Addictions and military service often go hand in hand. Life within the service isn’t always easy, especially for those who see active duty on more than one occasion.
The work done while within the service can leave trauma behind that increases addiction susceptibility. Stigma about addiction can keep you from getting the care you need while in the service, further compounding the problem.
As the recognition of the link between addiction and military service grows, so do the options available to veterans who need addiction care. We’ve outlined a few of the options available to you, along with information on how to access the care you need.
Life while in the service is, by its very nature, highly structured. You are given few to no choices about where you live, what you eat, what you wear, and what you say. You’re asked to obey your superiors and follow their commands at all times. You’re asked to trust that your superiors always have your best interests at heart, so they will not give you commands that aren’t safe for you to follow.
Presumably, no superior officer would command you to abuse drugs or alcohol. Even so, substance use and abuse are remarkably common within the military, and addictions within veterans are also relatively common.
According to a 2015 Substance Abuse and Mental Health Services Administration report, about 6.6 percent of veterans had a substance abuse issue within the year prior. To put this in perspective, the national average is 8.6 percent. Clearly, the addiction rate is lower among veterans when compared to the general population, but far too many veterans deal with an addiction issue on a regular basis.
Any form of addiction can cause damage and trauma, but the types of addictions veterans have can be complex and difficult to overcome. According to the U.S. Department of Veterans Affairs (VA), veterans with addictions often have mental illnesses too, such as post-traumatic stress disorder (PTSD).
Addictions and mental illnesses can augment and worsen one another. Someone with PTSD, for example, might lean on sedating drugs to cope with intrusive memories and vivid nightmares. But when the drugs wear off, those memories can return in a stronger form, and that can lead to heavier drug use.
Treatment for this type of issue involves untangling the two issues, along with offering strategies that can help people to deal with both issues at the same time. This kind of care is, obviously, more intricate than care for an addiction that appears alone. But this is the sort of care that veterans often need. Without it, the mental illness can work as a trigger for drug use, and the drug use can continue to worsen the mental illness symptoms.
According to research published in the journal Drug and Alcohol Dependence, of veterans with an alcohol use disorder, a drug use disorder, or both, between 55 to 75 percent also had a PTSD or depression diagnosis. Research like this demonstrates just how necessary it is for programs for veterans to include treatment for other complicating mental health issues.
Addictions in veterans can also be long-standing by the time care is delivered. As the National Institute on Drug Abuse (NIDA) points out, the military has a zero-tolerance policy for substance abuse, and stigma can be attached to breaking those rules.
As a result, addictions that develop while in active service must be hidden. People who hide their addictions allow them to strengthen and grow. Each hit of drugs can cause damage to brain cells, leading to a lack of control over substance abuse. The longer the addiction persists, the more damage is done.
As a result, veterans with addictions can have years, if not decades, of damage to overcome. They may also have many years of habits that support substance use and abuse. They can recover, but their programs must often be intense to help them deal with the damage that has been done.
Members of the military, including veterans who left the service and meet certain requirements, are eligible for benefits through the U.S. Department of Veterans Affairs. According to the organization’s website, the medical benefits package offered through the VA includes both inpatient care and outpatient care for addiction.
In an inpatient program, you move into the VA center for your care. Your meals are provided, your housing costs are covered, and you have access to treatment around the clock. You’re also protected from the temptations that may exist within your home or your neighborhood, as you’ll be in a secure and sober environment.
In an outpatient program, you head to a VA center for a series of appointments to help you work on your addiction. You might access medications, therapy, or both. When you are not engaged in your appointments, you will be at home with your family. You also may be able to keep working while you’re engaged in this form of care.
The care covered by the U.S. Department of Veterans Affairs is delivered at VA and Vet Center facilities, according to the organization’s website. Veterans can contact the center nearest them to access this level of care, or they can call a hotline on the VA website to find out where the center closest to them is located.
Unfortunately, there are a limited number of VA facilities within the United States, and their locations may not be convenient for all veterans who need help.
According to research published in the journal Substance Abuse and Rehabilitation, 41 percent of those enrolled in the VA system live in rural areas, and for these veterans, access to mental health care is difficult to receive. They may not be cleared to enroll in inpatient programs, but they may not be able to travel for hours to access outpatient care on a regular basis. For people in this situation, going without the necessary care might be common.
The VA does offer some forms of treatment with a doctor in primary care settings, and that could be a good option for those who cannot head to a center for treatment. In research about this addiction care approach, published in the Journal of General Internal Medicine, researchers found that the percentage of heavy drinking days was lower in those who got care through a primary care doctor when compared to those who got care in a VA treatment center.
This research suggests primary care appointments could work for some veterans with some types of addictions.
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While getting treatment through the VA might seem like the only option for veterans, there are plenty of other solutions available. Some of those solutions are available through participation in a private insurance program.
According to the United States Census Bureau, just 5.5 percent of working-age veterans were uninsured in 2016. This means most veterans have some kind of private insurance, and many plans offer coverage for addiction care.
Accessing that care can begin by calling the insurance company, asking how coverage works, and learning more about the facilities that accept payments from the insurance company. With this option, veterans can find a treatment program they like that is near to them, or that seems to offer the environment that is right for them.
They can call the facility to ask about insurance payments. Most private addiction treatment companies are adept at answering questions about payment. They may even be able to facilitate conversations with insurance companies to maximize benefits.
Many veterans choose to get care from a provider that is outside the VA system. In fact, in research conducted by Westat, researchers found that 63 percent of VA enrollees got care from an outside provider. They did so because they felt the provider offered:
How can you determine if the program you’re considering is effective and trustworthy?
According to NIDA, it is vital to ask about the steps the program uses. Reputable programs will include detoxification, counseling, medication, mental health treatment, and follow-up care for relapse prevention. If a program offers this comprehensive form of care and seems appealing to you, it could be a good choice.
Most private addiction treatment programs offer robust websites, so you can seek out the facilities that interest you and find out more about what they offer and how they work. You can call these facilities to learn how they might address your specific need for recovery, too.
Many programs have experience working with veterans and addressing the unique issues they face in recovery. Don’t be afraid to ask about their experience in this area. That information could be vital to the success of your program.
(May 2015). 1 in 15 Veterans Had a Substance Abuse Disorder in the Past Year. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/data/sites/default/files/report_1969/Spotlight-1969.html
U.S. Department of Veterans Affairs. Mental Health. Alcohol and Drug Misuse. Retrieved from https://www.mentalhealth.va.gov/substance-abuse/index.asp
(July 2011). Substance Use Disorders in Iraq and Afghanistan Veterans in VA Healthcare, 2001 to 2010: Implications for Screening, Diagnosis, and Treatment. Drug and Alcohol Dependence. from https://www.sciencedirect.com/science/article/pii/S0376871611000263
(April 2018). Medical Benefits Package. U.S. Department of Veterans Affairs. from https://www.va.gov/healthbenefits/resources/publications/hbco/hbco_medical_benefits_package.asp
Treatment Programs for Substance Use Problems. U.S. Department of Veterans Affairs. from https://www.mentalhealth.va.gov/res-vatreatmentprograms.asp
(August 2017). Substance Use Disorders in Military Veterans: Prevalence and Treatment Challenges. Substance Abuse and Rehabilitation. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587184/
(September 2013). A Randomized Clinical Trial of Alcohol Care Management Delivered in Department of Veterans Affairs Primary Care Clinics Versus Specialty Addiction Treatment. Journal of General Internal Medicine. from https://link.springer.com/article/10.1007/s11606-013-2625-8
(September 2017). Health Insurance Coverage of Veterans. United States Census Bureau. from https://www.census.gov/newsroom/blogs/random-samplings/2017/09/health_insurancecov0.html
(April 2018). 2017 Survey of Veteran Enrollees' Health and Use of Health Care: Data Findings Report. Westat. from https://www.va.gov/HEALTHPOLICYPLANNING/SOE2017/VA_Enrollees_Report_Data_Findings_Report2.pdf
(January 2018). Treatment Approaches for Drug Addiction. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction