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A-Z Guide to Veterans and Addiction
In this post, we discuss the topic of addiction amongst veterans. You may be surprised to learn that veterans are able to survive war zones but struggle to survive a peaceful environment when they return home. However, when veterans return from combat, they face multiple challenges as they adjust into ‘normal life’ outside of the military.
These challenges are often complicated by traumatic events they have experienced whilst in the military. Unfortunately, the events of war do not remain on the battlefield and instead spill over into the personal lives of those that experience them.
These traumatic events often take a significant toll on veterans psychological well-being. Unfortunately, many veterans attempt to cope with these challenges by ‘self-medicating’ with drugs and alcohol.
In this post, we discuss nine reasons why so many veterans turn to drugs and alcohol, and then we offer nine steps veterans can take to reverse their fortunes now they are a part of ‘civilian’ life.
But before we dive into the meat of this post, we would life to introduce you to Karl:
Meet Karl, a 34-year-old veteran from Texas
Karl joined the army at the age of 17 and he served in Iraq and Afghanistan. In fact, Karl’s family have served in the US army for many generations. Karl says he completed these deployments with a “chest full of medals” and a Bronze Star. But all these achievements seem like far distant memories for Karl.
Like tens of thousands of veterans, Karl is now addicted to a range of prescription drugs. Karl’s problems began when he was involved in a road accident when serving in Afghanistan. The accident was unrelated to combat duties.
Because Karl was a highly trained radio and satellite expert, his company did not want Karl to return home due early so he could fully heal. Thus, Karl’s superiors pressured him into returning to active duties before his injury had fully healed.
To reduce his pain, Karl began taking opiate painkillers such as Vicodin. When Karl returned home from Iraq, his doctors continued to prescribe him with opiates such as oxycodone, hydrocodone and Adderall. These prescriptions were authorised by army medics. You will not be surprised to learn that Karl had become addicted to opiates. However, Karl didn’t really understand what it meant to be addicted to opiates, at least not until he was called up to serve in Afghanistan. When Karl arrived in Afghanistan he failed to bring enough opiates to last him for the entire assignment. When Karl ran out of opiates, he began to feel sick. He was beginning to understand what it meant to experience an opiate withdrawal.
However, Karl didn’t really understand what it meant to be addicted to opiates, at least not until he was called up to serve in Afghanistan. When Karl arrived in Afghanistan he failed to bring enough opiates to last him for the entire assignment. When Karl ran out of opiates, he began to feel sick. He was beginning to understand what it meant to experience an opiate withdrawal.
Fortunately, a medic recognised Karl’s situation and prescribed his with some Percocet. When Karl returned home, his tolerance to opiates meant he needed to ingest a dangerously high dosage in order to function. When Karl was called up for another assignment in Afghanistan, he tested positive for morphine. This is because prescription opiates are synthesized into morphine in the liver. Because of this, Karl was dishonorable discharge from the army.
Karl lost everything. His wife left him. He lost his home. He lost his job and he lost his pride. Even when Karl moved in with his parents, his drug use and erratic behaviour eventually forced his parents to kick him out. Since Karl has no place to go, he began to live in his car. Karl frequently brushes with the law as a means of obtaining opiates and he fully expects to end up in prison. All Karl is offered by his Government is a methadone ‘harm reduction’ programme.
Signs indicating a veteran is addicted to drugs or alcohol
Below we list a number of signs that may indicate you or your loved one may be addicted to drugs or alcohol:
Finding any excuse to drink or take drugs
Experiencing withdrawal symptoms when drink or drugs are not consumed
Experiencing anger when considering cutting down on drug or alcohol use
Requiring more drugs and alcohol in order to ‘function’
Withdrawing from family and professional responsibilities
Why some veterans abuse substances
We now offer up nine reasons why some veterans end up abusing drugs and alcohol:
#1. Traumatic events
Veterans often experience trauma during their military career, particularly when veterans carried out ‘combat duties’ during their time in the military. This trauma gives rise to mental health problems such as anxiety, depression and Post Traumatic Stress Disorder (PTSD). For instance, around one in four US soldiers returning from active duty in Iraq or Afghanistan claim to experience from a mental disorder, whilst one in six of these soldiers exhibit symptoms of PTSD.
PTSD causes the sufferer to focus on thoughts and memories concerning the traumatic event they witnessed during combat duties. These events are typically violent in nature. The traumatic experience is re-experienced through flashbacks, intrusive (unbidden) memories, and nightmares. Sufferers of PTSD also experience a sense of anxiety and depression that’s related to their traumatic experiences. PTSD can continue even many years after the traumatic experience took place.
Symptoms of PTSD include:
Reliving the traumatic event through flashbacks, thoughts and nightmares (“re-experiencing”)
Avoiding people who remind the sufferer of the traumatic event
Inability to face work
Easily agitated and over-reactive to natural stimuli
Sudden rage or violent outbursts
Difficult to live with
Unfortunately, many of these veterans self-medicate these symptoms with drugs and alcohol in order to ‘numb’ their pain. Veterans may also be given prescription medications to treat their PTSD. These drugs typically include opioids and benzodiazepines. You thus won’t be surprised to learn that an addiction to these prescription medications may arise.
#2. Sexual trauma
Although this is directly related to point #1 above, we thought this was sufficiently important to be given its own section.
The number of women serving in the military has vastly increased over the past thirty years. Many of these women report experiencing sexual harassment at the hands of their male colleagues. US research reports around a fifth of female veterans experience PTSD due to a sexually traumatic event.
The symptoms of PTSD are generally more aggressive for female veterans than for male veterans. This is because females are known to carry a genetically higher response to fear than men. To overcome these exacerbated symptoms, female veterans are more likely to abuse prescription medications when compared to their male peers. Female veterans are four times more likely to abuse prescription medications compared to the civilian population.
Furthermore, experts say military victims of sexual assault or rape are six times more likely to attempt suicide than their peers who have not experienced this traumatic experience. In the US, it’s thought that female veterans are six times more likely to commit suicide compared to females who have not served in the military.
#3. Chronic pain
Soldiers commonly suffer from chronic pain caused by an injury suffered during combat duties. Alternatively, many soldiers suffer from chronic pain simply because they have suffered an injury during a ‘freak’ accident whilst on deployment.
Unfortunately, the military is all too happy to prescribe these people with opiate-based painkillers to control chronic pain. Opiate painkillers are highly addictive. Because of this willingness to prescribe opiate painkillers, tens of thousands of veterans are now dependent on these drugs in order to function.
#4. Breakdown in family life
Many people suffering from PTSD will act negatively towards their families. When this is mixed with addiction, you won’t be surprised to hear this causes family breakdown. A breakdown in family life fuels veteran’s drug or alcohol abuse.
#5. An unwillingness to seek out help
Many veterans may be unwilling to seek out professional help for their PTSD or accompanying addiction because they feel that doing so could somehow damage their good character, or perhaps many will simply feel too embarrassed to seek out help. Many of these people will not seek out help until they have hit ‘rock bottom.’
#6. Loss of structure and routine when leaving the army
Addiction is no new concept for ex-service men and women. When in the armed services these people enjoy a highly structured life and a real sense of purpose. Many of these people take this lifestyle for granted. This means many of these people are shocked to discover the void in their lives when they leave the armed services. This void is often filled by abusing substances such as alcohol, prescription medications and illicit drugs.
#7. Forbidden fruit and new found freedoms
Furthermore, the armed-services applies a zero-tolerance policy when it comes to illicit drugs. This means many veterans may dabble in illicit drugs when they are discharged from the armed-forces because they view this behaviour as a sort of ‘forbidden fruit.’ However, these new found ‘freedoms’ may quickly develop into an addiction to drugs or alcohol if this behaviour is not moderated.
#8. Reduced ability to make the right decisions
When a veteran leaves the armed forces, they will no longer have a superior to make basic decisions on their behalf. Because many veterans become so accustomed to ‘following orders,’ some of these people will have failed to develop their own coping skills and sense of good judgment when it comes to deciding on actions that will affect their long-term well-being.
#9. Traumatic brain injury
Traumatic brain injury (TBI) is surprisingly common amongst veterans. TBI arises when the brain is pushed against the skull. This causes mild-to-severe brain damage through nerve fibres injury. Studies reveal around 10-20% of veterans suffering from TBI go on to suffer from drug or alcohol addiction as a result of their injuries.
How to help a veteran who suffers from an addiction
Many veterans caught up in the deadly cycle of substance abuse may feel that drugs and alcohol are the only way to protect themselves against the symptoms of PTSD and other stress caused by the need to re-adjust into civilian life. Here, we aim to debunk this reasoning by providing 9 tips to help you readjust into civilian life without abusing drugs and alcohol.
Some of these tips are simple and direct, and you are probably already doing many of them already. However, we wish to remind you of the importance of this information and also get you brainstorming about creative ways you can help yourself or your loved one.
#1. Avoid prescription medications
If you suffer from PTSD, you will probably struggle to sleep. To overcome these symptoms, your doctor may offer you a drug classed as a ‘benzodiazepine’. You may be more familiar with trademarked benzodiazepines such as Valium and Xanax. This drug helps you sleep as it acts as a central nervous system suppressant. Benzodiazepines are similar to how alcohol affects the brain.
Although benzodiazepines may assist your symptoms in the short term, you run the risk of developing an addiction to these drugs. An addiction to benzodiazepines is difficult to treat once it’s developed, and you will likely require a costly residential treatment programme.
Benzodiazepines fail to treat the underlying psychological causes of PTSD and also cause painful withdrawal symptoms when you attempt to cease taking these drugs.
Despite these issues, the practice of prescribing benzodiazepines to veterans is surprisingly common, particularly in the USA where the military has earned itself the title of being the biggest pharmaceuticals customer in US history. Official US Government statistics reveal military spending on prescription drugs rose by more than 123% between 2002 and 2011, from $3 billion in 2002 up to $6.8 billion in 2011.
#2. Encourage your loved one to seek out help
The speed and effectiveness of a veteran’s recovery is hugely influenced by those closest to them. When somebody close to you is suffering from addiction and/or severe traumatic stress, sitting on the sidelines really isn’t an option.
If you are the loved one of a veteran and you suspect he or she is suffering from addiction or a mood disorder, it’s essential you try to encourage your loved one to seek out professional help as soon as possible. It’s rare for the problem to resolve itself and so your inaction is likely unnecessarily prolonging your loved-one’s suffering. If you loved one resists the idea of seeking out help, it may be necessary to stage on intervention. To achieve this, you must seek out the services of a professional interventionist. This person is typically a counselor or therapist who specialises in the treatment of substance misuse.
If your loved one resists the idea of seeking out help, it may be necessary to stage on intervention. To achieve this, you must seek out the services of a professional interventionist. This person is typically a counsellor or therapist who specialises in the treatment of substance misuse.
#3. Join a support group consisting of other veterans
We encourage veterans to reach out to existing support networks catering to their needs. If a support group does not exist in your area, consider forming one. This means you will be supported by others who understand what you are going through. These people will help you overcome feelings of loneliness and isolation.
These people will understand your pain on a level that other people do not. This support will make a massive difference to your progress and also help you avoid substance misuse.
#4. Engage in robust cardiovascular exercise
Engaging in robust cardiovascular exercise such as running, jogging and cycling is known to reduce mood disorders and have a positive effect on your overall levels of mental health.
#5. Engage in deep relaxation techniques
Deep relaxation techniques are highly effective at treating mood disorder. These techniques include yoga, mindfulness and tai chi. These techniques help you detach from your worries and allow you to see the impermanent nature of negative feelings and thoughts. This allows you to shut off external factors that fuel your mood disorder and an associated need to engage in substance misuse.
#6. Attend a rehabilitation clinic for veterans
If all else fails, you may consider attending a residential rehabilitation centre offering a programme specifically designed for the needs of veterans. Before you attend this centre, specifically ask how the centre caters to your needs.
In particular, the centre must be able to demonstrate their ability to:
Help you cope with severe trauma caused during combat duties
Offer you a programme tailed to your specific experiences and addiction
Teach you coping strategies that help you deal with your issues without resorting to substance misuse
Offer you group therapy consisting of other veterans
Offer you therapists who understand problems faced by veterans
An aftercare programme you can access in your local area
#7. Be accepting of your loved one
Offering your unconditional acceptance is one of the most powerful resources you can offer someone suffering with PTSD. Express this to your loved one by telling him or her you care, that you love him or her and that you will suspend your judgment of him or her. When a veteran experiences addiction and/or extreme traumatic stress, they will often find it difficult to accept what they have done. As they struggle to accept this, there’s not much space for them to try different activities that will help them heal.
When you say to them: ‘I care and I accept you as you are now’, you give your loved one enough emotional space to begin to heal.
Repeat the words ‘I care and I accept you as you are now’. They may not believe that somebody could accept them for what they’ve been through and what they’ve done, but repeating this phrase should get the message through in time. This will let your loved one see themselves through your eyes, and this acceptance will help them reverse their sense of self-hate and disapproval.
#8. Be prepared for the worst
If you are the loved one of a veteran, know that in some extreme circumstance of post-traumatic stress, the sufferer can become disconnected and hopeless. When this happens, your loved one may express suicidal thoughts and act out extreme behaviours. It’s important to plan for this possibility before it occurs so that you are prepared.
If your loved one expresses suicidal ideation, respond in a way that keeps them talking. Thank them for sharing their emotions to you and for giving you the opportunity to help them make positive changes in their live so suicide does not occur. Getting your loved one to talk about their problems should help give them back a sense of community and a realisation that they are not suffering alone.
#9. Always act in a peaceful and non-violent way
If your loved one suffers from PTSD, it’s essential to not re-traumatise your loved one or creating an event where there is more violence going on. All traumatic events are violent in nature. The person who suffers from PTSD is overwhelmed by the experience in such a way that they must give up their thoughts, feelings and beliefs in order to survive. To reverse this, you must try to create a safe environment that’s free of violence.
Written by, Paul Clarke
Addiction worker - Ocean Recovery Centre
Blackpool, Lancashire England FY2 9NS and or Watford, Herts England WD17 3BH
Link to Article: a-z-guide-to-veterans-and-addiction
International Chaplains Association of the Celtic Cross
Medical Outreach Divisions
Independent Article Submissions on Veteran Health Issues