Many veterans return home from scenes of combat that leave them suffering from various degrees of post-traumatic stress disorder (PTSD). This mental state leaves combat veterans susceptible to abusing substances, especially alcohol. Veterans who have enlisted in multiple tours of duty and experienced numerous exposures to combat have a greater likelihood of experiencing PTSD.

What is PTSD?

Exposure to a traumatic event or series of events can lead people to PTSD. A traumatic event, witnessing a natural disaster, can interrupt an individual’s mental, physical, social, and spiritual well-being. PTSD can occur in all people of any age, class, race, ethnic background, or economic status. According to the American Psychiatric Association, 1 in 11 people will be diagnosed with PTSD in their lifetime if they seek help. There are several related conditions to PTSD which include but are not limited to the following:

  • Acute Stress Disorder: this is an immediate reaction to a trauma that can lead to more severe symptoms of PTSD
  • Adjustment Disorder: this is an extreme response to a stressful life event with feelings and reactions that are more extreme
  • Disinhibited Social Engagement Disorder: this disorder occurs in children who have experienced neglect or deprivation before age two. The Prevalence of this disorder is challenging to diagnose

Symptoms of PTSD include feeling keyed up, having flashbacks of an event, avoiding reminders of the ever, or feeling numb to activities that used to provide a person with pleasure.

Other symptoms include:

  • Sleep disorders
  • Depression
  • Anger
  • On-guard/ fight or flight responses
  • Reliving the event
  • Flashbacks
  • Nightmares
  • Negative thoughts about oneself or the world
  • Feelings of guilt, shame, or fear 

What is SUD?

Substance use (drugs and alcohol) disorder occurs when it clinically and functionally impairs a person’s ability to maintain health obligations, including the ability to experience pleasure without using drugs or alcohol. This impairment generally involves health, financial, family, work, and school problems. The impairments affect both behavior and brain function because drugs and alcohol alter the way the brain communicates with the nervous system and the body. When the impairment to daily functioning happens, a person is driven to obtain more drugs or alcohol and to chase the next high.

According to the National Institute of Health, many people suffering from SUD experience mental health disorders simultaneously. The reverse is also true; those suffering from mental health disorders will seek drugs and alcohol to alleviate their feelings and agitation. Some common mental health disorders that co-occur with SUDs are:

  • Anxiety disorders
  • Depression
  • ADHD
  • Bipolar disorder
  • Personality disorder
  • Schizophrenia

Studies have demonstrated the connection between PTSD and SUD.

How Common Is Co-occurring PTSD and SUD and AUD in Veterans?

  • More than 2 of 10 Veterans with PTSD also have SUD
  • Almost 1 out of every 3 Veterans seeking treatment for SUD also has PTSD
  • The number of Veterans who smoke (nicotine) is nearly double for those with PTSD (about 6 of 10) versus those without a PTSD diagnosis (3 of 10)
  • In the wars in Iraq and Afghanistan, about 1 in 10 returning Veterans seen in VA have a problem with alcohol or other drugs
  • War Veterans with PTSD and alcohol problems tend to binge drink. Binge drinking is when a person drinks a lot of alcohol (4-5 drinks or more) in a short period (1-2 hours)

Combat Action and Mental Health and SUD (and AUD) Among Veterans

The link between combat, the number of tours, mental health, SUD, or alcoholism (AUD), has been studied for several decades. The military has been unable to slow the trend of veterans growing addicted to substances, especially alcohol. One study found that 30% of completed military suicides involved alcohol or drugs before the act. The numbers may not reflect today’s reality, as many veterans cannot access VA hospitals or receive help through the VA.

“Onset of SUDs can also emerge secondary to other mental health problems associated with these stressors, such as post-traumatic stress disorder (PTSD) and depression.” Alcohol use, as in the general population, continues to be problematic for active members of the military and veterans.

As stated earlier, the more combat a soldier experiences, the greater the risk for AUD (alcohol use disorder), including heavy binge drinking. Guilt and shame have been linked to alcohol and drug use. During combat, a soldier may be called upon to act in a way that is against his/her/their moral principles that guide his/her/their daily civilian life. Failing to stop the violence or witnessing violence during deployment raises the level of risk of experiencing PTSD. Moral injury, as it is known, profoundly impacts all aspects of an individual’s life.

“Veterans with PTSD-SUD experience more severe symptomatology, increased risk of suicidality, poorer quality of life, and poorer response to existing treatments than Veterans with either disorder alone. Furthermore, PTSD-SUD prevents Veterans from reintegrating into society and is associated with occupational and social dysfunction.”

The Veterans Benefits Administration considers alcoholism a disability when “it impairs a veteran’s ability to work. If your alcoholism is found to be service connected, you may be eligible for compensation, health care, and other benefits.

The VA contracts with outside treatment facilities to care for veterans and active service members. If you have PTSD, suffer from alcoholism (or other drug addictions), and struggle to cope with daily life, call our team now and find out how we can help. It is important to remember that wherever you go for help, the facility should provide best practices, utilize a team of addiction and mental health experts, have staff who understand PTSD and combat, medication management, and more. Additionally, if you served for over 20 years, are a Medal of Honor recipient, and are on disability retirement, you may be eligible for Tricare.