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Reform Needed: How We Should Be Addressing Addiction Issues Among Veterans

“Respecting our veterans includes providing them the ways and means they so desperately need to reintegrate into our lives and serve us again as productive members of our civilian community.” ~ Charles B. Rangel Veterans of the U.S. military often face a higher risk of substance abuse and addiction. This is especially if they have seen direct combat experience. The addiction issues among veterans often stem from other psychiatric issues. These include anxiety, depression and Post-Traumatic Stress Disorder (or PTSD). Being in the military is stressful. It is no surprise that veterans turn to substance abuse to deal with the long-term effects of their combat experience.

  • Current military service members and veterans show a lower rate of illicit drug use than the general population, but a higher rate of substance abuse for alcohol, prescription drugs, and tobacco.
  • In an average year, more than 10% of military service members misuse prescription drugs; others suffer from prescription drug addiction.
  • One in six military service members show symptoms of PTSD.
  • Nearly half of active duty service members reported binge drinking in 2008. 1 in 5 reported binge drinking every single week.
  • Ten years ago, over 7% of veterans met the criteria for a substance use disorder.

These veteran substance abuse statistics paint a sobering picture. Clearly, reform is needed to be able to address addiction issues among veterans. But what should this look like? The process of answering this question is not an easy one. But it is important nonetheless. Consider these suggestions as we continue to address the addiction crisis in this country.

Reform: Addressing the Psychological, Physical and Social Needs of Veterans

There’s no question about it: joining the military comes with an increased risk of addiction. Veterans often face addiction issues at a higher rate than the general population. Any reform should address the psychological, physical and social needs of veterans. Only addressing addiction issues is often not enough. There must be a holistic approach to these issues. “Members of the armed forces are not immune to the substance use problems that affect the rest of society. Although illicit drug use is lower among U.S. military personnel than among civilians, heavy alcohol and tobacco use, and especially prescription drug abuse, are much more prevalent and are on the rise.” ~ The National Institute on Drug Abuse The goal of is a holistic approach to addiction treatment for veterans. Any reform should focus on three crucial elements:

  1. Reducing Risk: The majority of addiction issues for veterans stem from prescription drug addiction. It makes sense to reduce the risk present by opioid prescriptions. Reducing risk also means improving the way other mental issues are addressed by veteran services (i.e. depression, anxiety, and PTSD).
  2. Dual Diagnosis: Veterans are more likely than others to face a dual diagnosis, like PTSD and addiction. Treatment for veterans should always keep this in mind.
  3. Tried Treatment: It may go without saying, but addiction treatment should be based on research and best practices. Talk therapy and group support often work, but there are also more direct ways to address trauma and addiction (i.e. EMDR treatment).

With these policy reform suggestions in mind, let’s jump into trauma and addiction.

The Strong Connection Between PTSD and Addiction

The veteran substance abuse statistics made it clear that there is a connection between PTSD and addiction. In fact, nearly a quarter of veterans with PTSD also have a substance use disorder. On the other hand, a third of veterans with a substance use disorder also have PTSD. It makes sense, then, that military veterans face higher rates of substance use disorders and PTSD. But where does this connection come from? Some people try to cope with their Posttraumatic Stress Disorder (PTSD) symptoms by drinking heavily, using drugs, or smoking too much. People with PTSD have more problems with drugs and alcohol both before and after getting PTSD. Also, even if someone does not have a problem with alcohol before a traumatic event, getting PTSD increases the risk that he or she will develop a drinking or drug problem.” ~ The U.S. Department of Veterans Affairs The connection between PTSD and substance use disorders for veterans stems from the fact that the two create a vicious cycle in any military veteran. Using drugs or alcohol often make PTSD symptoms worse in long-term. This makes an individual want to use more of the substance to try to solve the issue. Binging on drugs or alcohol lets a person avoid the memories and stress associated with PTSD. The more that they use, the more they can avoid these memories. The more they avoid these memories, the worse PTSD becomes. Overcoming both PTSD and a substance use disorder requires facing both trauma and addiction head on.

Veterans and the Opioid Epidemic in the United States – The Role of Prescription Drug Addiction

According to one news report on the topic, veterans who use Veterans Affairs healthcare face twice the risk of an opioid drug overdose than the rest of the population.This is just part of the larger issue of the opioid epidemic in the United States. And it’s an issue that affects millions of Americans all around the country. The truth is, the opioid crisis is rooted in the over prescription of opioid painkillers. It is arguably one of the major causes of the crisis for military veterans as well. As people become addicted to prescription opioids, they may start turning to cheaper illicit opiates like heroin or fentanyl. These illicit opioids account for more overdose deaths today. But most experts believe that addressing the opioid epidemic in the United States also requires stopping the overflow of opioid prescriptions. This could be a good starting point for addressing addiction issues in the military and for veterans. “The stresses of deployment during wartime and the unique culture of the military account for some of these differences. Zero-tolerance policies and stigma pose difficulties in identifying and treating substance use problems in military personnel, as does lack of confidentiality that deters many who need treatment from seeking it.” ~ The National Institute on Drug Abuse More than that, veterans are arguably more prone to falling victim to this opioid epidemic for two major reasons. First, they face more likelihood of a dual diagnosis. Second, they may face more barriers to getting the addiction treatment that they need.

Reform and Research: The Need to Adequately Address Addiction Issues Among Veterans

There is one major way to address substance abuse for active-duty service members and prescription drug addiction issues for veterans. That is to actually research what kind of addiction treatment works, and then reform accordingly. This sounds obvious, right? Making sure that we are using the best addiction treatment options also makes sure that we are able to address other psychological issues. This is particularly important for veterans who often face a dual diagnosis. Thankfully, the U.S. Department of Veterans Affairs (VA) has implemented quite a few policies that reflect best practices for addiction treatment. These are researched and proven methods. “VA initiatives include: equipping nonmedical staff and veterans with medication that reverses overdoses; requiring psychiatric emergency room physicians to be licensed to prescribe drugs that reduce opioid cravings; and offering alternatives to opioids for pain treatment.” ~ Peggy McCarthy, writing for the Hartford Courant A more recent development in psychiatric treatment is Eye Movement Desensitization and Reprocessing (or EMDR therapy). EMDR was originally designed to address PTSD and its corresponding symptoms. But in recent years, psychologists have found that the therapy approach is extremely valuable in treating substance use disorders as well. It makes sense that EMDR therapy can be used to address addiction issues for veterans, who often face both PTSD and substance abuse.

Insight: EMDR therapy is a relatively new approach that can benefit both veterans and active-duty service members. The therapy is designed to address and reprocess stressful memories and experiences.

In short, newer addiction treatment options like EMDR can provide even better services for those serving our country – and those who have served in the past.

Effective Treatment for Veterans Addicted to Drugs or Alcohol

Outside of newer approaches to prescription drug addiction treatment (and other forms of substance abuse), it is worth mentioning that any form of addressing the addiction issues of veterans should include the ‘basics’. Most residential addiction treatment programs and intensive outpatient programs include at least three of the same treatment approaches: drug and alcohol detox, individual counseling, and group support meetings. Drug and alcohol detox is a crucial first step in addiction recovery for active duty service members and veterans. It’s important for anyone, really. Detox works by ridding the body of the toxic effects of drug or alcohol abuse. Depending on the drug and the length of addiction, the detox process can take anywhere from twenty-four hours to a few days. Once someone is able to detox, they can jump into counseling and group support. Following detox, a veteran suffering from addiction or a substance use disorder can move onto addressing the underlying issues of their addiction. In some cases, this is another mental disorder (like PTSD). In other cases, it is a matter of processing their past, their present and their future.

Alternative Approaches to Effective Treatment for Veterans

Whatever the case, an individual starting their recovery process will benefit from processing these issues in both individual counseling and group support meetings. These sessions vary depending on the treatment program, but generally address coping mechanisms, processing past mistakes, and strategies for creating a healthier and happier self moving forward.

Insight: Medication-Assisted Treatment (MAT) is used by many addiction treatment centers as a means of treating opioid addiction for veterans. Also called replacement therapy, MAT replaces the illicit drug of choice with a prescribed medication designed to take away withdrawal and detox symptoms.

“To battle this growing scourge, Connecticut’s VA Healthcare has implemented initiatives to care for more than 1,000 veterans addicted to opioids and the federal government has awarded Yale University School of Medicine $9.7 million to research nondrug treatment for pain in veterans and military personnel, and provide national leadership in the effort.”

~ Peggy McCarthy, writing for the Hartford Courant

MAT is often used by government-sponsored addiction treatment programs – but that does not mean it only uses replacement medication. Instead, MAT is used in combination with behavioral therapy and group support sessions to treat substance use disorders among this nation’s veterans.

Addressing PTSD and Addiction With Dual Diagnosis Treatment

More than anything, addiction treatment programs should keep one thing in mind when treating veterans suffering from both PTSD and addiction: dual diagnosis treatment. As we have already seen above, a large percentage of veterans suffering from a substance use disorder also suffer from another mental disorder at the same time – and vice versa. Because of this, no addiction treatment is complete without also addressing the co-occurring disorder. In many cases, this is PTSD or another form of trauma-induced mental disorder. Even when it is not, treatment programs should account for the fact that veterans are also more likely to suffer from depression or anxiety disorders. By accounting for co-occurring disorders, dual diagnosis treatment programs are able to address the psychological, social and emotional elements of the addiction issues that veterans face.

Insight: Medical providers and addiction treatment centers should look into the use of Narcan and Naloxone, emergency measure medications for opioid addicts that can save lives in the face of an opioid overdose.

On top of dual diagnosis treatment for veterans, addiction treatment programs can make use of medication. Some medications can reverse the effects of an opioid overdose in an emergency situation. Narcan and Naloxone can work as life-saving measures. They counteract the veteran overdose statistics in the United States. Any reform aimed at addressing the addiction issues of veterans should include measures for including these worst-case scenario medications.

The Hope of Help in the Face of Addiction

In this post, we have mostly addressed the big picture issue. That is, how to approach reform for addressing the addiction issues of veterans in the United States. But we want you to know that if you are currently struggling with addiction or alcoholism, you are not without help. This is true for veterans, for enlisted service members, and for civilians alike. From addiction assessments to intensive outpatient treatment programs, we are here to help those struggling with substance use disorders to get the professional help that they need. If you have questions about the reform needed for addressing the addiction issues of veterans, or about how to get addiction treatment yourself, feel free to contact us today.