Treatment Options for Military Veterans
Members of the military have unique circumstance and demands that include heightened stress levels in combat situations. Psychological distress can be a risk factor for substance abuse.
Drinking alcohol or using drugs may provide a temporary relief in the form of self-medication. The U.S. Department of Veterans Affairs estimates that as many as one in 10 soldiers returning from the wars in Afghanistan and Iraq seen at Veterans Affairs (VA) centers have a problem with drugs or alcohol. Fortunately, there is a range of options available to both active duty members of the U.S. Armed Forces and veterans who served their country. Military or veterans’ benefits can be used to promote a successful recovery and a healthier lifestyle.
Treatment options may vary, depending on the unique circumstances of each individual. Some may benefit from outpatient services while others are better suited to residential treatment.
The duration of treatment also depends on the person and the type of recommended treatment.
Prevalence of Substance Abuse in the Military
Active duty military members may have issues with substance abuse at different rates than the general public. The Health Related Behavior (HRB) Survey – Active Duty Service Members estimated that as many as 84.5 percent of active duty military personnel were current drinkers in 2011, with 11.3 percent considered to be problem drinkers. This is higher than the national average, as the National Institute on Alcoholism and Alcohol Abuse (NIAAA) estimates that approximately 7.2 percent of American adults over the age of 18 in 2012 were classified as having an alcohol use disorder (AUD), while slightly more of the general population had ever drank alcohol at 87.6 percent.
The zero-tolerance policy on drug abuse in the military may be a factor as to why military personnel use illicit drugs at lower rates than the general population; however, injuries may explain the use of prescription drugs more often. Only 1.4 percent of military members serving in Afghanistan in 2007 were found to use illegal drugs. Prescription drug abuse is considered to be a greater problem among those in the military. Conversely, 9.4 percent of the general population was estimated to use illicit drugs in the past month, the majority of them abusing marijuana, according to the 2012 National Survey on Drug Use and Health (NSDUH).
Military Members and Substance Use Disorder
Being away from home and family and immersed in a high-stress environment may encourage military members to engage in substance abuse. Many substances, including alcohol, are central nervous system depressants, which can create calm and pleasant feelings, numbing sensations of pain and stress as some of the brain’s chemical messengers are suppressed. Per NIDA, in 2008, 47 percent of active duty military personnel reported binge drinking, while the 2013 NSDUH reported that only 22.9 percent of the general public did so in the 30 days prior to being surveyed.
Repeated episodes of binge drinking can increase the odds of developing a substance abuse dependency or disorder. Chronic use or abuse of a substance creates a physical dependency, as the brain begins to count on its presence. Users may become tolerant and need more and higher doses each time in order to create the same effects. Drugs and alcohol increase the production of dopamine, one of the brain’s chemical messengers, which is part of the body’s natural reward system, encouraging the use of these substances. As the reward pathways are reinforced chemically instead of naturally, drug or alcohol cravings increase, and withdrawal symptoms may crop up between doses or when the substance is removed from the body. Addiction is considered a chronic brain disease wherein drug- or alcohol-seeking behavior becomes a compulsion and is perpetuated regardless of any negative consequences. As a result, it may require specialized treatment in order to successfully break the cycle.
Military members and veterans are immersed in a unique culture. Trained professionals who understand the individualized pressures put upon military members and veterans can help develop care plans that aid the recovery process. Group therapy can induce feelings of inclusion and create a safe and secure environment that is conducive to healing. Cognitive Behavioral Therapy (CBT) in both group and individual settings works to teach coping skills and retrain negative thoughts into more positive ones.
Residential treatment may also initially include a detox protocol wherein drugs and/or alcohol can be safely removed from the body, at times using medications to make the transition to sobriety as smooth as possible. Residential rehab programs usually recommend a stay of at least 30 days, and some recommend a longer stay depending on the circumstances.
PTSD and Substance Abuse
Combat situations and the exposure to trauma, including injury and the threat of death or witnessing death firsthand, may lead to the development of post-traumatic stress disorder, or PTSD. PTSD is an anxiety disorder commonly tied to substance abuse, as well. According to Psychology Today, PTSD can be triggered in anyone experiencing a life-threatening event, however, military members may have increased risk factors due to the nature of their service, with 12 to 20 percent of Iraq war veterans being diagnosed with PTSD upon their return. Those suffering from PTSD may turn to drugs or alcohol to dull the anxiety, or as a form of self-medication. Unfortunately, this short-term solution may lead to more lasting side-effects including:
- Increased numbing of emotions
- Heightened irritability, hostility, and aggression
- Avoidance of events causing PTSD symptoms to be prolonged
- Difficulties concentrating
- Feelings of depression
- Decreased enjoyment in activities and in general
- Lower quality of sleep and further sleep issues
The U.S. Department of Veterans Affairs estimates that as many as two out of 10 veterans suffering from PTSD also have a substance abuse disorder (SUD), and one out of three veterans seeking treatment for their SUD also suffers from PTSD. When someone with a SUD also suffers from a mental health disorder like PTSD, the disorders are considered to be co-occurring. Successful treatment of co-occurring disorders requires comprehensive and integrated treatment. This means that both disorders are treated simultaneously by a team of medical professionals that work together to promote a healthy recovery. In some cases, the use of medication is necessary during treatment, and it is essential that all doctors involved in treatment understand the intricacies and history of substance abuse as well.
Family therapy can help with PTSD recovery, as it seeks to educate all members of a soldier’s or veteran’s immediate circle on what to expect while healing and recovering together. Cognitive Processing Therapy (CPT) further aids in awareness of the changes in thought process and behaviors related to PTSD and teaches management and new skills for handling these changes. Prolonged exposure therapy may be used effectively to treat PTSD by repeatedly using traumatic triggers to teach new skills for decreasing the power of the negative emotions associated with them.
Depression is also common in active duty service members, and as many as 27 percent of active duty service members exhibit symptoms of depression. PTSD and depression may be factors in the high rate of suicide among active duty, reservists, and National Guard members, which is estimated to be at a rate of one suicide every 18 hours, as reported by NBC News. Fortunately, depression, PTSD, substance use disorders, and other disorders can all be treated with high rates of success. Chronic PTSD symptoms, as well as depressive symptoms, may be managed with antidepressant medications, therapies and education; treatment is recommended for at least three months.
Using Veterans’ and TRICARE Benefits
The VA provides eligible former members of the U.S. Armed Forces with treatment options for mental health disorders and troubles with substance abuse and dependency. The VA may provide a wide range of services on an outpatient or inpatient basis through VA nursing homes, residential care facilities, and at VA medical centers (VAMC). Members enrolled in the VA health care system are eligible for these benefits. Contact your local VA center or the VA Mental Health department for more information on these benefits.
Private rehabilitation facilities are also an option for military veterans seeking further amenities or specific and specialized programs. Military health care benefits may still be applied toward the payment of treatment with an additional co-pay expense. Private health insurance can also be used in addition to VA benefits to supplement paying for rehabilitation and recovery. Specific facilities may offer discounts or scholarships to military veterans or those demonstrating financial need as well.
Active duty military service members may use TRICARE benefits to pay for recovery services with prior authorization and determination of medical or psychological need. Detox, outpatient, inpatient, group and family therapies all may be covered. For rehab treatment in an inpatient capacity using TRICARE, you will need to have the proper authorization and use a TRICARE-authorized facility. Detox services may be covered for up to seven days, inpatient rehab for 21 days, and acute inpatient psychiatric care may be covered for between 30 and 45 days. Up to 60 group therapy sessions and 15 outpatient family visits are also included.
If you’d like help determining the best course of action to promote lifelong healing, contact us today. We can also help you navigate how to use military benefits in order to help make recovery a viable and affordable reality. Call now.