Alcoholism in Veterans
Right now, there are over 18 million veterans in the United States. These brave men and women may have served during World War II, the Vietnam era, the Korean War, or during the Gulf War eras. The majority of veterans are male at 91.6%, with female veterans at 8.3%, but the number of female veterans continues to increase. According to the 2013 National Survey on Drug Use and Health, 1.5 million veterans had a substance use disorder, abusing drugs or alcohol. These substance use disorders are associated with medical problems, psychiatric disorders like anxiety and depression, employment problems, issues with relationships, and increased suicidal thoughts and attempts. About 20% of high-risk behavior deaths in military personnel were attributed to drug or alcohol overdose, and approximately 30% of completed suicides involved drug or alcohol use. The link between veterans and alcohol abuse is a concerning issue for this population, as alcohol is the most commonly abused substance among military personnel.
According to the National Institute on Drug Abuse, veterans are more likely to use alcohol and report heavy alcohol use, compared to non-veterans. About 1 in 10 veterans returning from the wars in Iraq and Afghanistan have a problem with alcohol or another drug. Both active duty personnel and war veterans with post-traumatic stress disorder (PTSD) were more likely to binge drink. Binge drinking is when someone drinks a large amount of alcohol in a short amount of time, defined by a man having 5 or more drinks in less than 2 hours, and a woman having 4 or more drinks in 2 hours. One of the short-term risks of binge drinking is that it can lead to alcohol poisoning, as the body cannot process drinks consumed in quick succession. Long-term risks include an increased risk for alcoholic liver disease, heart attack, and high blood pressure.
Not only are the numbers for veterans and alcohol use concerning, they also have high rates of nicotine and opioid use. With two thirds of veterans reporting that they experience pain, and severe pain being 40% more common in veterans than non-veterans, many of them receive an opioid prescription. The opioid overdose rates of veterans were 14% in 2010 and increased to 21% in 2016. The majority of overdoses were from synthetic opioids and heroin. One of the reasons that veterans so often struggle with a substance use disorder is their exposure to traumatic events. One out of every 3 veterans who seek treatment for their substance use disorder also has PTSD.
PTSD, Veterans, and Alcohol
The symptoms of PTSD vary in individuals, and they typically appear within the first month after the traumatic event but can occasionally appear months or years afterwards. The symptoms usually fall into 3 main categories:
- Avoidance and emotional numbing
Re-experiencing is the most common symptom of PTSD and consists of reliving the traumatic event through flashbacks, nightmares, physical sensations, and distressing images. These flashbacks can be triggered by the individual’s own thoughts and feelings, places, objects, words, or situations that remind them of the event. Re-experiencing can be extremely disrupting to daily life and cause serious troubles in work and family relationships.
Hyperarousal is when someone feels on edge, anxious, and has a difficult time relaxing. The individual may feel as though there are constant threats around them that they must be aware of. People with arousal symptoms are prone to angry outbursts and feelings of stress, as well as having trouble sleeping. These feelings also interfere with daily life and can affect concentration. Unlike flashbacks that are triggered at certain times, hyperarousal symptoms are usually constant. For those who experience avoidance symptoms, they likely stay away from places, events, and objects that remind them of the event, as well as avoiding any thoughts about it. Some may withdraw and isolate from others in an attempt to emotionally numb themselves.
Other symptoms that come with PTSD are physical symptoms like headaches and stomach pains, mental health problems like depression and phobias, and self-destructive behaviors like drug and alcohol misuse. Out of veterans who have PTSD, more than 2 out of 10 of them also have a substance use disorder. In one study of 600 veterans who were deployed to either Afghanistan or Iraq, 39% of them showed positive for probable alcohol abuse. Research from The Medical University of South Carolina states that repeated alcohol exposure during treatment for PTSD can cause memories to grow stronger instead of weaker over time. A person with both PTSD and an alcohol use disorder must be treated for both problems.
Treatment for Veterans with an Alcohol Use Disorder
A person with a mental illness as well as a substance use disorder has a condition referred to as a co-occurring disorder. Sometimes this is called a dual-diagnosis or dual-disorder. Typically, these disorders make each other worse, such as how alcohol abuse can worsen the symptoms of PTSD. These conditions can be treated at the same time. Treatment for PTSD typically consists of trauma-focused psychotherapies such as:
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure (PE)
- Eye Movement Desensitization and Reprocessing (EMDR)
Treatment for a substance use disorder may include:
- Cognitive Behavioral Therapy
- Relapse Prevention
- Contingency Management
If you or a loved one is suffering from an alcohol use disorder or a co-occurring disorder, know that there are options available to help you. The Veterans Alcohol and Drug Dependence Rehabilitation Program is an option for those enrolled in the VA health care system. There are also other inpatient and outpatient treatment centers that can help you overcome a co-occurring disorder. A treatment provider is available 24/7 to take your call and discuss your options with you for free. Don’t hesitate, reach out today if you need help.