How Common Is Substance Misuse Among Veterans?

Although substance use disorders (SUDs) have become more prevalent across all populations, veterans are at a significantly higher risk due to stressors they face before, during and after military service. 

Understanding the issue and its root causes can help both struggling veterans and their families find ways to get the care they need. 

Understanding Substance Misuse Among Veterans

According to the National Institute on Drug Abuse, 1 in 10 veterans seeking care meets the diagnostic criteria for an SUD. The following are some of the biggest contributing factors to substance abuse issues in veterans:

Mental Illness and Trauma

For many veterans without a strong support system, substances become an unhealthy means of coping with trauma or mental illness. 

Most veterans with SUDs also struggle with a co-occurring mental illness, which can often fuel the substance misuse. For example, 63% of Afghanistan and Iraq veterans who had SUDs also met diagnostic criteria for post-traumatic stress disorder (PTSD). And in general, more than 20% of veterans with PTSD also struggle with an SUD.

Other common co-occurrences among veterans with SUDs include:

• Schizophrenia
• Anxiety disorders
• Bipolar disorder
• Depression
• Traumatic brain injury (TBI)

Chronic Pain

Although modern medicine has made it possible for more service members to survive severe injuries than ever in history, many of these men and women are left with lasting physical consequences. 

According to the Military Health System, 9.1% of veterans have reported dealing with extreme pain, which is a 40% higher rate than in non-veterans. The rate is even higher for survivors of more recent conflicts — according to the Veterans Health Administration (VA), nearly half of the veterans seeking treatment after the second Gulf War were diagnosed with a chronic pain disorder within one year of their return.

Many of those pain patients developed iatrogenic use disorders as the result of extended treatment using prescription opioids, which has become significantly more common among military doctors. 

Social Factors

Returning to civilian life after military service is difficult for most veterans, especially those who experienced deployment-related trauma. Some of the challenges veterans often face when leaving the service include:

• Finding employment: Although service members can become experts in specific skills during their time in the military, their experience may not translate to civilian employer expectations. 
• Reuniting with family: Service members who have been deployed do not see their families for months or even years, and readjusting to family life is often incredibly challenging.
• Accessing benefits: While veterans are entitled to health and retirement benefits, the complex system makes it incredibly challenging to use them. As a result, many veterans who have been injured or disabled during their service struggle to access proper care and support.

To cope with these challenges, some veterans turn to substances. 

The Prevalence of Substance Misuse in Veterans

According to the most recent Health Related Behaviors Study (HRBS), which is the essential survey for understanding the well-being of our armed forces, substance misuse is significantly more common in veterans than in active duty service members. That said, it’s important to note that the HRBS relies on self-reported data, and response rates for these studies are typically low, often due to factors like negative mental health stigmas or fear of social implications. The true numbers may be very different from what we see in these surveys. 

The three most commonly misused substances among veterans include:

• Alcohol: According to the NIH, veterans are significantly more likely to misuse alcohol than their non-veteran counterparts — and 65% of those who seek treatment for substance use disorders say alcohol is the substance they abuse most often.
• Opioids: Due to the rise in opioid prescriptions to treat chronic pain, veterans are significantly more at risk of becoming addicted to or overdosing on prescription and illicit opioids. The opioid overdose mortality rate among veterans rose by 93.4% from 2010 to 2019.
• Marijuana: Cannabis is the most commonly used illicit substance among veterans, with 3.5% of HRBS respondents reporting use in 2015. 

How Substance Misuse and Addiction Impact Veterans

Substance misuse and addiction can have serious consequences for veterans and their loved ones, such as:

• Family life: Veterans struggling with PTSD and other co-occurring SUDs are significantly more likely to experience distress in their personal lives, which puts additional stress on their spouses, children and other family members.
• Employment: Many veterans already struggle to find work after leaving the service due to misalignment between military and civilian professional culture, and dealing with an SUD can make it even more difficult to gain lasting employment.
• Houselessness: More than three-quarters of veterans who are unsheltered struggle with substance misuse and addiction issues as well as mental illnesses, making it even more difficult to seek treatment, gain employment or find shelter. 
• Overdose: More than 9% of veterans with pain management issues say they experience severe pain, which puts them at a much higher risk for opioid addiction and overdose than non-veterans.
• Suicide: Substance misuse is often a sign of suicidality in both active and veteran service members. If you or someone you know is experiencing suicidal thoughts or behaviors, call 988 to access the Suicide and Crisis Lifeline. 

Unfortunately, many veterans do not seek help due to the stigma surrounding treatment, especially within the military community. Receiving assistance should never be seen as a weakness or personal failure, as it will only improve your quality of life. 

Remember that you’re never alone in this fight. We urge you to get help if you’re struggling with addiction or other substance misuse issues. 

Resources for Veterans Struggling With Substance Use Issues

Behavioral therapies and counseling are often the most effective ways to treat SUDs in veterans, as they can help present healthy alternatives to substance use during times of stress. For those dealing with co-occurring PTSD and SUD, trauma-focused psychotherapies are typically the best option for processing and dealing with their experiences.

Whether you’re seeking help for yourself or a loved one, recovery is possible with time and proper treatment — and that’s our mission at Diamond House Detox. We offer a Veterans’ Program that is run exclusively by veterans, so clients can work with people who know firsthand what they’ve been through. 

Our team of providers also has extensive experience in treating co-occurrences of SUD and mental illness, which can help provide veterans with coping strategies they can use to manage their symptoms without turning to substances.

Learn More About Diamond House’s Veterans’ Program

Service members shoulder an immense burden both during and after their time in the military, and finding a treatment center that understands that burden is often challenging. At Diamond House, we take a comprehensive personal approach to substance use treatment that aims to help our clients successfully reintegrate into civilian life. 

Get the help you need from people who understand. Reach out today to learn more about our treatment methods and programs. 

Vicky is a board certified Family Psychiatric Mental Health Nurse Practitioner, certified by the American Nurses Credentialing Center. She began her nursing career in healthcare by working in the intensive care unit, and then an inpatient psychiatric hospital. After realizing the mental health needs of both the patients and the families she served, she became a Psychiatric Nurse Practitioner. Throughout her experience working with clients, she has developed a passion for those with dual diagnoses and specializes in helping individuals recognize the issues driving their substance use. This recognition has been crucial to the individual’s success in treatment. Vicky opened Diamond House Detox so that she can address these issues early on in a therapeutic environment to allow clients to transition to the next level in their recovery.

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