motivation
  • Sleeping difficulties
  • Using opioids for longer periods than intended

addiction treatment for military veterans

Getting professional help to manage PTSD and SUD is important to veterans’ recovery and necessary to return to healthy living. Abusing alcohol and drugs as a coping mechanism for mental health disorders can be mentally and physically debilitating with extended use. Struggling to overcome these challenges can lead to long-term unemployment, dysfunctional social behavior, and strained relationships, among other challenges.