The Connection Between Veterans, PTSD & Substance Abuse

Transitioning from military service to civilian life can be difficult for many veterans. Amidst the challenges of reintegration, a significant portion of this population faces the dual burden of post-traumatic stress disorder (PTSD) and substance use disorders (SUDs). These invisible wounds, often rooted in the unique experiences of military service, can profoundly impact the well-being and recovery of our nation’s heroes. 

Understanding the complexities of this co-occurrence and exploring practical treatment approaches is crucial for supporting veterans in their pursuit of healing and wholeness.

The Prevalence of PTSD and Substance Abuse in Veterans

The prevalence of PTSD and substance abuse among veterans is staggeringly high. The National Center for PTSD, which is part of the U.S. Department of Veterans Affairs, has reported statistics from several studies that reveal the following:

• One in three veterans who opt for substance abuse treatment also have co-occurring PTSD
• Approximately one in ten veterans who fought in Iraq or Afghanistan have a substance abuse disorder 
• More than two out of every ten veterans with diagnosed PTSD also have a co-occurring substance abuse disorder 
• Combat veterans are more likely to binge drink than other veterans or populations

The co-occurrence of PTSD and substance abuse disorders in veterans is particularly pronounced in those who have experienced the traumas of combat, sexual assault, or other life-altering events during their military service.

Military Culture and Trauma Exposure

The unique culture of the military, with its emphasis on stoicism and self-reliance, can create barriers to seeking help for mental health and substance use issues. Additionally, the increased exposure to traumatic events, such as combat, deployment, and military sexual trauma, heightens the risk of veterans developing PTSD and turning to substance use as a means of self-medication and coping.

PTSD and Substance Abuse in Veterans

The symptoms of PTSD, including flashbacks, memory problems, and emotional distress, can trigger the onset or exacerbation of substance abuse. Conversely, the use of alcohol, opioids, and other substances can amplify the adverse effects of PTSD, leading to a vicious cycle of self-medication and worsening symptoms.

Navigating the Challenges of Dual Diagnosis

Those with co-occurring PTSD and SUDs face unique challenges in their recovery journey, and it can be particularly challenging for combat veterans with substance abuse disorder. The interplay of these conditions can complicate treatment, increase the risk of relapse, and contribute to a range of other mental and physical health issues.

Barriers to Treatment for Veterans

Veterans may be reluctant to seek treatment due to concerns about the impact on their military careers, the perceived stigma associated with mental health and substance use disorders, and the limited availability of specialized treatment options within the military and veteran healthcare systems.

The Importance of Integrated Care

Treating PTSD by itself and not the substance abuse disorder (or vice versa) can be ineffective because the two conditions are so deeply intertwined. For healing, integrated treatment approaches that address both conditions simultaneously are more successful in promoting long-term recovery and improving overall well-being.

Evidence-Based Treatments for Co-Occurring PTSD and SUDs

Researchers and clinicians have made significant strides in developing and refining treatment approaches for veterans with co-occurring PTSD and SUDs. These evidence-based interventions aim to address the unique needs of this population and provide a comprehensive path to recovery. Some models of care are listed below.

Psychotherapeutic Interventions

Trauma-focused therapies, such as cognitive processing therapy (CPT), prolonged exposure (PE), and eye movement desensitization and reprocessing (EMDR), have demonstrated effectiveness in helping veterans process and overcome their traumatic experiences. Complementary approaches, like Seeking Safety and Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), integrate trauma-focused treatment with substance use disorder management.

Pharmacological Interventions

Medication-assisted treatment (MAT) can play a crucial role in managing the symptoms of PTSD and SUDs. Medications like desipramine, paroxetine, and N-acetylcysteine have shown promise in reducing both PTSD symptoms and substance cravings when used in conjunction with psychotherapeutic interventions.

Comprehensive Care Models

The Department of Veterans Affairs (VA) and other healthcare systems have developed comprehensive care models that address the multifaceted needs of veterans with co-occurring PTSD and substance abuse disorders. These models often incorporate a combination of inpatient and outpatient services, medication management, individual and group therapy, and support services to ensure a holistic approach to recovery.

Overcoming Barriers and Improving Access to Care

Addressing the systemic barriers that prevent veterans from accessing and engaging in effective treatment is essential for improving outcomes and supporting their long-term well-being.

Increasing Awareness and Reducing Stigma

Ongoing efforts to educate the public, healthcare providers, and the military community about the prevalence and impact of co-occurring PTSD and SUDs can help reduce the stigma associated with these conditions and encourage more veterans to seek the care they need.

Expanding Treatment Capacity and Accessibility

Increasing the availability of specialized treatment programs, improving care coordination between the VA and community-based providers, and leveraging telehealth technologies can help bridge the gap and ensure that veterans have timely access to the required resources.

Fostering a Culture of Support and Understanding

Creating a supportive environment within the military and veteran communities, where open discussions about mental health and substance use are encouraged, can empower individuals to seek help without fear of judgment or negative consequences.

The Road to Recovery: Empowering Veterans with Co-Occurring PTSD and SUDs

The journey towards recovery for veterans with co-occurring PTSD and substance abuse disorders is a complex and deeply personal one. By recognizing their unique challenges, advocating for comprehensive and integrated care, and fostering a culture of understanding and support, we can empower vets to reclaim their lives and thrive in their post-military endeavors.

• Embracing a holistic approach to wellness: Recovery is not just about managing symptoms; it’s about cultivating a balanced and fulfilling life. Incorporating holistic wellness practices, such as mindfulness, physical activity, and social connection, can complement clinical interventions and promote long-term resilience.
• Empowering veterans as advocates and peer supporters: Encouraging veterans to share their stories, engage in peer support networks, and become advocates for improved treatment and resources can help break down barriers, inspire hope, and foster a sense of community and belonging.
• Honoring the resilience and strength of veterans: Ultimately, the road to recovery for veterans with co-occurring PTSD and SUDs is a testament to their resilience, courage, and strength. By celebrating their achievements, we can help our nation’s veterans reclaim their sense of purpose.

There are also programs, often in local communities, to help integrate veterans with PTSD and/or substance abuse back into everyday life, including finding jobs for veterans with PTSD.

The intersection of PTSD and substance use disorders among veterans is a complex and multifaceted challenge, but one that can be addressed through a comprehensive and compassionate approach. By understanding the unique needs of this population, advocating for integrated treatment options, and fostering a culture of support and understanding, we can empower veterans to overcome their invisible wounds and reclaim their lives with dignity and purpose. The journey may be arduous, but the rewards of a life in recovery are immeasurable.

Resources

Many veterans who have been struggling with substance abuse and PTSD may have trouble getting back on their feet during the early days of recovery. There are several resources available for veterans with PTSD, substance abuse disorders, and both, some of which are listed below. If you or your loved one are a combat vet or veteran with PTSD and substance abuse, help is available beyond substance abuse and mental health treatment. For example, some of the choices below include Social Security disability for veterans with PTSD and grants for disabled veterans with PTSD.

• Supplemental Security Income: Substance abuse and PTSD can be equally disabling and are recognized as disabilities. Veterans may be eligible for Social Security payments. Contact your local Social Security office or visit the website here.
• VA Disability: The Department of Veterans Affairs offers disability payments to those diagnosed with PTSD and approved. Veterans should submit form 21-0781 to apply.
• VA Hardship: If a veteran is experiencing an extreme financial crisis (such as getting evicted), they can contact their local VA office to apply for hardship.
• Other financial and medical assistance programs include Medicaid, Medicare, American Legion, Operation Family Fund, and USA Cares.