Hosted by Lauren Brande & Written by Dan Wagener | Published 4/30/18

Listen On: SoundCloud | Youtube | iTunes | Google Play

Imagine that you’ve spent years learning how to be a soldier, fighting hard to protect your country, your friends, and your family. But when you return home, you face a whole new battle that you were never prepared for.

Getting help isn’t easy. It may be hard to find, or you may not even want to seek it due to shame or fear of letting down your comrades.

Today, we’ll speak to someone who’s experienced this firsthand.

This episode is a continuation of our three-part series on drug use among veterans.

On the last episode of “Let’s Talk Drugs,” we looked at drug use during wartime, including the different reasons why drugs were used and some examples of how they were used in particular wars.

In this episode, we’ll examine drug addiction when veterans return home from war. Why they continue to use, what kinds of drugs they use, and the consequences of that use.

Statistics on Veteran Drug Abuse

We typically view veterans as tough. Able to handle anything. Disciplined.

That’s all true. But military life can take its toll, and even the toughest veteran can struggle once they’re no longer on the battlefield.

Unfortunately, many turn to drugs and alcohol to deal with their problems. Nearly 1 in 10 soldiers returning from Iraq or Afghanistan seen by Department of Veterans Affairs’ medical centers have a problem with alcohol or drugs.⁵

Prescription painkillers are a particularly problematic issue. Between March and April of last year, the VA treated an estimated 68,000 veterans for opioid addiction.⁷

Reasons Vets Use Drugs

Why are these rates so high?

When you’re in a war environment, you’re in a constant state of alert. You’re always on the move. You’re separated from loved ones for long periods of time.

On top of that, you have a strong chance of being exposed to violence and even seeing your friends killed. You could be hit by an IED (improvised explosive device), develop back problems, suffer from other injuries from hauling around equipment, or even get in an accident that leaves you with both injuries and psychological trauma.

When these things happen, there is enormous pressure on soldiers to keep going. They don’t want to let their squad mates or their country down. So, they might pop pills or drink to numb the pain.

But when they’re not in that environment anymore, it can be harder to function on a daily basis. What was basically a survival strategy in a war zone can turn into a self-destructive addiction in the civilian world.

These are some of the reasons today’s veterans abuse drugs after service: PTSD; traumatic brain injuries, also known as TBIs; chronic pain; and reintegration into civilian life.

Let’s take a closer look at these, starting with PTSD.

Post Traumatic Stress Disorder (PTSD)

Jay Russell, a treatment consultant with American Addiction Centers and a veteran who has dealt with PTSD himself, explains what PTSD feels like to people who aren’t familiar with it:

Jay Russell: The best way to describe PTSD for someone who doesn’t understand it is we all get nervous when someone tailgates us. I want you to imagine you’re on the highway and the person tailgating is so close you can’t even see their headlights. But guess what? It’s not a car, it’s a semi-tractor trailer with a full load. No matter how fast you turn, no matter which way you go, you cannot get this thing off your tail. The longer it sits there, the more hyper you get, and when you’re dealing with PTSD, it’s not only an active memory versus a passive memory, it’s a state of hypervigilance and anxiety. So, the longer it goes on untreated, the worse you feel.

PTSD is a mental health condition that some people develop after they’ve been exposed to a traumatic event, such as a car accident, abuse, or a situation in which either their life is threatened or they witness someone else’s death or life being threatened. People with PTSD typically experience certain symptoms such as flashbacks, nightmares, depression, and anger.⁸

The Substance Abuse and Mental Health Services Administration reports that about 18.5% of service members returning from Iraq or Afghanistan have PTSD or depression.⁹ That’s nearly 1 out of every 5, a huge number of vets.

Vets who have PTSD may use drugs or alcohol to bury painful memories or help them sleep. But this can progress from self-medication to addiction. More than 20% of veterans with PTSD also have a substance use disorder, or addiction. And to make matters worse, substance abuse tends to make PTSD symptoms worse.⁵

Traumatic Brain Injuries (TBIs)

Another major danger to many in the military is traumatic brain injury, or TBI.

In the Iraq and Afghanistan wars, members of the military on patrol or riding in vehicles can be hit by bombs out of nowhere that they can’t even see.

These IEDs, or improvised explosive devices, are a common cause of TBIs. These are injuries that occur with a sudden trauma to the brain such as violent contact with an object. Symptoms of a TBI include dizziness, vision problems, tinnitus (ringing in the ears), sleep issues, changes in behavior or mood, or problems with memory or concentration. TBIs can range from mild to severe.¹²

Nearly 1 in 5 service members returning from Iraq or Afghanistan report TBI.⁹ Again, an enormous percentage of our veterans.

The symptoms can make it hard to get through the day. And just like PTSD, veterans may turn to drugs and alcohol to manage the symptoms of TBI, which can have a major impact on other areas of their lives. As with PTSD, drinking and using drugs does nothing to treat the underlying issue.

But Jay says it’s not just the symptoms that can affect someone with a TBI’s decision to use substances.

Jay Russell: As far as the brain injuries, I mean it’s hard to even describe how unless you walk into a Veterans Administration hospital and you look at some of these guys that are scarred physically for life. Because when there is an IED explosion and there is a brain injury, there is usually a deformity—facial or otherwise that comes with it.

And if you think about someone whose face is scarred up that not only affects how they function in the world, but it affects self-esteem, it affects finding someone in their life and their future, and they feel like a misfit and out of place. And they will do whatever they can to medicate themselves and to numb that pain even if it means going to something like heroin or more likely, alcohol.

Chronic Pain

In addition to TBIs, many veterans suffer from serious injuries and chronic pain. If you think about carrying around a heavy pack on a regular basis or having a piece of heavy equipment fall on you, it becomes easy to see how this group can get pretty banged up.

And the military is quick to medicate them. Pain reliever prescriptions written by military physicians quadrupled between 2001 and 2009, to almost 3.8 million. Veterans may begin to use these medications while deployed and continue to use them when they return home—with or without medical supervision.¹⁰

Jay offers some insight on how liberal prescribing policies at the VA can lead to abuse.

Jay Russell: When you start getting these injuries and the only way they can deal with it is to start medicating you. The Veteran’s Administration is very lax in how they do that. The National VA where I live, you can actually order your refills online and have them mail it to you and all you need is the codes. You got veterans that are self-controlling their own medication this way instead of being able to come back into the VA and see a doctor due to a long wait time.

They get a 6-month prescription when they really should be going to see their doctor every 2 months or every 30 days to be reevaluated and they just keep refilling it. And after a 6-month period you’ve already got a chemical dependency and assuming you’re not abusing it. And the more you take these pains—opiates and things like that—the longer you’re on them, the less effective they are so they start overmedicating themselves and it’s just a downward spiral because of that.

Reintegration Into Civilian Life

Even if veterans manage to make it back without trauma or injury, it can be extremely difficult for them to go from the high-stress world of combat to regular civilian life. They’re going from an environment where they could be killed at any minute and have other people counting on them to protect their lives to suddenly being thrust out of that environment and needing to find a job or a place to live.

Many of them may turn to drugs or alcohol when they can’t get a job because of their PTSD or have lost connections with friends and family from being overseas for long deployments. Some of them may have never learned skills such as how to look for a job or how to apply for college.

Jay Russell: These are one thing after another laid onto a person. You already every veteran coming out has adjustment issues. That’s a given. There’s going to be some adjustment issues. If you served in combat there’s automatically some sort of trauma. If you come from a culture of a brash lifestyle with a lot of alcohol. I mean most veterans swear like as sailor, it’s just part of the culture and then you add in other things – trying to get a job when you come out of the military on it when the job market is already hard.

So, you’re struggling from the sense of stability where your food is provided for you, your bed is provided for you, every physical need to survive is provided for you, and now it’s not. And if you take an 18-year-old that served in the military for maybe 4-6 years and came out and they’ve never learned the skills that a lot of people do by going to college and things like that—even though they might want to go to college afterwards, they are ill equipped and ill prepared for that transition. Add into it injuries, brain trauma, and it all stacks up into this overwhelming burden on this person that they cannot handle.

Effects of Addiction

Once a veteran becomes addicted, it can quickly become a downward spiral where the person ends up homeless, in jail, or worse. In fact, veterans who struggle with substance abuse and mental illness are much more likely to die prematurely than their peers who do not have these conditions.²¹

If they become homeless, their odds of addiction go up. About 70% of homeless veterans have a problem with substance abuse.¹⁸ This percentage is slightly higher than within the homeless population in general, where about 67% percent have a substance use disorder or other chronic health condition.²⁴

Overdoses among veterans are also becoming more common. Sixty-three percent of attempted Army suicides in 2010 involved a drug or alcohol overdose.⁶ In general, veterans are twice as likely as non-veterans to die from accidental overdoses of prescription painkillers.⁷

In addition, substance abuse and addiction are among the top reasons why veterans become incarcerated.²¹ In 2011-2012, about 14% of male veterans in prison were there for drug offenses.²⁰

Barriers to Care

So there are clear consequences for veterans who become addicted. But when a veteran needs help, it can be hard for them to find it. Or they may not know how to ask for it.

The Veterans Administration, or VA, is the main source of care for many veterans. However, a large percentage of the population doesn’t trust the VA.

Veterans have reported lost paperwork, disorganization, and difficulty making appointments.6 As a result, many active-duty military personnel, veterans, and their families seek help from community and state services.⁹

But some may not even seek help at all for fear of letting down other veterans, losing career opportunities, and dishonorable discharge.¹⁰ They may hide their problems from their own families.

Many veterans place a great deal of emphasis on self-reliance, and they try to manage physical and mental health problems on their own. Men in particular may feel that they must appear masculine at all times, avoid being seen as vulnerable, and be the best at everything. They may view seeking help and assistance for their problems as a sign of weakness.⁶

Russell says that military code also plays a part in a veteran’s decision to seek help.

Jay Russell: These are people where there is also a mental battle that is really not noticed by most people because there’s one extra thing that veterans deal with: It’s that they were trained to serve with a code of honor. I mean the Marine corps, their motto is Semper Fi, and all of a sudden something is taking them down when they were trained to deal with absolutely anything in the world, and it is something that they don’t know how to deal with and all of a sudden, they can’t get a job and they’re on the street. And once they’re on the street, it gets even worse.

But the problems these vets are going through are really part of a larger problem that we need to address.

Jay Russell: It’s almost heart breaking that you have so many people that serve with pride and honor and our country loves our soldiers, we do. Our country is one that was built on patriotism but for some reason, once someone is no longer wearing the uniform, we forget. We all take an oath of no man left behind but I think that oath is forgotten by many when we forget that you can take the man out of the uniform but you can’t take the uniform out of the man. And that means that no man should be left behind even when they’re no longer serving actively. And there’s a big gap in that area—there’s limited resources.

The VA does the best they can. You’ve some great people at the VA but I think we have limited resources with an overwhelming number of people facing war because we’ve been in a constant state of war for over 8 to 10 years now, and we have more wars looming ahead. It’s just a non-ending stream that is overwhelming our system that is set up and needs an overhaul ‘cause if you can’t get a job, you can’t get on Medicaid because of issues that you’re having, you can’t get into the VA, there’s no options really left on it unless you know where to look, and many people don’t know how to look.

* * *

This is a population that clearly needs our help, and their struggles are largely unnoticed. They’ve taken care of us. It’s time for us to take care of them.

On the next episode, we’ll look at where and how veterans can get help. We’ll also dive into some of the treatments used to help veterans who struggle with addiction, including some advancements being made in the treatment of disorders such as PTSD as well as some new research that involves the use of nontraditional drugs, such as Ecstasy (also known as MDMA).

We hope you’ll join us as we continue to tackle this important issue.

If you are or know of a veteran struggling with drugs or alcohol, please reach out for help. Our treatment consultants are available 24/7 to help you find the care that you need. We understand the unique needs of veterans, and we want to help. Call us at to reclaim your life.

Next Time on Let’s Talk Drugs…

Prev Episode | Podcast Home

If you’re struggling with drugs or alcohol, don’t wait until it’s too late to seek help. Call us at to discuss your treatment options and get started on your recovery journey today.

Sources

National Center for PTSD. (2015). PTSD and Substance Abuse in Veterans.
Goldberg, B. (2017). Opioid abuse crisis takes heavy toll on U.S. veterans. Reuters.
National Institute of Mental Health. (2016). Post-Traumatic Stress Disorder.
Substance Abuse and Mental Health Services Administration. (2017). Veterans and Military Families.
National Institute of Neurological Disorders and Stroke. (2017). Traumatic Brain Injury Information Page.
National Council on Alcoholism and Drug Dependence. (2015). Alcoholism, Drug Dependence and Veterans.
Drug Policy Alliance. (2009). Healing a Broken System: Veterans Battling Addiction and Incarceration.
Substance Abuse and Mental Health Services Administration. (2014). Twenty-one Percent of Veterans in Substance Abuse Treatment Were Homeless. The TEDS Report.
Substance Abuse and Mental Health Services Administration. (2017). Homelessness and Housing.
Bennett, A., Elliott, L., and Golub, A. (2013). Opioid and Other Substance Misuse, Overdose Risk, and the Potential for Prevention Among a Sample of OEF/OIF Veterans in New York City. Substance Use and Misuse, 48(10), 894-907.
U.S. Department of Justice. (2015). Veterans in Prison and Jail, 2011-12.

War & Drugs: Veteran Battles Ep 2 – The Fallout