Veterans have among the highest substance and alcohol use disorder rates compared to the general public, with recent statistics showing a staggering one in ten veterans diagnosed with a substance use disorder. While addiction rates among veterans are well-known, addiction and substance use among active-duty military members remain less addressed, and are still highly problematic. While rates of illicit drug use have dropped in the past decade, growing alcohol use and addiction among veterans show that the battle is not over. In fact, there is so much more the military can do to curb substance addiction.
Improvements in Substance Use Have Been Slow But Steady
It's no secret that the military struggles with controlling substance and alcohol use among members. Drug use is so pervasive, that an investigation was launched by the Institute of Medicine in 2012 and found that the military is not doing enough to address addiction among military members. Everything from outdated drugs to inconsistent and outdated medicine led to a lower quality of care for addiction.
Drug Use in the Military Today
So, how has the military changed? The IOM study found that alcohol abuse rates were increasing, which has remained true even today. According to the National Institute on Drug Abuse, overall, illicit drug use among active-duty members is relatively low, which is a good sign. Cigarette smoking and misuse of prescription drugs has also decreased in recent years. Sadly, rates of binge drinking continue to be high when compared to the general population.
Room For Improvement
While illicit drug use and smoking have decreased, this still does little to support active-duty members who are actively using drugs and are too afraid to speak up. Why are active-duty military members still afraid to seek help for addiction treatment, despite recent implementations like the “Own Your Limits” or “Too Much to Lose” anti-drug and alcohol campaigns? Here are a few key changes the military could, and should, work to implement.
Standardize Screening and Treatment for Alcohol and Drug Abuse
While uniforms are standardized, as are hair cuts, personal appearance, and even pay grades, the standardization doesn't translate well among different commands and their medical facilities. While one military base might have substance abuse treatment centers nearby and trained medical staff ready to handle cases, others might not. Standardizing screening and treatment across all branches of the military allows for consistent care and support for service members struggling with substance abuse.
As recently as 2022, an audit conducted by the Department of Defense on “Active Duty Service Member Alcohol Misuse Screening and Treatment” found shocking results. Among some of the many issues they found were:
- Military Service health care providers not performing annual AUDIT-C screenings for alcohol misuse in a timely manner for hundreds of Service members.
- Lack of effectiveness due to the types of questions on the alcohol screening questionnaire.
- No standard mechanism to track the frequency of service members’ alcohol use screenings
- Military Services did not provide timely intake assessments or treatment for alcohol misuse
Unfortunately, much of this lack of timely care stemmed from issues with unclear and inconsistent guidance among different military substance use clinics. Substance abuse centers, medical treatment facilities, or residential treatment facilities were understaffed or unavailable, causing delays in care for those who need it.
Provide Early Intervention
The same audit conducted by the DoD also found that due to inconsistencies and lack of staffing, service members experienced delays in alcohol use diagnoses. This diagnosis is essential when determining appropriate care, and lack of action can lead to negative physical, social, psychological, and employment health.
Moreover, the longer someone goes without treatment, the higher the chances of them experiencing negative consequences like workplace accidents, legal problems, and interpersonal conflicts. Therefore, early intervention is crucial in addressing alcohol misuse among service members. Research on alcohol addiction treatment also shows that continuous abstinence early in alcohol treatment leads to more positive treatment outcomes.
Reduce Stigma and Fear of Career Consequences
The military has made an effort to allow active-duty members to self-refer to treatment and get help from their command to do so. However,news reports show that even as recently as the Biden administration, testing positive for marijuana was grounds for discharge.
This fear of career consequences often deters active-duty members from seeking treatment for substance abuse issues, even if it's available.
To reduce stigma and fear of career consequences, the military has implemented some helpful programs including:
- Military Substance Abuse and Addiction Prevention (militaryonesource.mil), which offers a range of resources for service members and families, including prevention programs and treatment options.
- Army Substance Abuse Programs (ASAP), which provides support and resources for Army personnel facing substance abuse issues.
- TRICARE, which can help cover the costs of substance use disorder treatment services to active duty service members and their families.
Commands must remind their service members regularly of the availability of these resources and encourage them to seek help if needed. Encouraging open communication while emphasizing mission-readiness and the importance of seeking help for substance abuse issues can be the push service members need to seek treatment, rather than fear having their career cut short.
Offer Support During Transitional Periods
Stress is one of the most well-known risk factors for veterans in the development of addiction and relapse. Stressful experiences while in the military can include:
- Transitioning from military to civilian life
- Returning from or preparing for deployment
- Changing commands
- Getting new orders for a new base
- Dealing with combat trauma
It's important for service members to have access to support during these stressful periods of their lives. From addiction treatment to individual counseling, peer support groups, and other resources, these are critical times they're vulnerable to relapse and substance use and must have access to help.
Tailored Addiction Treatment
Whether someone has a co-occurring disorder like PTSD or depression, identifies as female or male, or needs a higher level of care, they deserve access to tailored treatment options. These tailored programs may include:
- Gender-specific therapy groups
- Trauma-focused therapy
- Holistic therapies like art therapy or yoga
- Family therapy and support
These are just some of the many tailored treatment approaches that should be available to military members. Service members come from all walks of life and change during their time in service. It only makes sense that treatment options should be just as unique as their journey.
About the Author
Scott H. Silverman is an addiction and recovery expert with 40 years of experience. He is the Founder and CEO of Confidential Recovery, a San Diego substance abuse treatment center that specializes in helping active military service members, veterans, and first responders get and stay sober. He is also a founder and board member of The Veterans Navigation Center, a San Diego-based organization that helps Veterans transition to civilian life.
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