Active duty and retired military members are not immune to the substance use problems that affect society. There are significant deployment stressors during wartime, along with the unique culture of the military, which increases the risk of drug and alcohol addiction. For example, someone who has gone through multiple deployments and had combat exposure and related injuries are at the greatest risk of developing an addiction. Unfortunately, the number of active duty service members that ask for help is low. There are zero-tolerance policies and a significant stigma surround addiction in the military that prevent most active duty service personnel from not asking for help.
According to the National Institute on Drug Abuse, deployment is associated with smoking initiation, unhealthy drinking, drug use, and risky behaviors. Within the military are zero-tolerance policies, lack of confidentiality, and mandatory random drug testing that deters drug use. Still, it also adds a stigma and may discourage people from asking for help. However, there are treatment options and services provided within the military for active-duty personnel and retired veterans. Treatment services are provided through health insurance providers, Veterans Affairs, and programs like counseling and therapy provided within the military.
Although there are still barriers for those who need help. Per NIDA, half of the military personnel have reported that they believe seeking help for mental health issues would negatively affect their military career. Active duty service members can even face a dishonorable discharge and criminal prosecution for a positive drug test. Overall, illicit drug use in the military is relatively low, and prescription drug misuse has declined, yet binge drinking rates are high compared to the general population. More than one in ten veterans have been diagnosed with a substance use disorder, which is slightly higher than the general population.
How do Drug and Alcohol Treatment Programs Operate for Members of the Military and Veterans?
According to an article talking about substance abuse prevention, treatment, and research efforts in the military, the United States Congress has identified options to address substance abuse within the military. The Department of Defense has substance abuse policies that are implemented by various DOD components and each military service. The focus is on administrative and medical approaches to prevention, screening, treatment, compliance, and retention/separation. The substance abuse policies involve conducting substance use education and awareness activities and implementing a urinalysis drug testing program.
Additionally, the DOD conducts regular and systematic medical screening for at-risk substance use and provides evidence-based substance use disorder services to eligible services members. The purpose is to return service members to full duty following substance use disorder treatment, if feasible. Also, the DOD will separate all service members who knowingly misuse drugs. The rehabilitation process operates the same way as any other program, but it is specific to active duty service personnel. Also, TRICARE health insurance provides treatment options for its members who have a health insurance plan. TRICARE is one of the primary health insurance providers for the United States Military.
According to the Department of Defense, service members may receive addiction treatment at certain military treatment facilities or through TRICARE, which contracts civilian healthcare providers. The services covered by TRICARE may include inpatient services, medication-assisted treatment, office-based opioid treatment, partial hospitalization, and residential programs. The DOD also mandates prevention efforts, and substance abuse education is provided to all service members. Each military service operates a substance abuse prevention program that provides a wide range of education and training services.
These services are targeted to individual service members, health providers, and unit commanders. Prevention efforts also include the Drug Take Back programs at every military treatment facility. There is also active health surveillance for at-risk service members and annual screening for problematic substance use behaviors. Services provided internally are a good option, and active duty service members can access civilian programs through TRICARE.
Substance Abuse Among Military Personnel and Veterans and Treatment Options
According to the National Institute on Drug Abuse, as mentioned above, the reported rates of illicit drug use increase when active-duty personnel leaves military service. Among veterans, marijuana is the most widely used drug, with 3.5% reporting use. Also, approximately 1.7% report the use of illicit drugs other than marijuana. Pain medication abuse is also problematic because many veterans have unique pain management issues and two-thirds report they experience pain. Veterans Health Administration reports that the number of veterans receiving opioid prescriptions increased from 17% to 24%.
Additionally, opioid overdose rates among veterans increased to 21% in 2016 from 14% in 2010. A 2017 study cited by NIDA mentions that veterans were more likely to use alcohol and report heavy alcohol use. Approximately 65% of veterans who enter a treatment program report alcohol as the most frequently misused substance. Moreover, suicide deaths among active-duty military and veterans exceed the rate for the general population.
In 2014, veterans made up 20% of national suicides, and in 2016, the suicide rate was 1.5 times greater for veterans. Unfortunately, substance abuse is a common underlying factor for suicidal behavior in the military. Along with veterans struggling with addiction, approximately 11% of the U.S. homeless population are veterans. Veterans can access services through the Veterans Health Administration and Veterans Affairs. However, programs are often limited, and veterans must rely on civilian programs, whether private or public. Health insurance also covers treatment services, and TRICARE provides coverage for retired military personnel.
Substance Abuse in The Military and the Best Time to Consider Substance Use Treatment
Substance abuse and addiction impact all areas of the military, and the problems are often overlooked despite more effort made to help those struggling. According to an article written by the U.S. Army, it had the highest rate of alcohol-related trips to the hospital between 2009 and 2018. The Army was followed by the Marine Corps, Navy, and then Air Force, according to a study released by the Defense Department. In March of 2019, an Army directive was signed by the Secretary Of the Army Mark Esper, which made it that soldiers can now seek treatment for alcohol abuse without fear of career consequences. The Army directive allows soldiers who meet specific criteria to receive care without notification to their commanders, as long as the criteria for non-notification are meth and maintained through voluntary care.
An article published by the Military Times talks about how combat troops are at a higher risk for opioid and heroin addiction. The article cites a paper published by the National Bureau of Economic Research, which points out that combat exposure puts troops and veterans at substantial risk for abusing pain medication and heroin. The study indicated that opioid abuse among combat-exposed veterans was 7% than those who deployed but did not see combat. Also, combat exposed personnel uses heroin one percent more than other service members. Unfortunately, about one-third of opioid abuse among service members and veterans is due to war injury and pain management. Heroin abuse was linked to about of service members who suffered a war injury.
The best time for active duty service members and veterans to seek addiction treatment is immediate. Any form of substance abuse becomes progressively worse. However, there is still a strong stigma within the military, preventing service members from reaching out for help. It is essential for family and fellow service members to be aware of the indicators. Many of the problems that military members and veterans struggle with go overlooked by the general population.
In an article titled Substance Use and Psychological Distress Before and After the Military to Civilian Transition, it explored the high-risk status of substance when military service ends. The findings concluded that alcohol use and prescription drug abuse was similar during active service and post services. However, marijuana and street drug abuse increased significantly in the six months following leaving active duty. Also, of the study participants, only a minority of veterans they knew were doing emotionally well or did not have a drug or alcohol addiction. There is a clear need for substance use and psychological intervention during and after military service, and early intervention is essential.
Problems with Addiction Extend to Services Members and Veterans Families
The issues that service members and veterans face with addiction do impact their families. According to information taken from the 2015 National Survey on Drug Use and Health, a study examined substance use and mental health issues among U.S. military personnel spouses and children. Among an estimated 910,000 military wives aged 18 to 49 in 2015, 12.8% used illicit drugs. Moreover, 5.1% used marijuana, 16.2% smoked cigarettes, and 67.8% drank alcohol, while 31.5% engaged in binge drinking.
Additionally, among the 524,000 military children aged 12 to 17 in 2015, 19.6% used illicit drugs, 10.7% used marijuana, and 9.3% drank alcohol. Approximately 4.6% engaged in binge drinking, and only 0.8% received any substance abuse treatment. Families of military personnel are resilient and endure many hardships. For example, this includes adjusting to extended periods of separation from their military family member. Also, there is uncertainty about when the next separation could be and coping with the risk of serious injury or death. Many of these problems become worse when the service member is struggling with addiction.
Per a 2015 Health-Related Behaviors Survey, approximately 30% of service members were binge drinkers, and across all services, 5.4% of personnel were heavy drinkers. More than one three service personnel met criteria indicative of hazardous drinking or possible alcohol addiction. Also, about 8.2% of service personnel reported one or more serious consequences from drinking. At the time of this report, more than two-thirds of service personnel perceived military culture to be supportive of drinking. Fewer than one in five service members felt their supervisor strongly discouraged alcohol use.
Additionally, about one in seven service members reported past-month use of at least one type of prescription drugs, and pain medication was the most commonly used. For example, sedatives, pain medication, and antidepressants were more likely used by women than men and by personnel in the Army than in any other services. Among active duty service members, 4.1% misused one or more prescription drugs. Prescription drug misuse was highest in the Army and lowest in the Coast Guard.
Substance abuse and addiction impact every aspect of the family dynamic and rip millions of families apart every year. Active duty service members and their families face unique problems, and when drug or alcohol addiction is involved, these problems become worse. Treatment is the only solution for members of the military, veterans, and their families.
Common Terminology with Substance Abuse Treatment and Military Personnel/Veterans
|Active Duty Military Personnel||someone who is active duty is in the military full time. They work for the military full time and may live on a military base, and can be deployed at any time.|
|Military Veterans||a military veteran is a person who has served and is no longer serving in a military. Military veterans that have served directly in combat in a war are further defined as war veterans.|
|Alcohol Addiction||Alcoholism is the inability to control drinking due to both physical and emotional dependence on alcohol. Someone with an alcohol use disorder may have problems controlling their drinking, continue to use alcohol even when it causes problems, or have withdrawal symptoms when they stop drinking.|
|Binge Drinking||the problem is defined as a drinking pattern that brings a person's blood alcohol concentration to 0.08g/dl or above. This happens when five or more drinks are consumed within two hours. Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States.|
|Prescription Drug Addiction||the misuse of prescription drugs means taking medication in a manner or dose other than prescribed. The three classes of medication most commonly misused are opioids, central nervous system depressants, and stimulants.|
|Post-Traumatic Stress Disorder||is a disorder that occurs when a person has difficulty recovering after experiencing or witnessing a terrifying event. PTSD is a common disorder among war veterans and is one underlying issue for substance abuse and addiction.|
|TRICARE Health System||TRICARE is a health care program for uniformed service members, retirees, and their families around the world. TRICARE provides comprehensive coverage to all beneficiaries, which includes treatment options for addiction.|
|Veterans Health Administration||the VHA is the largest integrated health care system in the United States, providing care at numerous health care facilities, VA medical centers, outpatient sites to over nine million veterans.|
|Veterans Affairs||the United States Department of Veterans Affairs is a federal cabinet-level agency providing healthcare services to eligible military veterans at VA medical centers and outpatient clinics located across the country.|
|Department of Defense||the United States Department of Defense is an executive branch department for the federal government charged with coordinating and supervising all government agencies and functions directly related to national security and the Armed Forces.|