Substance Abuse Within the Military

This is a contributed article by Helen Young:

 Military troops and veterans are generally regarded to be some of the most disciplined and 'strong' members of our society. So it may come as a surprise to learn that they are just as susceptible, if not more, to substance abuse and addiction as other civilians. Research indicates that tobacco, alcohol and prescription drug abuse are on the rise within the US military forces and factors such as the stressful nature of their job, military culture and trouble integrating back into society following a period of deployment (along with the possibility of PTSD) are thought to be some of the reasons behind these surprising statistics. 

We are all guilty of making judgmental assumptions when it comes to those who are 'most likely' engage in substance abuse, but there are actually several unlikely sections of society that are suffering. Military troops and veterans fall into this category. Here are some of the reasons behind this invisible abuse.

Alcohol culture

People in the military may abuse alcohol for the same reasons that civilians do – because they want to unwind, relax and forget about their problems. It is estimated that 47% - almost half – of servicemen and women binge drink on a monthly basis. This figure is similar to that of college students - perhaps a less surprising section of society to engage in alcohol abuse. Along with drinking as a stress reliever, there is also a certain culture within the military in which servicemen may ritualistically get together over a few drinks to socialize and bond. Indeed, research states that historically alcohol was used as a form of 'man management' to encourage and allow men to let loose and relive stress. But when this stops being an occasional, enjoyable pastime and starts to become a dependency it can have real consequences. Being drunk or hungover can majority impact cognitive function, reducing readiness and making you less equipped to fulfill your duties properly. In the military this can have life endangering consequences for both you and your colleagues.

Tobacco

Like alcohol, tobacco is legal but in vast quantities can be detrimental to the health. It might not present the same sort of immediate performance issues as drinking or drug abuse but over time it can have a serious impact on overall health. Similarly to alcohol, tobacco use tends to begin after joining the military with one study indicating that 30% of smokers within the military began after joining. Again, this could be seen as a coping mechanism or way of fitting in with peers.

Drug dependency

The military issues a strict zero tolerance policy in regards to illicit drugs so rates of this sort of substance abuse are generally quite low. However, it still remains one of the top reasons for military discharge in the United States. Prescription drug abuse, however, is another matter. One study placed the rates of prescription drug use within the military at 11.7% which is two and a half times higher than prescription drug use in civilians. When servicemen are required to monitor and regulate their own intake of anti-depressant medication, opiate painkillers and other prescription drugs it can lead to unintentional misuse and later, addiction. This can have a very detrimental effect on both their personal and professional lives, especially when faced with the possibility of running out of their medication and being forced to go cold turkey.

Post Traumatic Stress Disorder and Integration Issues

During or after a stint in the military, especially after being involved in combat or working within a warzone, many servicemen experience after effects from the traumatic things they have witnessed or been involved in. Many servicemen returning from combat are though to suffer from substance abuse and PTSD with studies revealing a clear link between the two. Once home, integrating back into normal life following a deployment can also be a tough adjustment. Returning servicemen may feel isolated, bored or unable to simply slot back in to their previous life. In this situation they may turn to substance abuse in an attempt to dull the pain and mask their emotions. They miss the support and camaraderie of their fellow troops and feel disconnected from those around them, even if they have a tight knit and loving family and friendship circle. This is why therapy and treatment are so essential to those suffering from mental illness or trauma following (or during) their time in the military.

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Post-Traumatic Stress Disorder and Alcoholism - an article by Helen Snider

Vietnam Veterans, Alcoholism, and a New Perspective

Every Vietnam veteran is a hero but it would seem that not everyone remembers that: In fact, the issues faced by Vietnam veterans have been sorely overlooked by the central Government since the end of the conflict and this continues to this day. Approximately nine million American men entered military service during the lengthy process of the Vietnam war (which has the dubious honor of being America’s longest war) and yet public spending on veterans has been consistently low and consistently inconsistent (with the average vet in Boston receiving $25,000 per annum in benefits, whilst the average vet in Cape Cod receives just $5,500 per annum in benefits, for example). This poor treatment has served to exacerbate feelings of being disconnected from society for some veterans, leading to post-traumatic stress disorder, alcoholism, drug misuse, and other mental health disorders cause by trauma.

Post-Traumatic Stress Disorder and Alcoholism

60 to 80 per cent of Vietnam veterans seeking treatment for post-traumatic stress disorder
 (PTSD) are also presenting with some form of alcohol abuse. The Veterans Administration who primarily deal with the care of veterans from Vietnam conservatively estimate that between 500,000 and 700,000 of Vietnam veterans are still experiencing severe mental and social problems related to their experiences whilst they were in Vietnam. Significant numbers of this vast number of men are also alcoholics. In layman’s terms, these men are choosing to use alcohol to numb the pain and attempt to erase the memories of what they experienced when they were on active duty in Vietnam.  It is interesting that most veterans choose alcohol rather than illicit drugs, no doubt because of the socially acceptable nature of choosing to drink a beer or head to a bar: staying within the confines of the law and under the radar of what is societally normal is important here. It is clear, then, that alcoholism is a problem and has been a problem for many Vietnam Vets.

Treatment Options

Treatment plans for alcoholic veterans, particularly those veterans who are also presenting with some form of Post-Traumatic Stress Disorder, has always been vigorous and intensive. Often involving intensive therapy with a trained psychologist, the two conditions are treated simultaneously. Group counselling is recommended as the most successful form of treatment, which is generally offered in VA centers alongside other veterans, as many emotionally battered Veterans, particularly those suffering from post traumatic stress disorder, struggle to trust or connect to others but find it easier to open up to and forge relationships with those that have experienced the same war time situations of themselves. The goal of those counselling sessions and treatment plans is to cure both the PTSD and the alcoholism with complete abstinence and sobriety.

Yet a new perspective posed by new research from the FDA could change that, although no one knows yet what impact this might have on veterans. Sobriety has always been the main goal of all alcoholic rehabilitation programs: this includes both expensive residential rehabilitation centers and the free AA support groups that are held in every town up and down the country. Now though the FDA have turned this on its head by suggesting that complete sobriety now doesn’t have to be the sole goal of treatment for alcoholism. In February they drafted an article that proposed that sobriety and complete abstinence was no longer essential for an alcoholic to no longer be considered ‘sober’: instead reduced drinking and consistent ‘non heavy drinking’ days would have the same effect. This flies in the face of the conventional wisdom that alcoholics are, by the very nature of their condition, unable to have just a drink or two and that they will always be vulnerable to the impact of ingesting alcohol regularly.                     

How this new report will affect the treatment plans of vulnerable Vietnam veterans is yet to be seen: the concept of allowing an alcoholic to still drink regularly seems counterproductive to the hard work of the therapy and counselling they have already undertaken. And these brave veterans who have already given so much for their country certainly don’t deserve to be used as guinea pigs to test this new theory from the FDA.