Substance abuse, addiction and other mental health disorders are significant problems among returning U.S. military veterans.
While tobacco and illicit drug use has decreased in the past few decades, alcohol abuse among veterans continues to be a significant problem.
In addition, prescription drug abuse has become a major concern in recent years even while illegal drug use has gone down. Veterans are also at increased risk for developing various behavioral addictions.
Risk Factors for Addiction
Military veterans face significant challenges when returning from active duty. They must adjust to a completely different environment than the one in which they have loved for the period of their deployment, and they must also adjust to a new social and work structure. Some may be dealing with diagnosed or undiagnosed mental illness, while others may be coping with physical injuries that affect the temporary or permanent course of their lives.
All of these challenges put returning veterans at greater risk for developing substance abuse or other addiction problems. Returning military personnel may use alcohol or illicit drugs to help them cope with undiagnosed mental illness or turn to substances or damaging behaviors to help them deal with such a major life transition. Physical injuries or diagnosed illnesses may also lead to prescription drug problems, particularly with opiate pain medications.
Rates of Substance Abuse
Alcohol abuse has been and continues to be the largest mental health and substance abuse problem among returning veterans. A study of military personnel returning from Iraq showed that approximately 27% of veterans met the criteria for alcohol abuse. These numbers include individuals with alcohol addiction, as well as those who engage in other dangerous alcohol-related behaviors such as binge drinking.
Prescription drug abuse is not yet as big a concern as alcohol abuse among returning veterans, but it is easily the fastest-growing problem. The rates of prescription drug use among veterans doubled between 2002 and 2005 and then tripled between 2005 and 2008. The most commonly abused prescription medications are stimulants, depressants, and pain medications.
If there is a bright spot on the horizon, it is the 2008 Department of Defense Health Behavior Survey showing that tobacco and illegal drug use has generally gone down over the past decades. However, overall addiction figures have not decreased, indicating that substance abuse is now a different but not a smaller problem.
Mental Illness and Addiction
Non-addiction related mental disorders are the second largest mental health concern among returning veterans. In addition, these problems are frequently inter-connected, with 20-30% of veterans suffering from a mental illness also suffering from a substance use disorder.
Depression, generalized anxiety disorder, and post-traumatic stress disorder (another kind of anxiety disorder) are the most common non-substance related mental illnesses among veterans. Self-medication for these kinds of mental illnesses is relatively common, particularly when the illness has not been formally diagnosed.
Veterans and Treatment
Substance abuse or other addiction problems may begin while service members are still on active duty. Although surveys show that a relatively high number of military personnel abuse alcohol or other substances, only a small number are referred for treatment. It may be that the majority who report problems in research studies neglect to formally report problems to the military, and it may also be that some individuals who report problems are not ultimately referred for treatment.
Inside the military, personnel often face pressure to be strong and hide any weaknesses. As a result, some individuals may feel discouraged from seeking treatment for substance abuse or other mental health concerns. Once they have left the military, veterans may retain the same attitudes about seeking mental health treatment even though they are no longer surrounded by the same pressures and expectations.