For many veterans who return home from duty, their very sense of self has been shaken or altered by the memory of their service. Many suffer from post-traumatic stress disorder and other problems, while others reflect on their actions with remorse, even though they were positively serving their country.
During active duty, a person is thrust into a traumatic and physically, mentally, and exhausting world. When they return home, they often have mental or physical health problems that are disturbing or even disabling. Sadly, too many veterans choose to use and abuse alcohol as a means to cope with these heightened levels of stress. However, there is help for this ever-growing concern.
Why Are Alcohol Use Disorders So Prevalent For Veterans?
Veteran stress derives itself from many things, including: the transition from civilian life to that of the military; leaving your home, community, job, family, and friends behind; and living and working within a harsh environment. The latter point includes the rigors of their job and rank, least of not which is combat. These stresses exert a massive amount of pressure on a person.
Here are some common traumatic circumstances that returning military personal may have encountered that may result in a greater risk of alcohol use and dependence:
- Mental or cognitive disorders
- Traumatic brain injury (TBI)
- Other injuries
- Sleep disruption
- Relationship problems, including violence with a relationship.
- Combat exposure, including killing during a combat situation
- Military sexual trauma (MST)
The hardest thing for veterans is returning to a life that has no understanding of these things. Many choose to bury their service-related or wartime memories away, not being able to cope or deal with them. Others may find it hard to convey such foreign or uncomfortable things to those around them.
Even worse, certain mundane or innocuous events, objects, or places may trigger a flashbacks. People around them might not understand this and react impatiently or without proper sensitivity, leaving a person feeling emotionally vulnerable and adrift.
With this onslaught of stress comes a breadth of emotions, emotions that may be very hard to vent or show. Pushing them inside can allow them to fester and grow into deeper emotional issues.
The Emotional Imbalance That Can Result From Service
Emotional turmoil or emotions that are not properly handled are one of the largest precursors to substance abuse. Leaving active duty behind does not necessary put an end to these emotions. Though some may be alleviated, they will be quickly be replaced by new ones that result from the challenges of living a life as a veteran. Here are some emotions that a veteran may struggle with as they strive to reach equilibrium in their changed life:
- Loneliness: Veterans return home to lives and people that are disconnected from their experience during active duty. Even if they have the support of family or friends, these people often cannot begin to understand those experiences and why they make them act or feel the way they do. For this reason, some choose to suppress their emotions or experiences. Despite this, these things still exert a mental and emotional pressure on them and may manifest as other emotions, including angry outbursts.
- Distrust: As a person feels lonely, they may push people away even further. As they lose the interaction that is crucial for empathy, support, and understanding, they might fall prey to negative mindsets or outright lies about how other people feel about them. Some veterans may return home and not have the family or friends waiting for them that were there when they left. This might encourage them to put up walls and have a hard time trusting people. Due to their mental state, they might have a hard time trusting themselves or the ways they react in situations.
- Fear: A veteran may feel very disembodied. The person that they were prior to their service may seem very different from the person that they are now. They might be fearful of how to integrate this change into their life or of the impact it has on those around them. Due to underlying mental and emotional conditions, they might not be able to process their emotions properly and be fearful about the next time they might have an outburst or experience a flashback. Their PTSD might make them fearful of going out or being around people.
- Anger: A veteran might be angry at themselves for leaving their family behind or angry at the way their family or loved ones reacted to them upon their return. They may harbor emotions towards the government or the service due to things they witnessed or experienced.
- Self-blame: Deployment for veterans means leaving their family behind. This might cause them to struggle with a sense of abandonment, and if they return to any family relationship problems, they might be apt to blame it on themselves for leaving. Some veterans, especially those that have killed a person within the line of duty, have experienced situations that were intense and painful. Some veterans may begin to hate themselves for things they did or things that they couldn’t understand or control.
- Self-loathing: As a person continues to blame themselves, the blame often morphs into something darker. This is a very dangerous emotion, because as a person begins to hate themselves they believe they don’t deserve health, happiness, or self care, which facilitates self-destructive tendencies.As these emotions go unchecked, they alienate a person from those around them. This can increase the feelings of isolation or a lack of identity. These problems, if left untreated, can become deeply rooted and develop into a mental health condition. Mental health issues are widespread in service men and women and many are self-medicated by alcohol.
Comorbid Disorders Can Cause or Further Aggravate An Alcohol Use Disorder
A large number of vets suffer from mental illness, including anxiety, depression, and PTSD. For many, these issues go undiagnosed or untreated. SAMHSA reports that overall “approximately 18.5% of service members returning from Iraq or Afghanistan have post-traumatic stress disorder (PTSD) or depression.”
Far too often a person that struggles chooses to self-medicate by means of drugs or alcohol. In doing so, they are negating the recognition of underlying problems and allowing them to grow. This is an especially dangerous concern since substance use can further exacerbate and cause these very things.
The American Journal of Public Health (AJPH) published the results of a study that investigated 596 veterans from both Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) within one year of returning from their deployment. Researchers found that “mental health functioning was significantly worse compared with the general population; 13.9% screened positive for probable posttraumatic stress disorder, 39% for probable alcohol abuse.”
Within the study, they sought to examine variance, if any, of the effects on men and women within the different branches. What they found were “higher rates of alcohol use in men, and worse mental health, PTSS, alcohol, and drug use among Army and Marine Corps veterans were observed, suggesting that these veteran subgroups were at higher risk for mental health problems.”
If a person struggles with any of these things, they need to treat them along with their alcohol abuse disorder to create a better chance at a successful recovery. Mental health issues make it harder for a person to gain the balance, perspective, and mindfulness that is essential for recovery and sobriety.
PTSD Within The Veteran Population
When many people hear PTSD, the first population they may think of are veterans. Though this disorder is not exclusive to veterans, it is common within this group. PTSD is caused by exposure to a traumatic event. Service and war can expose people to much trauma. NIAAA published a study saying that “research has found that PTSD and related disorders, such as depression, can develop in military personnel not only as a result of combat exposure but also as a result of childhood traumas, military sexual trauma (MST), mortuary affairs duty, and training accidents.”
The U.S. Department of Affairs defined the following four symptoms of PTSD:
- Reliving the event (also called re-experiencing symptoms)
You may have bad memories, nightmares, or feel like you’re going through the event again. This is called a flashback.
- Avoiding situations that remind you of the event
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
- Negative changes in beliefs and feelings
The way you think about yourself and others may change because of the trauma. You may feel fear, guilt, or shame. Or you may not be interested in activities you used to enjoy. This is another way to avoid memories.
- Feeling keyed up (also called hyperarousal)
You may be jittery, always alert and on the lookout for danger or you may have trouble concentrating or sleeping. This is known as hyperarousal.
If any of the above symptoms are present for four weeks or longer to the extent that they disrupt your life, you may have PTSD. This condition can be stressful on your family members or loved ones.
PTSD can begin immediately or even months (and sometimes years) after trauma. In some cases, episodes may be intermittent. It is most always disruptive and upsetting, to the point that it can get in the way of your life. It also increases your odds of developing an alcohol abuse disorder, which is especially dangerous because it allows you to perpetuate avoidance.
The U.S. Department of Affairs published the following statistics on the connection between PTSD and substance abuse:
- More than 2 of 10 Veterans with PTSD also have a substance abuse disorder.
- War veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to bad memories of combat trauma.
- Almost 1 out of every 3 Veterans seeking treatment for a substance abuse disorder also has PTSD.
- In the wars in Iraq and Afghanistan, about 1 in 10 returning soldiers in VA have a problem with alcohol or other drugs.
Recently, a paper published in Drug and Alcohol Dependence studied how substance use disorders and PTSD together increased the instance of mortality in Veterans. Researchers followed almost 275,000 veterans of varying ages and deployment locations, all of whom received medical treatment or support through the Veterans Administration.
They found that substance abuse disorders and PTSD increased the chances of mortality and that “among Veterans with PTSD, the association between SUD and mortality was most pronounced for the youngest age group, which included Iraq/Afghanistan Veterans.”
Substance Abuse May Often Start During Active Duty
In order to understand alcohol use and abuse after enlistment, we need to understand its roots. For some people, an alcohol abuse disorders develops during active duty. The day to day life of a service man or woman is physically and emotionally strenuous and can at times be dangerous and traumatic.
NIDA observes that those within military service have a greater rate of alcohol use than civilians. They cited that “almost half of active duty service members (47 percent) reported binge drinking in 2008—up from 35 percent in 1998. In 2008, 20 percent of military personnel reported binge drinking every week in the past month; the rate was considerably higher—27 percent—among those with high combat exposure.”
What we do know is this that binge drinking increases the chance of developing an alcohol addiction. When this behavior paired is with other factors, they may interact in a manner that propels them towards greater abuse and addiction.
NIAAA published a study that focused on stress in the military. In it, they outlined that there were certain factors that put military personal at higher risk for heavy drinking. They were:
- Gender: Men were 3.5 more apt than women
- Ethnicity: Hispanic and non-Hispanic Whites had the highest rates
- Military Rank: The study cited that “rates were six times greater among enlisted personnel with the lowest rankings compared with officers.”
- Military Service Branch: Individuals in the Army, Navy, and Marines reported higher than those within the Air Force.
- Age: Younger veterans tend to suffer from higher rates of alcohol abuse, with the NIDA saying that “according to a report of veterans in 2004-2006, a quarter of 18- to 25-year-old veterans met criteria for a past-year substance use disorder, which is more than double the rate of veterans aged 26-54 and five times the rate of veterans 55 or older.”
Another AJPH study also sought to track the rates of substance abuse disorders in conjunction with major depressive disorders for those on active duty. Researchers sought to determine if deployment, specifically the location and duration of the tenure, had any effect on the development of these conditions, along with any difference being attributed the branch of service.
They found that deployment length was not attributed to a greater chance of developing either of the disorders, except in the instance of individuals within the Army. Their results illustrated that enlisted nondeployed personal had decreased instances of these disorders and that “in general, deployment under OIF/OEF increased the risks of being diagnosed with both substance use disorder and major depression substantially.”
Their findings echoed in part our perviously mentioned AJPH study that they found enlisted in either the Army or Marine Corps showed higher instances of both, the former having more than two times the instances of an substance abuse disorder, and the later nearly two times. Across all branches, 30% of the substance abuse disorders were alcohol. They also found that those with depression suffered from another comorbid condition, specifically that “25% had substance use disorder… and 18% had PTSD.”
If left untreated, alcohol use disorders will endanger a person’s mental, emotional, and physical health. Unfortunately, the veteran population does not often seek help. This is unfortunate, because the military does provide its veterans with care and medical assistance through the Veterans Administration (VA).
After being brave and strong in the face of such adversity, many veterans are often afraid to seem powerless or weak by admitting to a problem. On the contrary, asking for and receiving help takes great strength and is the first step towards wellness and balance.
The U.S. Department of Veteran Affairs lists the following avenues of care offered at the VA for a substance use disorder:
- first-time screening for alcohol or tobacco use in all care locations
- short outpatient counseling including focus on motivation
- intensive outpatient treatment
- residential (live-in) care
- medically managed detoxification and services to get stable
- continuing care and relapse prevention
- marriage and family counseling
- self-help groups
- drug substitution therapies and newer medicines to reduce craving
To receive this care, they suggest contacting your local Vet Center, speaking with your current VA healthcare provider, or contacting the OEF/OIF Coordinator at your local VA Medical Center.
Some people may not feel comfortable seeking care or treatment from the VA. For these people, private treatment exists that offer the same services listed above. It may also provide them with the sense of anonymity or change of location that they crave in order to focus on their wellbeing. A person may find it refreshing to seek treatment in a facility with civilians. This can remind them that they’re not alone.
Don’t Wait Any Longer
If you have an alcohol use disorder or if you’re starting to feel the weight of your stress, depression, PTSD please contact us today. At AlcoholTreatment.net, we can help you find the care that is best for you, so you can move forward and make a better life for yourself.