Military Veterans and Substance Abuse: How Best to Handle PTSD

Military veterans provide a valuable service to our country — but for many of them, it comes at great cost in the form of post-traumatic stress disorder, or PTSD.

PTSD can have a devastating effect on a person’s life. For military veterans, the stress of combat can trigger symptoms such as horrible flashbacks, negative thoughts, loss of self-esteem, feelings of guilt and shame, outbursts of anger or aggression, and depression or anxiety. Someone with PTSD may feel continually on edge or experience a numbness to the enjoyable things in life. It can be easier to avoid everything associated with the trauma rather than deal with the troubling side effects. That urge may explain why some people with PTSD turn to drugs and alcohol, and why the problem of military veterans and substance abuse is a very real one that requires treatment.

PTSD and Substance Abuse

The relationship between substance abuse and PTSD can be deeply ingrained. In some cases, veterans return from a tour of duty and develop PTSD, and then turn to drugs, alcohol, or other substances as a way to cope. In other cases, someone may have a preexisting substance use disorder and that can trigger the symptoms of PTSD. And in still other instances, military veterans who sustained injury or are dealing with a mental health issue may be prescribed powerful medication — such as Valium, Vicodin, or Oxycontin — that, if not properly managed, can lead to abuse or even addiction.

Unfortunately, cases of PTSD co-occurring with a substance abuse problem aren’t isolated incidents. Two out of 10 veterans who have PTSD also have a substance use disorder, according to the U.S. Department of Veterans Affairs. The federal department also estimates that about 1 in 3 veterans who seek treatment for substance use disorder also have PTSD. And even if a veteran doesn’t present with a substance use disorder, that doesn’t mean there is no danger of it happening in the future. For instance, about 1 in 10 veterans of the Iraq and Afghanistan wars reported having issues with drugs and alcohol. Veterans Affairs also reported that active military and veterans drink more than civilians, and that veterans who reported having problems with alcohol tend to binge drink, which means they consume five or more drinks in a short time. Binge drinking is a disorder that carries a high risk of spiraling into alcoholism.

If either PTSD or substance use disorder is left untreated, it can pose grave health risks and lower the person’s quality of life. That is why it’s so important to understand how veterans can handle substance abuse and PTSD.

Ways to Cope with PTSD and Substance Abuse

One of the most important things to note is that PTSD and substance abuse can co-occur, which means they are both present and interrelated. Because of that, the greatest chances for successfully coping with them is to treat them together at the same time. Military veterans who are seeking treatment for both PTSD and substance abuse should look for a program that offers treatment, resources, and services for both conditions.

There are several different kinds of therapies that can help with PTSD and substance use disorder, and a treatment plan should be tailored to each individual patient. It can include a mix of therapies in combination to address specific concerns.

Generally, PTSD treatment can include some form of trauma-focused psychotherapies. Cognitive Processing Therapy (CPT), for instance, helps patients identify negative thoughts surrounding the trauma and change their beliefs so they aren’t as hurtful. Another form is Eye Movement Desensitization and Reprocessing (EMDR), in which a therapist guides patients through specific memories and feelings while they pay attention to a sound or movement. This helps the brain process the trauma and can lead the way to cognitively re-framing the incident. With Prolonged Exposure Therapy (PE), there is no avoiding the trauma — instead, patients face it head on by talking about it repeatedly with a therapist.

For substance abuse, there are also several kinds of therapy modalities that can be implemented. Patients can enter a rehabilitation treatment program to detox from the substance they are addicted to. While in the program, they can also work with counselors on relapse prevention and start Cognitive Behavioral Therapy, which aims to make negative behaviors, emotions, and thoughts more positive.

One form of therapy that integrates techniques aimed at both disorders is called Concurrent Treatment of PTSD and SUDs using Prolonged Exposure, called COPE. Generally, COPE programs combine Prolonged Exposure with relapse prevention, along with education on the interaction between PTSD and substance abuse. Treatment programs can also focus on specific symptoms, such as anger issues or mental health disorders like depression, and employ techniques such as family counseling and support group meetings.

Some veterans may hesitate to seek treatment if they are concerned about how it will affect their lives, whether they are still in the military or if they have re-entered civilian life. Programs that offer confidentiality and resources for transitioning from treatment to normal life are crucial in order for patients to feel supported and safe. The goal for treating military veterans and substance abuse/PTSD is to improve their quality of life so that the trauma doesn’t define them. They should get the tools and help they need to move on and move forward.