HEALTH: Veterans and Addiction
HEALTH FEATURE: January 23, 2023 - The Lawrence County Zephyr will be doing a weekly segment on drug addiction issues and health related features. This is thanks to BOCA Recovery Center who is providing the information for this series. This is to serve as a resource of information due to the growing drug epidemic within Lawrence County.
As a group, veterans often struggle with addiction. Substance use disorders and substance abuse are fairly common among those who have served in the military. There are a number of factors that contribute to this issue, with a big one being the often lax or pro-drug culture many people in the military find themself immersed in.
Substance Abuse Among Veterans
Substance abuse among veterans is significant, with more than 1 in 10 veterans seeking first-time care in the Veteran Affairs (VA) health system meeting the criteria for a substance use disorder (SUD), primarily alcohol use disorder (AUD). This is in addition to a high rate of drug abuse that would not necessarily qualify as a substance use disorder, such as binge drinking (although many people with AUD also engage in binge drinking).
Moreover, the rate of substance abuse among veterans appears to be trending upward despite various active efforts by the relevant organizations to address this high rate of drug abuse. Opioid misuse is rising, many veterans smoke, and their rate of using illicit drugs such as marijuana and methamphetamines is comparable to civilian rates.
A number of factors are known to contribute to veteran drug abuse and addiction.
Lax or Actively Pro-Drug Culture
Heavy alcohol use has traditionally been a tolerated or outright encouraged norm in the military when members are not on duty. Drinking to excess is often seen as a normal way of reducing stress and socializing with other service members.
This is despite the numerous negative health consequences associated with alcohol abuse, especially binge drinking. Smoking tobacco-based products is similarly seen as normal and accepted in military life. When veterans exit the military, they often carry these learned habits with them and may also have already developed a substance use disorder while serving.
Limited Access to Treatment Resources
Many veterans live in rural communities, which can make getting treatment for mental health conditions more difficult. Even with the availability of telehealth solutions, where (often effective) treatment can be conducted remotely over the internet, many of these communities may have low-quality internet connections.
A veteran may be limited in their ability to get treatment depending on the ease with which they can get necessary medications or pay for the appropriate treatment option. While there are resources veterans can access to help with treatment costs, financial considerations are often a barrier to treatment.
Reluctance to Seek Treatment
Historically, there has been a stigma and perceived shame around those suffering from addiction in the military (and outside the military), especially for women. This can cause some veterans who could benefit from treatment for a problem with substance abuse to avoid getting the help they need.
While this stigma is not as bad as it was decades ago, it is still present and more needs to be done to address it.
High Rates of Co-Occurring Mental Health Conditions
A significant portion of veterans struggling with a substance use disorder also have a co-occurring mental health disorder. For example, a veteran may struggle with PTSD or depression, which can complicate their treatment. This co-occurring mental health issue may be one of the major reasons they abuse drugs.
Veterans, Mental Health & Addiction
As touched on above, veterans often struggle with mental health problems beyond the presence of a substance use disorder. Among veterans with PTSD, more than 2 in 10 also have a SUD. The rate of smoking nicotine products is also about double among veterans with PTSD.
The reasons veterans often struggle with mental health are complex. Broadly, life while in military service is often difficult and very different compared to civilian life. The chances that a person is exposed to significant trauma, such as witnessing a death (including being a perpetrator as part of one’s duty) or experiencing sexual violence, is much higher while in the military.
An individual may go for long periods in an unfamiliar place with no real release mechanism if they notice they’re in poor mental health. Military service can have a rigid structure to it, and leaving one’s post early is often not possible.
Addiction is often (although not always) the result of unhealthy coping mechanisms used to try and escape struggles with other mental health problems. Drugs can provide a temporary relief from anxiety and help a person forget about trauma they’ve experienced for short periods.
Unfortunately, this is not a sustainable solution for several reasons. A person may become addicted to the substances they’re relying on and must now contend with another mental health issue in addition to their previous problems.
One dilemma many people face, but especially veterans who have been injured in service, is that sometimes prescription medications that may be legitimately helpful in some ways also have significant abuse potential.
As noted in an article by Dr. Rod Amiri, veterans who have been injured and required pain relief may need alternative pain relief options where opioids would normally be used, so they can avoid being exposed to the risk of developing an addiction. Doctors treating veterans with PTSD, depression, or severe anxiety often need to be especially vigilant in controlling this risk.
When potentially addictive pain medication is necessary, experts recommend veterans find trusted caregivers to administer the medication. If the veteran has continual access to their medication and self-administers it, there is an increased risk of abuse.
When possible and still an appropriate treatment for their needs, veterans with mental health issues should often consider requesting non-habit-forming pain relief options. While doctors are more aware of the addiction risks pain medications have than they once were, it is also important to keep aware of your own risks and mental health. Alcohol & Drug Use in the Military & Among Veterans
One of the most significant issues relating to drug abuse among military and active servicemembers is the fact that the military is, in some ways, a “drug culture.” Drug abuse, at least of legal substances like alcohol and nicotine products, is widely tolerated and sometimes encouraged by one’s comrades and superior officers.
Combined with the stresses military life can put on an individual and the way military life can make one feel uniquely isolated in civilian life, surrounded by individuals who can’t fully relate to one’s military experiences, this can be a deeply unhealthy situation for an individual.
This is all heightened when simultaneously dealing with other mental health issues.
Addiction Treatment for Veterans
For most veterans struggling with addiction, the ideal solution is to seek counseling with a well-reputed mental health treatment professional who specializes in treating addiction using evidence-based methods. If the individual also struggles with other mental health issues, they should work to get those problems addressed, which may or may not require a different mental health professional depending on the nature of the problem.
Addiction treatment can work in a number of different ways, with a primary goal generally being to help a person understand why they abuse drugs. The therapist then aims to equip the individual with the tools they need to avoid drug abuse by restructuring their life and the way they think.
Depending on the severity of physical dependence and the type of drug regularly abused, an individual may need to undergo withdrawal at a treatment facility. With medical detox, medical specialists will monitor the person’s health, improve their comfort, and help them avoid the pull of drugs as they go through this early phase of overcoming addiction.
A person in crisis may need a more long-term inpatient treatment program to fully address their needs, where they stay at a specialized treatment facility for multiple weeks. While there, the staff and structure of the program will help the person recover physically and mentally enough that they are out of crisis. Then, their treatment team will equip them with the necessary tools to avoid drug use once released into a more traditional outpatient program. Barriers to Treatment for Veterans
Several barriers can make it difficult for a veteran to get treatment, even if they acknowledge they have a problem. Many of these share similarities with the factors that can contribute to a person struggling with addiction in the first place.
Barriers to treatment for veterans include the following:
Inability (or perceived inability) to pay for or receive treatment
Reluctance to get treated due to social stigma
Misunderstanding of how drug addiction is treated and/or a sense of hopelessness at the prospect of improving
Feeling like no one understands their past military experiences
In addition, some individuals may be simply unwilling to seek help or don’t want to admit they may have an issue that requires the help of a mental health professional. This is often related to real or perceived social stigma around addiction, where an individual may be judging themselves against the same negative, unhealthy standards those around them may judge those with mental health issues. For veterans, this stigma can be intensified due to the expectation that those in the military don’t show weakness. Veterans may be less likely to admit when they need help.
For those dealing with such reluctance, it is important to understand that addiction is a mental health issue. It is a disorder of the brain (although it also has a physical component that can affect the body) that a person is unlikely to be able to treat on their own.
There’s also no value to “fixing yourself” if better, professional options are available. Mental health professionals can make overcoming an addiction significantly easier and greatly improve your chances of avoiding future drug abuse.
A common metaphor is that mental health issues like addiction or PTSD are as real of an issue as a broken bone would be, even if they’re less obvious. Similar to how broken bones generally require professional treatment to heal properly, mental health issues do as well.
How Veterans Can Pay for Addiction Treatment
Through VA healthcare benefits, a person can generally access the necessary treatment for addiction and other mental health issues at no or low cost. While the VA won’t cover everything, they will cover most evidence-based treatments, including short-term counseling, more intensive outpatient treatments, and residential or inpatient care.
An individual can also consider using Vet Centers, community-based counseling centers designed to provide veterans with mental health and social services. For veterans who qualify for the services Vet Centers offer, those services are provided to them and their families at no cost.
Veterans can sometimes get the VA to cover private treatments, including mental health treatments, in a limited context (usually if wait times for treatment or your estimated travel time to the nearest VA treatment option is unusually long). More often though, you may need traditional health insurance if you want to receive treatment from a professional practice not typically covered under your VA benefits.
Health insurance will typically cover some or all of the cost of treating legitimate mental health issues, including addiction, as long as the treatment option being used is of comparable cost to the cheapest alternative that a medical professional would deem reasonably effective for the same purpose.
Helpful Resources for Veterans
The U.S. Department of Veterans Affairs offers a detailed page explaining how to get help for substance use issues through the VA, which also links to a variety of other useful, related articles and tools. Even if you don’t have VA healthcare benefits, people who have served in a combat zone can get free private counseling, alcohol and drug assessment, and related help at Vet Centers, with that same page providing a link to help you find the one closest to you.
If you are a veteran in crisis, you can call, text, or chat online with the Veterans Crisis Line. They are available 24/7 to help veterans in crisis due to substance abuse, mental health issues, or any other problem. There are numerous addiction hotlines that can help veterans through any crisis.
If you are struggling with addiction, professional treatment can help you leave substance abuse in your past. Many treatment providers have experience caring for veterans and can understand where you’re coming from. Reach out for help today, so you can embrace a better tomorrow.
References Addiction vs. Medication: The Dilemma Impacting Veterans. (2022). Military.com. PTSD and Substance Abuse in Veterans. (March 2022). U.S. Department of Veterans Affairs. Substance Use Disorders in Military Veterans: Prevalence and Treatment Challenges. (August 2017). Substance Abuse and Rehabilitation. Substance Use Treatment for Veterans. (February 2022). U.S. Department of Veterans Affairs. Vet Centers (Readjustment Counseling). U.S. Department of Veterans Affairs. Seeking Treatment for Mental Illness and Substance Abuse: A Cross-Sectional Study on Attitudes, Beliefs, and Needs of Military Personnel With and Without Mental Illness. (March 2022. Journal of Psychiatric Research. Emerging Findings on Trauma in the Military. (2019). Psychological Trauma: Theory, Research, Practice, and Policy. How Patients Perceive the Relationship Between Trauma, Substance Abuse, Craving, and Relapse: A Qualitative Study. (January 2016). Journal of Substance Use. Pharmacological Strategies for Detoxification. (February 2014). British Journal of Clinical Pharmacology. Stigma as a Barrier to Substance Abuse and Mental Health Treatment. (January 2011). Military Psychology. Understanding Substance Use Disorders in the Military. (2013). Substance Use Disorders in the U.S. Armed Forces. Substance Use and Psychological Distress Before and After the Military to Civilian Transition. (May–June 2018). Military Medicine.
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