Substance Abuse in the Military

Alcohol use among active-duty service members is a significant issue due to various factors such as stress, combat exposure, deployment-related challenges, and a culture that often encourages heavy/binge drinking.

According to the Department of Defense, over 30 percent of military personnel report binge drinking. Studies show being deployed to combat zones increases the risk of alcohol abuse. Factors such as stress, trauma, and the high demands of deployment can contribute to the increase.

Alcohol abuse often co-occurs with mental health disorders such as post-traumatic stress disorder (PTSD), depression, and anxiety. While the military has implemented initiatives to reduce the stigma and encourage service members to seek treatment, the fear of career implications stops many members from seeking help.

Substance abuse in the military often involves using prescription drugs, including opioids, stimulants, sedatives, and benzodiazepines. While the military has a zero-tolerance policy for illicit drugs, abusing prescription drugs has increased over the years.

Factors contributing to prescription drug abuse in the military include combat-related injuries, chronic pain, mental health issues, easy medication access, and self-medicating to cope with stress.

Opioid abuse has received significant attention over recent years. Prescription opioids are often used to treat pain from combat injuries and surgeries. However, abuse and addiction occur when service members take higher doses than prescribed, use other people’s medications, or self-medicate.

Stimulant medications are prescribed to treat attention-deficit/hyperactivity disorder (ADHD). These medications may be misused to enhance performance or cope with long hours and demanding missions. However, stimulant abuse can lead to negative health effects and impair operational readiness.

The prevalence of illicit drug abuse in the military has varied over the years. The military has made many efforts to address illicit drug use, including regular drug testing programs. These programs aim to promote a drug-free environment and maintain a high standard of readiness and professionalism.

The vast majority of military personnel do not engage in illicit drug use. But, if any member is found to be using illicit drugs, they may face legal consequences and disciplinary actions, including discharge from service.

Combat exposure and trauma are significant risk factors for substance abuse in the military. The experiences and stressors that come with combat can profoundly impact people, increasing the risk of abusing drugs or alcohol.

If a loved one is active-duty military and struggling with substance abuse, it can be hard for friends and family to understand why. Here are common reasons combat exposure and trauma are risk factors for substance abuse.

• Drugs or alcohol may be used to numb the emotional pain, alleviate distressing moments, or escape the reality of combat-related trauma.
• Post-traumatic stress disorder is strongly associated with combat exposure. Individuals with PTSD often self-medicate with drugs or alcohol to alleviate symptoms.
• Combat may result in traumatic brain injuries from explosions or blasts. The effects of a TBI can increase the risk of substance abuse to cope with the challenges and symptoms.

The military culture itself can involve certain norms and expectations regarding alcohol consumption and socializing. Although the military upholds high standards of professionalism and discipline, some aspects of the culture can influence substance abuse.

The risk factors of substance abuse due to military culture include:

• Peer influence and certain norms
• Coping mechanism for stress and high-demand schedules
• Downtime
• Accessibility to drugs and alcohol

Mental health conditions are a significant risk factor for substance abuse in the military. The relationship between mental health and substance abuse is complex.

Many people with mental health issues turn to drugs or alcohol to self-medicate. However, co-occurring mental health disorders and substance abuse interact and may worsen each other.

Depression and anxiety disorders triggered by the stress and challenges of the military can also contribute to substance abuse. Although military personnel struggle with mental health issues, almost 60 percent of them do not seek help.

To increase access to mental health care, the military offers a wide range of behavioral health providers including:

• Psychologists
• Psychiatrists
• Clinical social workers
• Psychiatric nurse practitioners
• Behavioral health technicians
• Unit-embedded behavioral health providers
• Primary care behavioral health consultants and facilitators
• Non-clinical providers like chaplains and family counselors

The first step in treating substance abuse in most people is medical detox. It is a critical step in treating substance abuse in the military. It involves going through withdrawals safely while under medical supervision.

Withdrawal symptoms can range from mild discomfort to severe and potentially life-threatening. Medical detox programs use medications and supportive care to help manage withdrawal symptoms like nausea, anxiety, and insomnia.

Medical detox is the first step in a comprehensive treatment plan. After detox, individuals are encouraged to continue into an inpatient or outpatient treatment program. If they do not continue treatment, the risk of relapse is extremely high.

Inpatient treatment for substance abuse in the military is a form of intensive care where a person lives in a treatment center. During their stay, they receive comprehensive therapies and support to encourage lifelong recovery.

The benefits of inpatient treatment include:

• 24/7 supervision and support including medical staff, therapists, counselors, and support staff
• Specialized therapies tailored to military personnel such as individual therapy, group therapy, and family therapy
• Building practical skills
• Education for relapse prevention, stress management, communication, and life skills
• Dual diagnosis treatment
• Peer support

Outpatient treatment for substance abuse in the military provides a flexible and convenient option for those who don’t require round-the-clock supervision. People can receive treatment while living at home, maintaining their daily routines and military duties.

Like inpatient treatment, outpatient treatment plans are tailored to each person’s specific needs, like previous substance abuse and any co-occurring mental health issues. Outpatient treatment also includes various therapies, skill-building, and relapse prevention.