Contributor: Staff at Sierra Tucson
There has long been a link between military veterans and addictions to alcohol or other drugs. More than 1 in 10 veterans have been diagnosed with a substance use disorder, a rate that is higher than that of the general population.
While just more than 10% may not seem that concerning a statistic on the surface, numbers like those often rely on self-reporting, and in a field like the military, where being diagnosed with any sort of behavioral health concern may be seen as a weakness or cause for discharge, there is more incentive for a person to hide their struggles.
Why are veterans more susceptible to substance use disorders than those who don’t have a military background? What substances do they tend to misuse?
As we hit the two-year mark of the COVID-19 pandemic, has this global crisis exacerbated the concern for veterans and addiction? Are treatment options more plentiful, or are we still spinning our wheels trying to find the right mix of increased access and proper care?
Alcohol & Opioids: A Troubling Trend for Veterans
According to the American Medical Association, of the more than 20 million people nationwide who are living with a substance use disorder, only about 10% receive treatment [1].
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One study found that 70% of veterans who have a substance use disorder failed to receive treatment, and only 5.4% of veteran respondents reported needing and not receiving treatment [2]. While it seems encouraging that that percentage is lower than that of the general population, it doesn’t tell the whole story.
Two-thirds of veterans report that they experience pain on a regular basis, which puts them at an increased risk for misusing prescription drugs [3]. From 2010 to 2016, the rate of opioid overdoses among veterans increased from 14% to 21%, and that rise wasn’t even linked to the use of opioids for pain relief; instead, it was largely related to heroin and synthetic opioids [4].
The most common substance military personnel tend to misuse is alcohol. Sixty-five percent of veterans who entered an addiction treatment program reported alcohol as the substance they most frequently misused, a rate that is double that of the general population [5].
Where Substance Abuse & Veterans Mental Health Can Overlap
Substance abuse often leads to mental health struggles — or vice versa — and veterans are especially vulnerable to some of these. Many veterans are living with depression, anxiety and posttraumatic stress disorder (PTSD).
Veterans who have a substance use disorder are three to four times more likely to receive a diagnosis of depression or PTSD, and the U.S. Department of Veterans Affairs (VA) notes that nearly one-third of veterans who seek treatment for a substance use disorder also have PTSD [6].
U.S. military veterans are also believed to make up around 11% of the country’s homeless population. One 2014 study estimated that nearly 70% of homeless veterans have a substance use disorder [7]. These veterans, more so than others, face incredible barriers to receiving proper treatment for addictions.
These combinations offer a good explanation of why veterans comprise more than 20% of national suicides, with an average of 20 veterans dying by suicide daily. In 2016, the suicide rate was 1.5 times greater for veterans than for nonveteran adults after adjusting for age and gender [8].
Studies of how veterans have adapted to the pandemic are still in the early stages, and some suggest more struggles related to mental health rather than addiction. However, one survey conducted by the University of Southern California found evidence that veterans who had PTSD prior to the pandemic were now managing their symptoms with more frequent use of alcohol and marijuana [9].
The Changing Landscape of Treatment Options for Veterans
A 2012 Institute of Medicine report identified a number of potential barriers to addiction treatment among veterans, which included:
- Gaps in insurance coverage
- Stigma
- Fear of negative consequences
- Limited access to treatment
- Lack of confidential services
The report also provided possible solutions, including increased use of evidence-based prevention and treatment interventions. It recommended expanding access to care and broadening insurance coverage to include outpatient treatment options.
In the decade since, great strides have been made. The Veterans Health Administration began the Opioid Safety Initiative, which helped reduce opioid prescriptions by 16% in its first two years. In 2016, the military’s TRICARE health system for active-duty personnel announced that it would be expanding its services to include outpatient options and featuring an alcohol and drug use assessment tool on its website. Having outpatient options available is especially helpful now, as many treatment centers have begun to offer teletherapy as a result of the pandemic.
In 2018, the VA created the Community Care Network (CCN), a system designed to connect qualified veterans with trusted treatment providers throughout the United States. This has helped veterans who may not be able to find an affordable treatment program on their own gain access to care.
There is still much work to be done to reduce stigma and expand access to treatment so that every veteran can get the help they deserve. But compared with where the situation was just ten years ago, the recognition of the need for a wider scope of service and the implementation of evidence-based options that can help have vastly improved.
References:
[1] O’Reilly, K. (2019, Oct. 22). 90% who need substance-use disorder treatment don’t get it. The American Medical Association. https://www.ama-assn.org/delivering-care/opioids/90-who-need-substance-use-disorder-treatment-don-t-get-it.
[2] Boden, M. T. & Hoggatt, K. J. (2018). Substance use disorders among veterans in a nationally representative sample: Prevalence and associated functioning and treatment utilization. Journal of Studies on Alcohol and Drugs, 79(6), 853–861. https://doi.org/10.15288/jsad.2018.79.853.
[3] 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. https://doi:10.1016/j.jpain.2016.10.021.
[4] 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.
[5] Veterans’ primary substance of abuse is alcohol in treatment admissions. (2015, Nov. 10). The CBHSQ Report. https://www.samhsa.gov/data/sites/default/files/report_2111/Spotlight-2111.html.
[6] PTSD: National Center for PTSD. (n.d.). U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/understand/related/substance_abuse_vet.asp.
[7] Twenty-one percent of veterans in substance abuse treatment were homeless. (2014, Jan. 7). The TEDS Report. https://www.samhsa.gov/data/sites/default/files/spot121-homeless-veterans-2014.pdf.
[8] VA National Suicide Data Report, 2005-2016. (2018). Office of Mental Health and Suicide Prevention. https://www.mentalhealth.va.gov/docs/data-sheets/OMHSP_National_Suicide_Data_Report_2005-2016_508.pdf.
[9] Lipinski, L. (2021, Jan. 11). COVID-19 pandemic increasing substance use among veterans with PTSD. USC Suzanne Dworak-Peck School of Social Work. https://dworakpeck.usc.edu/news/covid-19-pandemic-increasing-substance-use-among-veterans-ptsd.
About Our Sponsor:
Located in Tucson, Arizona, Sierra Tucson is the nation’s leading residential and outpatient treatment center for substance use disorders, trauma-related conditions, chronic pain, mood and anxiety disorders, and co-occurring concerns. We provide integrated, holistic care for adults age 18 and older of all genders, including specialized programs for military members, first responders, and healthcare workers. Sierra Tucson was ranked No. 1 in Newsweek’s list of Best Addiction Treatment Centers in Arizona for 2020.
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Published on February 3, 2022
Reviewed by Jacquelyn Ekern, MS, LPC on February 3, 2022
Published on AddictionHope.com