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Veterans and Addiction – A Forgotten Consequence of War

As Veterans Day rolls around, we all take a moment to pay our respects to those who’ve fought for our freedom in both historical and current conflicts, but it’s easy to forget that veterans can’t leave the horrors of war on the battlefield. Drugs have been a part of war for centuries, and although in recent years prescription medicines have become a bigger issue than illicit ones, the problem of addiction among returning veterans is still a very real one. Finding out more about the problem, its history and the issues faced by soldiers fighting in present conflicts helps you understand the importance of getting more of our veterans into treatment.

History of Drugs and War

A surprisingly large number of wars have been associated with the use of addictive substances. From the Civil War and the excessive use of morphine to the extensive cigarette rations of World War I and the amphetamine and alcohol abuse of World War II, drugs and war go hand in hand. Vietnam saw the trend continuing, with marijuana and heroin being the most widely abused substances. However, in modern wars, prescription medicines have been in the spotlight.

Understanding Drug Abuse in the Military

The problem of drug abuse in the military is fairly easy to understand. In short: war is a horrifying, traumatizing and deeply stressful experience for everyone involved, and many veterans turn to drugs as a method of coping. As you may expect, those deployed multiple times are at the greatest risk for ending up addicted to something. Like with non-deployed individuals, substance use is a poor coping mechanism for stress. In the past, the use of substances in this way was almost purposeful, with cigarettes being issued to soldiers in World War I for example. In the modern age, zero-tolerance policies and stigma surrounding drug abuse make it harder to identify those who are developing issues. There are also additional stressors for women in the military. Specifically (and in addition to the factors affecting any soldier), the risk of sexual assault or rape in the mainly male environment may make female veterans particularly likely to struggle with drug abuse.

The PTSD Problem

Post-traumatic stress disorder (PTSD) is common in veterans, affecting around one in six soldiers returning from Iraq or Afghanistan. This is typified by extreme anxiety and stress persisting long after the event that caused it (with flashbacks, nightmares and frightening thoughts being common) and is particularly associated with substance abuse. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 50 percent of returning service members who need treatment for a psychological condition seek it out, and only about half of those receive suitable support. Other issues common in veterans are also associated with drug abuse, such as traumatic brain injury (experienced by just under one in five service members from Iraq or Afghanistan). Overall, one in four modern veterans reports symptoms of a mental or cognitive disorder. 

Modern Veterans and Prescription Drug Abuse

On the face of it, it seems like drug abuse isn’t a particularly big problem with modern military personnel. For example, a 2008 survey found that just 2.3 percent of military personnel were illicit drug users, compared with 12 percent of civilians, and this is likely due to the zero-tolerance policy (accompanied by random testing) instituted in 1982. However, illegal drugs aren’t the big issue in the present day. Much like at home, the big problem for military personnel is prescription drug abuse, ordinarily in the form of opioid painkillers. In 2002, just 2 percent of troops reported abusing prescription medicines, but this had doubled to 4 percent by 2005 and then almost tripled to 11 percent by 2008, far exceeding the number of civilians reporting opioid abuse in those years. In 2009, almost 3.8 million prescriptions for pain relievers were written by military physicians, having quadrupled since 2001. Alcohol abuse is also more common in the military than in the general population, with one in five veterans reporting binge drinking every week in 2008. Particularly notable is the fact that those with high combat exposure had a considerably higher rate of 27 percent. Smoking rates were also tied to levels of combat exposure.

What Can Be Done?

There have been many suggestions as to how we can help veterans and active military personnel avoid problems with substance abuse, and some steps have already been taken. For example, the Army now has a rule that opioid pain relievers can be prescribed for a maximum of six months. However, a bigger issue is improving access to evidence-based prevention and treatment interventions. A 2012 report to the Department of Defense suggested expanding insurance coverage to include outpatient treatment and helping healthcare providers identify and screen for addictions. Other strategies included limiting access to alcohol on bases. Finally, the stigma that surrounds drug abuse in the military is a core part of the problem, discouraging those in need from seeking help. So while we pay our respects to those who’ve fought for our freedom, we should remember that they can’t just leave their problems on the battlefield. In fact, many veterans come home with mental health issues and addictions to grapple with, and we shouldn’t let them struggle in silence. They put themselves on the front lines to help us, and now we need to help them.

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