Addiction Treatment for Veterans

Author

Olivia Pennelle

About the Author

Medical Reviewer

Libby Pellegrini

About the Reviewer

Military personnel may valiantly fight for our freedom, but that independence sometimes comes at a cost, as many active-duty military turn to drugs and alcohol to cope. In fact, according to the U.S. Department of Veterans Affairs, more than one in ten veterans who served have misused drugs or alcohol to cope with stress and trauma of combat.¹ Unfortunately, those factors can make veterans vulnerable to addiction and mental health problems.²

The Institute of Medicine has called alcohol and drug use in the military a public health crisis requiring a serious intervention.³

Veterans and Addiction

Researchers have been studying the military and veterans for some time to understand the unique challenges faced in an effort to reduce rates of addiction and mental health disorders. Studies show that substance use and addiction among veterans is thought to be attributable to several factors:

Trauma: Combat can have a significant traumatic impact on veterans. One in three veterans seeking treatment for addiction also has post-traumatic stress disorder (PTSD).³
Pain: Veterans face combat related injuries and strains from carrying heavy equipment struggle with severe pain.⁴ Approximately, 9 percent of veterans report struggling with severe pain6. Military Physicians wrote nearly 4 million prescriptions for pain medications in 2009, quadruple the figure since 2001.³
Stress: Increased exposure to combat involving violence and trauma has been associated with increased drug and alcohol use and addiction.⁴
Suicide: Substance use has been associated with increased rates of suicide in the military, with approximately 30 percent of suicides, and 45 percent of suicide attempts involved drug or alcohol use, according to the National Institute on Drug Abuse.⁶

What Stressful Challenges Do Veterans Face in Civilian Life?

According to the National Institute on Drug Abuse, veterans returning to their family and civilian life can struggle to reintegrate. During combat they live in highly stressful environments, may not get much sleep, and have experiences that we don’t normally see in everyday life, which can lead to mental health challenges.⁷

Some of those challenges include:

Opioid pain relief and overdose: Ten percent of veterans report experiencing severe pain for which they take an opioid pain medication.⁸ Unfortunately, taking potentially addictive opioids also increases veterans’ risk for accidental opioid overdoses, which are responsible for 21 percent of veteran overdose rates.⁹
PTSD: The symptoms of post-traumatic stress disorder can be highly activating. Veterans may experience flashbacks, memory problems, relationship difficulties, difficulty sleeping, and self-destructive behavior. It is not surprising that many veterans turn to substances to cope with nearly 60 percent using alcohol heavily.¹
Addiction: 63 percent of veterans who served in Afghanistan and Iraq met the criteria for substance use disorder and PTSD. They are also more likely to have other co-occurring conditions such as anxiety, bipolar disorder, HIV, liver disease, and schizophrenia.¹
Suicide: Veterans account for 20 percent of national suicides, and a staggering 20 veterans die by suicide every day — a rate one and a half times greater than non-veterans.10 Researchers attribute this rate to increased use of opioid pain medications, unresolved chronic pain.¹¹
Homelessness: A staggering 11 percent of homeless adults are veterans,12 and approximately 70 percent of those houseless veterans also have substance use disorder.¹³
Barriers to resources: Veterans face a number of unique challenges in accessing care, such as treatment gaps, no insurance or coverage gaps, stigma, fear, and a lack of trust in confidentiality.³

Veterans and Alcohol Abuse

Research shows that binge drinking and alcohol use disorders are higher among active military personnel than the general population.⁴ According to the National Institute on Drug Abuse among active service personnel:^6,14

30 percent were binge drinkers
1 in 3 met the criteria for hazardous drinking
1 in 3 met the criteria for alcohol use disorder
65 percent of veterans in addiction treatment report alcohol as their most misused substance.

Veterans and Drug Abuse

It is difficult to ascertain drug use among active military personnel because the surveys rely on self-reports, and only 8 percent of staff responded.⁶ However, according to survey data, reported rates of drug use among veterans showed:¹

3.5 percent reported using cannabis
1.7 percent reported using illicit drugs other than cannabis.

However, a different report conducted by the U.S. government noted that 10 percent of veteran admissions to substance use disorder treatment were for heroin, and 6 percent for cocaine.¹⁴

Addiction Treatment for Veterans

The Substance Abuse and Mental Health Services Administration collects data on substance abuse treatment admissions, called the Treatment Episode Data Set (TEDS). Excluding admission to a Veterans Affairs facility, TEDS data showed that in 2013, there were 62,000 veteran admissions to an addiction treatment facility. Admissions data revealed the primary substance of abuse in those admissions as follows:¹⁶

65.4 percent for Alcohol
10.7 percent for heroin
6.2 percent for cocaine

Veterans seeking addiction treatment may want to access one of several veteran-specific directories, including:

VA Mental Health Services for Veterans and Families: A guide to mental health services and addiction treatment for veterans and their families
Give an Hour: Connects vets to local mental health clinics for free counseling
Vet Centers: Community-based counseling centers for veterans and their families, specializing in trauma and mental health
Homecoming 4 Veterans: A search directory that shows addiction, PTSD, and other types of co-occurring treatments for veterans in their local vicinity

Does TRICARE Cover Addiction Treatment for Veterans?

TRICARE is a medical insurance program for military personnel, veterans, and their families and they typically provide coverage for drug and alcohol addiction treatment.

The VA is also a helpful resource, providing many addiction treatment options including medication-assisted treatment, inpatient treatment, outpatient, detox, intensive outpatient, and various therapies.

Other helpful guides and websites for veterans include:

VA Office of Mental Health and Suicide Prevention Guidebook for helpful information on mental health services available at the VA
VA National Center for PTSD provides information on trauma and evidence-based treatments
Veterans Crisis Line for 24/7 emergency mental health support. Dial 988 then press 1, or text 838255.

Resources

Teeters, J.B., Lancaster, C.L., Brown, D.G., & Back, S.E. (2017). Substance use disorders in military veterans: prevalence and treatment challenges. Substance Abuse and Rehabilitation. 8, 69-77. doi:10.2147/SAR.S116720
Sinha R. (2008).Chronic stress, drug use, and vulnerability to addiction Ann N Y Acad Sci;1141:105-30. doi: 10.1196/annals.1441.030. PMID: 18991954; PMCID: PMC2732004.
Institute of Medicine. (2012). Substance Use Disorders in the U.S. Armed Forces. https://nap.nationalacademies.org/resource/13441/SUD_rb.pdf
Meadows, S.O., Engel, C.C, Collins, R.L, et al. (2015). Health Related Behaviors Survey: Substance Use Among U.S. Active-Duty Service Members. Santa Monica, CA: RAND Corporation, 2018. https://www.rand.org/pubs/research_briefs/RB9955z7.html.
VA.gov. PTSD: National Center for PTSD. Published March 2023. Accessed May 16, 2023. https://www.ptsd.va.gov/understand/related/substance_abuse_vet.asp
National Institute on Drug Abuse. (2019). Substance Use and Military Life DrugFacts. Retrieved from https://nida.nih.gov/publications/drugfacts/substance-use-military-life on 2023, May 16
Substance Abuse and Mental Health Services Administration. (2012). Behavioral health issues among Afghanistan and Iraq U.S. war veterans. In Brief, Volume 7, Issue 1. Retrieved from https://store.samhsa.gov/sites/default/files/d7/priv/sma12-4670.pdf
Nahin R. L. (2017). Severe pain in veterans: The effect of age and sex, and comparisons with the general population. The journal of pain: Official journal of the American Pain Society, 18(3), 247–254. doi:10.1016/j.jpain.2016.10.021
Lewei, A.L., Peltzman, T., McCarthy, J.F., et al. (2019). Changing trends in opioid overdose deaths and prescription opioid receipt among veterans. American Journal of Preventive Medicine, 57(1), 106-110. https://doi.org/10.1016/j.amepre.2019.01.016
Department of Veterans Affairs, VA Suicide Prevention Program. (2016). Facts About Veteran Suicide. Retrieved from https://www.va.gov/health-care/health-needs-conditions/mental-health/suicide-prevention
Ilgen, M., Bohnert, A., Ganoczy, D., et al. (2016). Opioid dose and risk of suicide. Pain. 157(5). doi: 10.1097/j.pain.0000000000000484.
Perl, L. (2013). Veterans and Homelessness. Washington, D.C. Congressional Research Service Report for Congress. Retrieved from https://fas.org/sgp/crs/misc/RL34024.pdf
Center for Behavioral Health Statistics and Quality. (2014). Twenty-one percent of veterans in substance abuse treatment were homeless. The TEDS Report. https://www.samhsa.gov/data/sites/default/files/spot121-homeless-veterans-2014.pdf
Substance Abuse and Mental Health Services Administration. (2015). Veteran’s Primary Substance of Abuse is Alcohol in Treatment Admissions, The CBHSQ Report https://www.samhsa.gov/data/sites/default/files/report_2111/Spotlight-2111.html
Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). Treatment Episode Data Set (TEDS). https://www.samhsa.gov/data/sites/default/files/report_2111/Spotlight-2111.html
Treatment Episode Data Set: Admissions 2013 (TEDS-A-2013-DS0001) | SAMHDA. (n.d.). Www.datafiles.samhsa.gov. https://www.datafiles.samhsa.gov/dataset/treatment-episode-data-set-admissions-2013-teds-2013-ds0001