Melissa Walsh

Veterans and Addiction

Salem Press | 2011 | Salem Health: Addictions & Substance Abuse

Essay title: Veterans and Addiction Category: Social Issues

Definition: Combat-related stress disorders leave veterans vulnerable to alcohol and drug abuse. To intercept this vulnerability to substance addiction among combat veterans, military and civilian mental health specialists are seeking out best practices and implementing programs for supporting the emotional state of veterans.

Combat-Related Stress Disorders The connection of battle trauma symptoms to substance abuse is not unique to veterans returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Veterans of World War II and the Vietnam War have also presented classic symptoms of PTSD, and researchers have been studying the disorder for decades. Yet according to a 2010 article in Behavioral Healthcare, since the start of OEF in 2001, at least 15 percent of American and 6.1 percent of Canadian military personnel have presented symptoms of post-traumatic stress disorder (PTSD) or major depressive disorder (MDD). In a 2009 Social Work article, specialists pointed out that 25 percent of the more than 100,000 veterans treated by VA health services received a mental health disorder diagnosis. More than half of these were diagnosed with both PTSD and a substance abuse disorder. In addition, an estimated 70 percent of homeless veterans struggle with substance addiction.

In the book After the War Zone, the authors recommend that military personnel experiencing PTSD and substance abuse disorders be treated for both conditions at the same time. Explaining the common parallel occurance of both, they wrote, "Some say that substance abuse needs to be dealt with before you can deal with PTSD symptoms. Some say that you need to get treatment for PTSD before you can deal with the substance abuse. Since it's really difficult to disentangle these two conditions, we strongly urge that you seek treatment for both at the same time." PTSD and substance abuse disorders are under-diagnosed among military servicemen, largely because both disorders carry a heavy stigma in the military; if either condition is reported on one's record, the individual cannot continue to pursue a career in defense or law enforcement.

Substance Abuse Treatment for Veterans With combat-related stress disorders, the serviceman's or -woman's thoughts are overwhelmed by memories of battle trauma. These thoughts are played over and over in the person's mind. Symptoms include anxiety, anger, depression, and chronic nightmares. Therefore, since the start of OEF in 2001, specialists are becoming increasingly convinced that addiction among veterans is directly related to the stresses experienced during deployment and combat and that the treatment of substance abuse disorders among war veterans must be in tandem with treatment for combat-related stress disorders like PTSD. Recovery strategies should involve undergoing psychological therapy, addressing spiritual issues, and acquiring relaxation techniques and anger management. Because disorders like PTSD and substance abuse are chronic and dangerous disorders that are extremely difficult to recover from, veterans, their family members, and care specialists should expect follow-up therapies, such as 12-step and other support programs, to continue for several years following initial treatment.

According to Gary A. Enos in a 2010 article in Addiction Professional, increasingly more veterans are seeking treatment at the community level, rather than receiving services through the Department of Veterans Affairs (VA). There is a degree of distrust in relying on the government to treat their condition. Any diagnosis or treatment given via the VA will show up on the serviceman's record. Knowing the military personnel are more inclined to seek help outside the military structure, the VA is seeking to partner with community resources. Treatment strategies include support groups, "stop, think, "act" impulse control programs, and "soldiers helping soldiers" programs, where soldiers are trained to help their peers in dealing with combat-related stress. According to a June 2010 poll by Addiction Professional, more than 90 percent of respondents felt that there is a shortage of community-based assistance for returning veterans, many citing the lack of PTSD treatment.

Outlook

Knowing the potential for veterans to tap the services of community mental health providers rather than government services, the government seeks to raise awareness of the specific mental health issues impacting veterans. In 2006, the U.S. Substance Abuse and Mental Health Services Administration and the Therapeutic Communities of America held the National Behavioral Health Conference on Returning Veterans and Their Families with the aim to facilitate the partnership of government VA services with mental health practitioners and specialists in the private sector. In July 2010, U.S. National Institutes of Health (NIH) announced the approval of $6 million in federal funding to support research by institutions in 11 states specializing in substance abuse among military personnel, veterans, and their families. The National Institute on Drug Abuse (NIDA) partnered with the Department of Veterans Affairs to award the grants earmarked for investigating the links between deployment and combat-related trauma to the prevalence of substance abuse, mainly among veterans returning from the wars in Iraq and Afghanistan.

Melissa Walsh

Further Reading Enos, Gary A. "Doing Whatever It Takes: Treatment Programs Try to Employ a Full Arsenal to Meet the Complex Needs of Veterans." Addiction Professional (2010): 16.

Hambley, Janice M. and Anne Pepper. "An Assault on Trauma and Addiction: Returning Military Personnel Often Carry Hidden Wounds that Need Intensive, Long-Term Addiction Treatment." Behavioral Healthcare 30.9 (2010).

Peters, Katherine McIntire. "Agencies Examine Combat-Related Substance Abuse." Govexec.com (Aug. 26, 2010).

Savitsky, Laura, Maria Illingworth, and Megan DuLaney. "Civilian Social Work: Serving the Military and Veteran Populations." Social Work (Oct. 2009): 327.

Schneider, Mary Ellen. "Long Tours Put Vets at Greater Risk for PTSD, Substance Abuse." Internal Medical News (Dec. 1, 2009): 37.

Slone, Laurie B. and Matthew J. Friedman. After the War Zone. DeCapo Press, 2008, 175-82. Experts from the VA National Center for PTSD offer guidance to service members and their families for dealing with deployment- and combat-related stress issues.

"The General's Drug Problem, Ibogaine Treatment a Promising Solution." PRWeb Newswire (Feb. 2, 2011).

Volkow, Nora D. "Substance Abuse Among Troops, Veterans, and Their Families." NIDA Notes (Dec. 2009): 2.

Web Sites of Interest American Council for Drug Education http://www.acde.org

National Institute on Drug Abuse http://drugabuse.gov

Not Alone http://www.NotAlone.com.

Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.samhsa.gov/militaryfamilies/