Substance use disorders, or SUDs, are common among military veterans in the United States. About 11% of veterans who use the Veterans Administration for healthcare services show signs of substance use disorder. Male veterans are more than twice as likely to deal with alcoholism than female veterans. Males also present with exactly two times as many instances of drug use disorders than female veterans.
Substance use disorder is also correlated to other serious problems faced by veterans. These include mental health issues like anxiety and depression. Veterans who have difficulty with relationships at home and at work are also more likely to struggle with substance use problems. Substance use disorder can also be related to instances of suicides, as measured in reports of ideation and even attempts. Because of the prevalence of substance use disorder among veterans and its relationship to other disorders, it’s very important to make veterans aware of the resources that are available to treat this issue.
Publicly Funded Resources
The first resource every American should be aware of when it comes to addiction is the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA was established by Congress in 1992, and it’s designed to help improve the behavioral health of the United States as a whole. SAMHSA provides information for clinicians, family members, and people struggling with substance use disorders. There is an evidence-based practices resource center, as well as information about medication-assisted treatment. The SAMHSA website includes tools that can help people struggling with substance use find treatment.
Another very important resource for veterans who struggle with addiction is the Veterans Alcohol and Drug Dependence Rehabilitation Program. Anyone enrolled in the Veterans Administration healthcare program is eligible for this program. In order to enroll, veterans need to contact the VA facilities closest to their homes. A checklist is available on the website to help former service members determine whether they’re eligible for the program.
Veterans With Dual Diagnoses
Dual diagnosis is a term that refers to people who struggle with both a mental illness and a substance use disorder. Being involved with both is common among veterans. One of the most common comorbidities for veterans with substance use disorder is post-traumatic stress disorder, or PTSD. About 33% of veterans who report symptoms of substance use disorder also present with symptoms of PTSD. One of the most common substances used by veterans is nicotine, usually in the form of smoking. Among veterans, smokers are twice as likely to have PTSD as non-smokers. Drinking, especially binge drinking, is also common among veterans who have PTSD.
One reason for the high instance of dual diagnoses is that people with PTSD need tools to cope. In the absence of healthy coping strategies, they may reach for substances instead. It’s not uncommon to hear stories of veterans who struggle to sleep due to trauma. For these men and women, drinking or taking opioids can provide some relief and calmness. Unfortunately, this kind of substance use is not without side effects. The goal of treatment for dual diagnosis patients is two-fold. The first objective is to eliminate dependence on substance use, and the second is to provide the patient with healthier coping mechanisms to replace inappropriate ones.
Causes of PTSD
PTSD can develop after people experience a traumatic event. In veterans, PTSD can be the result of witnessing casualties in combat, hearing explosions go off repeatedly, or being involved in other challenging situations. The VA keeps statistics about how many veterans have PTSD, and which conflicts they served in. Between 11% and 20% of Operation Iraqi Freedom and Operation Enduring Freedom veterans deal with PTSD. Close to 12% of Gulf Storm veterans present with PTSD. Among Vietnam Conflict veterans, the figure is close to 15%. Military sexual trauma is another cause of PTSD in veterans.
PTSD is diagnosed in people who have persistent struggles with trauma. If someone is robbed or assaulted, for example, it’s normal to feel anxious for a week or two. However, if that feeling persists for months, it’s time to seek help. The same is true of military-related PTSD. It’s normal to feel anxious or fearful in the moment and immediately afterwards. But ongoing or recurring feelings of anxiety, fear, or paranoia should be reported to a doctor or counselor who can help treat these emotions.
It can be difficult for veterans to admit that they struggle with these issues. Many former service members pride themselves on toughness. However, asking for help is not a sign of weakness. People who ask for help show they’re not afraid to admit that they aren’t perfect. Asking for help shows self-awareness, a desire to get better, and the ability to trust others. Veterans and their families should never be ashamed of reaching out for help.
Types of Treatment Available
Today, there are many treatments available for veterans who struggle with addiction. Sometimes, different patients will click with different treatment programs. There’s no cure-all when it comes to addiction because people may start to use substances for a number of reasons. They may also have different comorbidities. Other disorders may need specialized treatment, and this can address some aspects of addiction as well.
Some common treatments for addiction include:
•12-step programs: The 12-step program is one of the oldest and most widely available approaches to treating addiction in the United States. The first 12-step group, Alcoholics Anonymous (AA), was founded in 1935 in Ohio. AA is free to anyone, and there are meetings in almost every town or city in the United States. These 12-step programs help people put structure, order, and meaning back into their lives. They also teach participants how to build relationships again. Companion 12-step programs like Al-Anon are designed to provide support and tools for the friends and family members of people who have substance use disorder.
•Medication-assisted therapy: Today, there are medications available that help to treat people who struggle with alcohol use disorder and opioid use disorder. The most well-known of these may be methadone and suboxone. In addition, FDA-approved medications designed to treat alcohol use have come a long way in recent years. Antabuse was developed in the 1950s and is still available, but it’s not particularly popular. It makes people sick when they consume alcohol. More recent medications designed to treat alcohol use disorder include Naltrexone. When using this drug, drinkers are unable to derive any pleasure from alcohol. Finally, acamprosate helps people with alcohol use disorder by mitigating their withdrawal symptoms. In the weeks and months after they stop drinking, some people still experience anxiety, depression, insomnia, and other symptoms. Essentially, acamprosate helps to level the brain chemistry of people who have recently stopped drinking.
•Cognitive behavioral therapy (CBT): This form of psychotherapy is designed to increase self-awareness. In cognitive behavioral therapy, one major role of treatment is to help people understand the way their thoughts, actions, and feelings are linked to their behaviors. In CBT, therapists also challenge the negative thoughts and feelings that patients have about themselves. The goal is for clients to see and to understand themselves clearly.
•Eye movement desensitization and reprocessing (EMDR): EMDR can be very useful in treating veterans who struggle with dual diagnoses. EMDR was developed in order to help people process trauma better by using eye movements to stimulate action in both hemispheres of the brain. The eyes move back and forth in response to a stimulus as a part of this treatment. This doesn’t just change the way people think about their traumas; it also changes the way the brain works. People don’t have memories erased after using EMDR, but the recollections are often much less intense. Many people who’ve tried EMDR report great results after just a handful of sessions. For many veterans, EMDR can help remove the traumatic stimuli that are at the root of substance use disorder.
Inpatient rehab is one of the most intensive and well-established ways to treat substance use disorder. It’s a wonderful option for veterans with addiction disorders. A typical day at inpatient rehab is structured and supportive. Activities include:
• Morning meditation: This process is a tradition in 12-step groups. In the morning, it’s suggested that steppers connect with their Higher Power before starting the day. The meditation time is still traditional in most inpatient rehabs.
• Chores: One important facet of rehab for substance use disorder is structure. One tradition that rehab facilities usually partake in is encouraging patients to make their beds. Some facilities also assign other chores, and residents rotate through performing them.
• Therapies: During inpatient rehab treatment, people attend individual and group therapies. These are structured throughout the day, starting after breakfast and continuing after lunch.
• Activities: Particularly when it comes to the weekends, there’s time set aside for residents to participate in activities. These can be art-related, or more unstructured time for people to read and play games with one another. There’s also time to visit family members built in to most inpatient rehab programs.
Outpatient rehab is less intense than inpatient programs. Outpatient programs can be structured in different ways. Some are appropriate for people who are experiencing substance use disorder but who are still functioning fairly well. This type of program can be a great treatment option for people who are dealing with dependence more than addiction.
Other outpatient rehab programs are designed as aftercare. This means that the participants recently completed an inpatient program. This kind of outpatient treatment is designed to help people in recovery adapt to the outside world. Sometimes, this kind of program lasts up to a year. This means that people will experience all their “firsts” while still getting some treatment.
Finally, other outpatient programs are very intensive. They are designed to accommodate people who may have high-pressure careers where they work long hours. Because they can’t make the time commitment to a full inpatient program, an intensive outpatient program becomes a good option.
The Granite House
At The Granite House, we help people transform their lives. Addiction is a difficult disease. Treating it requires patience, understanding, and vigilance. Treatment modalities that we use at The Granite House include traditional 12-step strategies along with trauma-informed counseling. To put it simply, we take a holistic approach to give you or your loved ones the best chance at recovery. At The Granite House, we treat a person, not just a disorder.
We offer all stages of treatment at The Granite House, from medical detox to rehab to staying in touch with our alumni network. When program alumni support each other, they have the best chance at lasting recovery. If you or a loved one struggles with substance use disorder, mental illness, or both, contact us today. The Granite House is always proud to help veterans along the road to recovery.