Alcohol Use and Abuse in the Military


Military veteran alcohol abuse is a serious issue that often occurs along with mental health conditions like posttraumatic stress disorder (PTSD), depression, and anxiety. Treatment that addresses both alcoholism and mental health is available for vets through the Department of Veterans Affairs (VA) and community care providers.

Military Life and Alcohol Use

Many veterans face unique stressors during their time in the military that can increase their risk of developing alcohol problems. A 2017 survey found that vets were more likely than civilians to use alcohol and engage in heavy drinking, which involves drinking 5 or more drinks on a single occasion.1

In fact, alcohol use disorders are a common form of substance use disorder in military service members.2 For some vets, alcohol abuse may have begun during their time in the military and extended beyond their service, while others may not have developed a problem until after their service ended.

man drinking hard liquorMilitary drinking culture is one factor that may contribute to alcohol abuse among service members.3 In the military, alcohol is often used as a way to bond with one another and relieve both stress and boredom.3 Service members may be influenced by the drinking habits of their peers and assume that heavy drinking is common and accepted. Service members also commonly overestimate how heavily their peers drink.3

Military service members are also more likely than civilians to experience traumas, either before or during their military careers.3 Stressors experienced during childhood have been associated with high-risk drinking behavior in military recruits.3

History of trauma is linked to serious issues such as PTSD and alcohol abuse.3 Drinking alcohol may be a way for vets to cope with the emotional pain brought on by past traumatic events.3 Combat exposure has also been linked to psychological distress as well as hazardous drinking.3 Drinking to cope with boredom, stress, emotional turmoil, or trauma could progress to the point of leading to serious problems in a vet’s life.

Signs of Alcoholism in Veterans

Signs that a vet may have an alcohol use disorder include:4

  • Failed attempts in the past to cut down or stop drinking.
  • Drinking more alcohol or drinking for longer than planned.
  • Spending significant amounts of time drinking or recovering from the effects of alcohol.
  • Experiencing strong cravings for alcohol.
  • Drinking alcohol even though it causes problems with friends and family.
  • Participating in dangerous behaviors while drinking, like driving under the influence or operating heavy machinery.
  • Giving up on activities or hobbies that were once enjoyable because of alcohol.
  • Experiencing problems at home, work, or school because of drinking.
  • Drinking alcohol even though it negatively affects your physical and emotional health.
  • Feeling less of an effect from the same amount of alcohol or needing to drink more to feel the same effects.
  • Experiencing withdrawal symptoms, like anxiety, depression, nausea, shaking, sweating, or seizures, when stopping or cutting back on alcohol.

Other warning signs of alcoholism in veterans include:5

  • Blacking out while drinking.
  • Sneaking alcohol when other people are not looking.
  • Lying about drinking.
  • Using alcohol to cope with stress and other negative emotions.
  • Using alcohol for “liquid courage” or to feel confident or relaxed in social situations.
  • Thinking about alcohol often.
  • Drinking at work, school, or in other places where it is considered inappropriate.
  • Being arrested or charged with alcohol-related offenses.
  • Spending large amounts of money on alcohol and/or experiencing financial problems.
  • Ignoring personal hygiene.
  • Experiencing falls or other injuries while under the influence.
  • Denying that alcohol is a problem.

VA Alcohol and Mental Health Online Screening

The VA offers an alcohol use screening tool to help a veteran or loved one to assess whether their alcohol use has become problematic. It involves answering 4 brief questions about your alcohol use.

Vets who are concerned about their mental health can also complete the VA’s 10-question screening for depression and 17-question screening for posttraumatic stress disorder.

The VA’s online screening tools are not meant to replace an assessment and diagnosis provided by a professional.

How Alcohol Abuse is Secondary to PTSD

Certain experiences during a vet’s time in the service can put them at higher risk of developing problems with alcohol. Vets who experience combat exposure, training accidents, and military sexual trauma are more likely to develop mental health issues such as PTSD.6

PTSD involves exposure to a traumatic event, re-experiencing of the event, such as through flashbacks or nightmares, increased arousal, negative emotions, and avoidance of thoughts, feelings, and/or reminders of the event.4 Between 7 and 8% of veterans experience PTSD at some point in their lifetimes.3

Vets who experience trauma during their time in the military are also more likely to have problems with alcohol, even if they don’t develop PTSD.6,7 Around 75% of people who experience abuse or violent traumatic events report problems with alcohol, and around 33% of people who experience trauma related to accidents, illness, or natural disasters report alcohol problems.7 The risk of developing an issue with alcohol use following a trauma is also higher for people dealing with health issues or pain.7

Vets may use alcohol as a way of masking distressing emotions and/or reducing psychological or physical pain symptoms.6 War vets are more likely to binge drink, which involves drinking a significant amount of alcohol within a short period of time, when they experience memories or flashbacks to combat.7

While this self-medicating may work in the short-term by temporarily alleviating a vet’s symptoms, it can cause more significant long-term problems and worsen the symptoms of PTSD.3

A significant number of vets suffer from both alcoholism and PTSD. Treatment that addresses both alcohol and mental health is necessary to help vets recover.3 Fortunately, there are options available for help through the VA and community care providers (CCPs).

Alcohol Rehab for Veterans

There are several different options available for alcohol rehab for veterans. VA alcohol treatment programs use scientifically proven approaches to alcoholism that also address co-occurring conditions like depression, PTSD, and chronic pain.8

The VA provides different levels of care and services, including inpatient detoxification, residential treatment, intensive outpatient, and short-term outpatient counseling.8 Treatment may include individual, group, and marital/family therapy, as well as medications to help deal with alcohol cravings and withdrawal.8 There are also options for continuing care and relapse prevention following treatment.8

In addition to treatment directly through the VA, some vets may be eligible to participate in the community care program, which replaces the Veterans Choice Program (VCP).9 This program allows vets who meet certain criteria to see medical and mental health providers outside of the VA network.9

A vet may be eligible to see a community care provider in the following cases:10

  • The VA is unable to provide the service that the vet needs.
  • The vet does not live in a state with a full-service VA.
  • The vet’s average driving time to the nearest VA facility is over 30 minutes for primary and mental health care or 60 minutes for specialty care.
  • The average waiting time at the nearest VA is over 20 days for primary or mental health care or over 28 days for specialty care.
  • Both the vet and the referring provider believe that it is within the vet’s best interest to see a community care provider.
  • The specific VA service line needed by the vet does not meet the VA’s quality standards.
  • The vet met the 40-mile criterion of the VCP prior to the MISSION Act going into law on June 6, 2018 and continues to meet that criteria. The vet also must live in one of the following states: Alaska, Wyoming, Montana, North Dakota, or South Dakota.

Vets must receive approval from the VA in order to participate in the community care program. The process begins by speaking with a VA staff member to determine eligibility and receive approval.

Sunrise House has two sister facilities that are approved community care providers: Desert Hope located in Las Vegas, Nevada and Recovery First in Hollywood, Florida.

Both facilities provide treatment for addiction and co-occurring mental health disorders. They offer several different levels of care, including medical detoxification, inpatient rehabilitation, residential treatment, partial hospitalization programs, and intensive outpatient programs.

Both Desert Hope and Recovery First also offer the Salute to Recovery program, which is a program unique to American Addictions Centers that was designed for veterans and first responders. Veterans in the program will:

  • Connect with other vets and first responders in a safe and supportive environment.
  • Receive evidence-based therapies, such as cognitive behavioral therapies and trauma therapies.
  • Participate in services that will help support sobriety, such as 12-Step and other mutual help groups.
  • Engage in positive therapeutic activities, such as exercise, yoga, music therapy, and nutritional counseling.

Salute to Recovery’s specialized approach for vets and first responders can help them recover from substance use and mental health problems, like depression, PTSD, and anxiety.

Veterans face a greater risk than civilians of developing alcohol and mental health problems, especially if they have been exposed to combat or other traumas. However, getting the proper treatment can help vets cope with their past, attain sobriety, and find recovery from these conditions.

 

References:

  1. National Institute on Drug Abuse. (2019). Substance use and military life.
  2. Teeters, J. B., Lancaster, C. L., Brown, D. G., & Back, S. E. (2017). Substance use disorders in military veterans: Prevalence and treatment challenges. Substance Abuse and Rehabilitation, 8, 69-77.
  3. Dworkin, E. R., Bergman, H. E., Walton, T. O., Walker, D. D., & Kaysen, D. L. (2018). Co-occurring post-traumatic stress disorder and alcohol use disorder in US military and veteran populations. Alcohol Research: Current Reviews, 39(2), 161-169.
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  5. Military One Source. (2020). Understanding and identifying substance use disorders.
  6. Schumm, J. A., & Chard, K. M. (2012). Alcohol and stress in the military. Alcohol Research: Current Reviews, 34(4), 401-407.
  7. U.S. Department of Veterans Affairs. (2019). PTSD and problems with alcohol use.
  8. U.S. Department of Veterans Affairs. (2019). Treatment programs for substance use problems.
  9. U.S. Department of Veterans Affairs. (2019). Community care: Veterans overview.
  10. U.S. Department of Veterans Affairs. (2019). Veteran community care eligibility.

 

 



About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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