Addiction is a growing problem in the United States, with opioid addiction and overdose deaths on the rise. But while much of the media reporting about addiction focuses on low-income communities and rural areas that have seen addiction rates spike in light of economic depression, it’s overlooked a particularly vulnerable group: military veterans.
Military veterans, many of whom also have PTSD from their time in battle, experience high rates of addiction, yet medical professionals often overlook their problems. It’s vital that we develop better ways of identifying addiction risks in this population. Our vets deserve better care, and preventing and treating addiction is central to that mission.
Dealing With A Dual Diagnosis
Mental illness and addiction are closely related, with nearly half of those with serious mental illness also meeting the criteria for substance abuse. When assessing veterans for addiction, then, the first step should be to determine whether they are struggling with a mental health condition. This may be PTSD or another condition, such as anxiety, bipolar disorder, or depression. Any of these conditions can increase the likelihood of substance abuse and requires a dual diagnosis treatment program that addresses both problems simultaneously.
Certain symptoms of illness are especially likely to trigger addiction behaviors. PTSD can cause flashbacks, nightmares, and insomnia, such that veterans may use drugs or alcohol to get to sleep and dull the memories, while those with depression may turn to uppers to deal with low mood and persistent sleepiness. Another subset of veterans with traumatic brain injuries (TBIs) from combat may use drugs and alcohol due to loss of inhibitions and impaired judgment.
Addiction From Injuries
Another group of veterans that is vulnerable to addiction are those who were injured in battle, and their addiction is the result of a mixed blessing: modern medicine. Many of these men and women wouldn’t have survived the same injuries in prior wars, but better field medicine means 60% of veterans today have chronic pain from their injuries. The final result: many became addicted to opioids, and the VA may be partially responsible for that.
A study of patients who received surgery at the VA showed a high incidence of opioid overdose after discharge and an increased chance of addiction. Though opioid prescribing has been reduced at VA hospitals in recent years, this hasn’t been enough to protect patients. Vets – and providers – should be given better education to reduce the risk of addiction and pain management doctors should be especially careful when prescribing opioids to injured veterans.
Returning With Addiction
Finally, there’s a subset of veterans who return from service already struggling with an addiction, but there is limited data on this group. Illicit substance use in the military is grounds for discharge, so even military members who want help may not be able to ask for it. Better pre-screening may help identify these individuals before they enlist, but service changes people, and it can be hard to predict how they will respond under the pressures of war.
As many as 13% of veterans struggle with substance abuse, but regardless of when addiction strikes, it’s incumbent upon the VA and other service providers to appropriate care. When traumatized and injured vets develop an addiction, they’re doubly victimized. Our healthcare system is capable of more, and it needs to be held to those responsibilities.