There are over 20 million veterans in the US according to the Department of Veterans Affairs. Most of these veterans have a healthy relationship with alcohol, but some of them do not. And, as a result of their service, their alcohol abuse can be particularly dangerous and destructive.
Veterans deserve respect and gratitude. They also deserve support and sympathy. The realities of military service are hard to reconcile, and some veterans find escape in a bottle. Thankfully, there is hope for any veteran struggling with alcohol use disorder (AUD) and hope for their friends and family as well.
PTSD and Vets
Post-Traumatic Stress Disorder (PTSD) is nothing new, but it’s only beginning to be understood. Soldiers from every era in history have had to grapple with mental scars as a result of their experiences in war. But it was only recently that we began to understand how deep these scars run and how important it is for anyone with PTSD to seek out therapy and treatment.
Anyone can suffer from living through a traumatic event. In fact, as much as 8% of the US civilian population struggles with this condition. Due to the unique experiences of veterans, however, the rates of PTSD are much higher. For veterans of the Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) the rate is as high as 20%. Over their lifetime, up to 30% of Vietnam War veterans experience PTSD.
The violence and danger of war are one cause of PTSD, but not all veterans who suffer from this condition had a traumatic battlefield experience. For example, PTSD can be exacerbated by other mental health issues, or be related to deeply-held personal and political beliefs. PTSD in women veterans may be related to sexual assault. The point is that the popular notion of veterans suffering from “shell shock” is entirely incorrect. PTSD is a complex condition that has as many causes as it has symptoms.
Alcohol Abuse and PTSD
It makes sense that stressful events trigger stressful feelings. Anyone who suffers through a trauma is likely to have a lingering negative reaction. One of the defining features of PTSD is that those reactions linger for an irrational amount of time. Generally, feelings that last longer than 3 months, cause great distress, or disrupt work/life are considered problematic.
There are four distinct symptoms associated with PTSD:
Reliving the Traumatic Event
This could come in the form of nightmares, persistent flashbacks, or through triggers that recall memories of the event(s).
Changes in Feelings and Beliefs
PTSD can cause veterans to adopt negative or paranoid feelings about people, relationships, places, or ideologies.
Avoiding Situations that Cause Triggers
Veterans with PTSD may avoid people, places, images, or objects that cause them to remember and relive their trauma.
Feelings of Hyper-Arousal
Veterans who feel jittery and anxious all the time have trouble sleeping or relaxing, which are possible indicators of PTSD.
Alcohol abuse is not a direct symptom of PTSD. However, in order to manage the direct symptoms, veterans often turn to alcohol. Imagine a vet who is haunted by memories, struggling to sleep, and anxious in his own skin. The intoxicating effects of alcohol dull those feelings (at least temporarily) and offer relief from the trauma that dominates the veteran’s life.
There is a strong correlation between PTSD and substance use disorder (including both alcohol and drugs). More than 20% of veterans with PTSD also have SUD. Similarly, almost a third of veterans currently being treated for SUD also have PTSD. The veterans who have both diagnosis tend to be binge drinkers, which is the most dangerous way to abuse alcohol.
Heavy Drinking and Vets
Alcohol may provide some temporary relief from PTSD, but over time it only makes the symptoms worse. And if the drinking is particularly problematic, it can become its own form of trauma and inflict even greater mental and physical scars. Here are some examples of how heavy drinking makes it harder for vets to overcome PTSD and re-enter society as positive and productive participants:
PTSD makes it difficult to sleep, and so does alcohol. Even when alcohol does induce sleep it is often turbulent and restless. The long-term effects of a lack of sleep create a lack of mental clarity and a pervasive feeling of exhaustion.
PTSD encourages veterans to avoid their bad memories and to put off addressing their problems. Alcohol erodes that motivation even further by offering a temporary escape. But, ultimately, alcohol allows veterans to avoid confronting their trauma, which makes treatment and recovery even harder.
PTSD makes it harder to enjoy friends/family, hold down a job, pursue hobbies, or be the person that veterans really want to be. Alcohol has the same effect. Alcohol abuse only creates more stress for veterans who are trying to put their wartime experience behind them and live civilian life to the fullest.
PTSD produces feelings of anger, irritability, and depression. These are all feelings that alcohol amplifies. As a result, the social isolation that vets experience as a result of PTSD is only made worse when they drink in order to cope.
Signs of Alcohol Use Disorder in Vets
It can be difficult to define problematic drinking and to separate it from veterans who are simply blowing off some steam. Not every veteran who enjoys a night out has a problem with alcohol or PTSD. Conversely, now every vet who has alcohol use disorder suffers from pronounced symptoms.
It’s important to understand that alcohol use disorder is different for everyone. More so, the tough, self-reliant culture of the military makes it hard for some vets to acknowledge they have a problem with alcohol and to seek out help. It may be up to friends and family to notice the problem and push the vet to get help. Here are some signs that could signal alcohol use disorder:
Someone who spends a lot of time drinking, whether alone or with others.
Someone who thinks or talks about alcohol a disproportionate amount, as if it’s in control of their thoughts and actions.
Someone who continues to drink despite facing negative consequences for their physical or mental health.
Someone who needs to drink more in order to experience the same level of intoxication.
Someone who suffers from alcohol withdrawal symptoms including trouble sleeping, shakiness, sweating, or anxiety.
Effect of AUD on Families
A veteran may be the only one suffering from PTSD, but that does not mean he or she is the only victim. If trauma (or any other trigger) causes a veteran to begin drinking heavily, their family and friends suffer consequences as well. Trying to help a problematic drinker causes tremendous amount of turbulence in families, which, unfortunately, can also cause someone with AUD to drink more. Every family is different, but here are some common examples of how heavy drinking hurts spouses and kids as well:
Growing Jealousy
The foggy mental state created by alcohol often leads to feelings of jealousy. Affected family members may also feel jealous of veterans who are consumed by their own problems rather than focused on the needs of the family.
Conflicted Partnerships
Alcohol also causes people to become confrontational while producing resentment in their spouse or partner. Increased dependence on alcohol can also cause veterans to become withdrawn and self-centered.
Conflicted Parenting
Alcohol abuse can also strain relationships with children. More importantly, having a parent with AUD can cause a child to become scared of that person or to disrespect his or her authority.
Money Problems
Drinking is an expensive habit that also makes it difficult to hold down a job or earn a steady income. Alcohol also leads to impulsive or irrational spending that may put the family finances in jeopardy.
Emotional Scars
The effects of alcohol can cause people to lash out, act cruelly, and say extremely insensitive things. This type of emotional abuse is particularly hard on partners and children who are eager to reconnect with a veteran who has recently returned home.
Family Violence
Consuming excessive amounts of alcohol can lead to aggressive behaviors and physical violence towards partners or children. Family strife can also lead to violence against the veteran.
Infidelity
The same factors that can drive veterans to drink can lead them to seek out the physical pleasures of sex. A strained relationship with a partner also makes it more likely that person will seek out someone else.
Formal Separation
The stress of living with someone who is drinking excessively and possibly also dealing with other issues can lead to separation, divorce, or intentional isolation.
Bad Influence
People are influenced by their surroundings, especially children in the formative stage of their lives. Problematic drinking makes it more likely that kids or others will struggle with alcohol abuse as well.
Resources for Veterans with Alcohol Use Disorder
https://www.vets.gov/health-care/health-conditions/substance-use-problems/
Veterans who are diagnosed with AUD have several options through the VA. These include medication options, treatment, such as outpatient, inpatient and IOP. Within these treatment options, the veteran receives individual and group therapy, marriage and family counseling, and continuing care and relapse prevention. If the veteran has a VA primary care provider, they can speak to their doctor about their problems with alcohol. If they served in Operation Enduring Freedom, Operation Iraqi Freedom or Operation New Dawn, by calling their local VA medical center and asking for the OEF, OIF or OND coordinator, they may be able to find help.
https://www.ncadd.org/about-addiction/drugs/veterans-and-drugs
This site also provides information on addiction, depression, PTSD and seeking help. Unfortunately, the stigma of addiction and mental illness stops too many veterans from seeking the help they need. This site also encourages veterans and their family members to gather the support they need and reach out so they can begin recovery.
https://www.opioidtreatment.net/inpatient-drug-rehab/veterans/
This website provides links to alcohol treatment facilities for veterans suffering from AUD. VA regulations do apply for vets seeking help.
https://www.militaryonesource.mil/-/help-for-veterans?inheritRedirect=true
This website directs veterans in need of alcohol abuse treatment to available treatment resources. Since so many of our veterans today suffer from post-traumatic stress disorder (PTSD), a link is provided for those vets who believe they may be suffering from this disorder.
https://www.va.gov/directory/guide/SUD.asp
The U.S. military is highly vested in ensuring that its military force is as healthy as it can be, physically and emotionally. The Department of Veteran Affairs maintains a substance abuse disorder program locator. Treatment programs are available in all 50 states, the Philippine Islands, American Samoa, Guam, the U.S. Virgin Islands and Puerto Rico.
https://maketheconnection.net/conditions/problems-with-alcohol
This resource is not a treatment facility. Instead, it encourages veterans with AUD to reach out to resources for the help they need—beginning with their physician, local support groups, mental health professionals, the Vet Center or a spiritual/religious adviser. Another link on this page directs veterans to finding treatment for their alcohol dependence.
https://www.ncadd.org/about-addiction/drugs/veterans-and-drugs
This site also provides information on addiction, depression, PTSD and seeking help. Unfortunately, the stigma of addiction and mental illness stops too many veterans from seeking the help they need. This site also encourages veterans and their family members to gather the support they need and reach out so they can begin recovery.
Treatment Centers with Veterans Programs
https://newstartrecoverysolutions.com/northern-california-veteran-drug-addiction-alcoholism-rehab/
This rehab facility customizes its treatment offerings to veterans suffering from AUD (alcohol use disorder). Veterans living in northern California get referrals from the Northern California VA for an addiction assessment.
https://casapalmera.com/specialty-treatment-programs/military-service/
Casa Palmera is a private substance abuse treatment facility that is Tricare-certified. This means that veterans suffering from AUD can enter this program to get the help they need, with Tricare covering the costs.
https://www.theredpointcenter.com/
This treatment facility offers several treatment modalities for its residents. Adventure therapy and intensive trauma therapy are also offered.
https://foundrytreatmentcenter.com/
Veterans seeking help from the Foundry Treatment Center learn to live sober. They also learn how to create a new, healthy lifestyle, creating life goals.
https://www.stjoestreatment.org/help-for-a-loved-one/veterans-residential-services/
At St. Joe’s, veterans with AUD work individually, in group sessions and in family sessions to address their addiction and its causes. While in residence at St. Joe’s, veterans are also encouraged to explore their spirituality. In addition, veterans are encouraged to focus on vocational skills as they reintegrate into society. This facility is fortunate to have a trauma therapy dog. Hershey, the therapy dog, aids all veterans, providing emotional support.
This facility offers a Veteran Scholarship Package, providing several amenities, such as reduced rates, private suites, massage therapy, EMDR (Eye Movement Desensitization and Reprocessing), biosound and biofeedback.
https://www.voamid.org/veteransaddictionrecovery
This small facility, established in 2013, targets only dually-diagnosed homeless veterans and homeless veterans. Its 10-bed facility provides veterans a place to live for 90 days as they complete treatment. Vocational training and community employment training are also offered to each vet.
https://www.texvet.org/resources/aliviane-inc
This treatment facility in El Paso, Texas has been in operation since 1970. Veterans who live in El Paso or surrounding areas can request services from Aliviane; they will receive intervention, treatment, prevention and recovery support services.
https://www.texvet.org/resources/el-paso-behavioral-health-system-east
https://www.texvet.org/resources/el-paso-behavioral-health-system-northeast
The professional and clinical staff are particularly passionate about serving the military population in this part of the state. It has a designated, military-only unit, as well as a women-only unit and a military women’s program. Because this program is 28 days long, veterans will receive the basics of recovery. They will also go through crisis stabilization, if they need this. Veterans can take advantage of a partial-hospitalization outpatient program. Treatment modalities include 12-step facilitation, EMDR, DPT, DBT, motivational interviewing and DBT.
https://www.texvet.org/resources/peak-behavioral-health-services
Located near El Paso, Texas, in Santa Teresa, New Mexico, PEAK provides inpatient services for veterans addicted to alcohol. Its Mission Recovery Program is tailored to active duty military. This program provides treatment for adults with chemical dependency and a variety of behavioral, emotional and cognitive issues. Services include family therapy, individual therapy, physical training and art therapy. All therapeutic modalities are evidence-based. PEAK boasts military veterans on staff and will consult with commanders. Work is done in partnership with military treatment facilities as well.
https://www.warriorsheart.com/alcohol-abuse/
This alcoholism treatment facility accepts veterans from all over the United States. Certified counselors who, themselves, have suffered the effects of PTSD and addiction within their families, provide counseling and support to veterans who want to enter recovery. Staff members are highly aware that alcohol masks symptoms of PTSD and leads to symptoms of depression.
https://www.recoveryways.com/veterans-with-ptsd-and-addiction/
People (including veterans) with PTSD try to self-medicate so they can get some relief from their hyper-awareness, flashbacks, nightmares, depression and anxiety. Alcohol is the most common substance used by veterans suffering from PTSD. Recovery Ways uses an integrated system of treatments to teach veterans that they can live life free of alcohol addiction. This facility provides spiritual and social activities for its residents to take part in. Each person’s trauma is treated with a combination of therapy and medication. Veterans with co-occurring disorders, such as PTSD or depression receive treatment for both the disorder and their addiction.
https://www.recoveryfirst.org/veterans/alcoholism/
With facilities in Florida, Recovery First explains the treatment options available for veterans who have realized they are addicted to alcohol. These include a short-term inpatient facility, intensive outpatient treatment (IOP), residential/inpatient treatment, marriage and family counseling, self-help and mutual support groups, such as SMART or Alcoholics Anonymous, and facilities that provide support for specific demographic groups. Residents undergo medically supervised detox, then start to go through the assessment process. They learn what mental health issues they may have, including traumatic brain injury (TBI). Then, they begin the treatment process.
https://www.tarzanatc.org/us-veterans-alcohol-and-drug-treatment/
This facility provides both alcohol and drug treatment, using integrated behavioral healthcare modalities that have been specialized for the unique needs of U.S. veterans. Addiction counseling and mental health support are available while the veteran is receiving treatment. Treatment facilities are located in Los Angeles, California, Orange County, Los Angeles County and Antelope Valley (in Lancaster). Other facilities are available in Northridge, Long Beach and Reseda, located in the San Fernando Valley.
https://tranquilshores.org/specialty-services/military-rehab/
At Tranquil Shores, military veterans receive the alcohol addiction help they need. This program also treats other substance abuse issues. In Tampa, Florida, this program is located so veterans can focus on their need to recover. Because AUD develops in conjunction with depression or PTSD, treatment for co-occurring disorders is also provided.
https://blackbearrehab.com/ptsd/treatment-options-for-military-veterans/
Black Bear Lodge has a treatment program for veterans suffering from AUD. If the veteran also suffers from depression, PTSD or bipolar disorder they will receive treatment for their addiction and for their mental illness. Treatment options include individual counseling and group counseling. Black Bear Lodge will help veterans access their military benefits so they can begin their recovery journeys.
https://www.beachway.com/veteran-substance-abuse-program/
Here, veterans receive treatment customized to their unique experiences and needs. The experience staff understands the importance of the right treatment and even the right staff members to a veteran’s ability to gain recovery. Staff includes doctors, nurses, psychiatrists, addiction counselors and case managers.
https://www.therecoveryvillage.com/resources/veterans/
The Recovery Village has a program especially designed for veterans suffering from mental health issues and alcohol abuse issues. Once the veteran has been examined, evaluated and detoxed, they begin their rehabilitation program. With facilities in Washington, Colorado, Florida and Ohio, veterans can find a facility that is not too far for them to travel to. Here, they will receive outpatient care, residential care, partial hospitalization, medical detox, medication-assisted treatment, treatment for co-occurring disorders (mental health issues coupled with addiction) and aftercare services.
https://luxury.rehabs.com/drug-rehab/rehab-for-navy-army-or-marine-veterans/
This website provides links to treatment centers for veterans in every branch of the military—Marines, Navy, Air Force and Army. The treatment specialists know that several factors combine to create PTSD, mental health issues and alcohol abuse within the individual veteran. Working with the VA, Rehabs tries to extend help to every veteran who needs support and treatment.
https://www.serenitylightrecovery.com/
This facility in Angleton, Texas provides inpatient services to veterans suffering with alcohol dependency and co-occurring mental health issues. Veterans undergo assessment and inpatient treatment, which lasts 30 to 35 days. Along with 12-Step work and counseling, psychoeducational workshops, biofeedback and brain mapping are offered. A trigger awareness program helps to prevent relapse.
Veterans with co-occurring disorders will receive a targeted dual diagnosis treatment. The treatment plan is created with the veteran’s specific needs in mind. Family members can take part in a family program. Aftercare support is also available, so the veteran doesn’t relapse.
Treatment Options
Overcoming AUD is not easy, and there is no one-size-fits-all treatment. It takes time to make positive changes, and veterans often have to mix and match treatment options according to their individual needs. Luckily, there are a number of options to choose from:
Behavioral Treatments
These are offered in individual or group settings and aim to change a person’s drinking habits through counseling and targeted therapies.
Medication
There are several prescription medications designed to discourage people from drinking. They are only available by prescription and are often used in conjunction with counseling.
Support Groups
Groups like Alcoholics Anonymous (AA) and others provide a supportive and anonymous environment for anyone to discuss their issues and avoid the temptation to drink.
Rehabilitation Facility
If a more extreme intervention is necessary, the best place for a veteran with a drinking problem may be in a dedicated rehabilitation facility. There they can get round-the-clock monitoring and support, plus a space to confront their problem head on.
Sources: