Substance Misuse / Addiction

Trauma-related responses such as uneven moods and heightened anxiety may lead to increased substance misuse (for example, alcohol and marijuana) or addiction (for example, opioids and benzodiazepines), the latter involving a physiological dependence on the drug and withdrawal symptoms.

Many men and women who have served in the United States military struggle with a substance use disorder or an addiction. Veterans who have seen combat may have co-occurring disorders, such as depression or post-traumatic stress (PTS), in addition to addiction. Many veterans suffering from an addiction have co-occurring post-traumatic stress disorder. Once referred to as "shellshock" and later "battle fatigue," PTS can be caused by witnessing warfare or other significantly tragic or startling events. Traumatic events such as combat exposure and multiple deployments can trigger drug or alcohol use, which all too often can lead to substance misuse or addiction.

Although most cases of PTS are caused by combat, veterans may also develop the disorder after sexual abuse. About 23 percent of female veterans have reported being sexually assaulted during their time in the military.

Some symptoms of PTS include:

Flashbacks
Memory impairment
Impaired concentration
Low sense of self-worth
Hopelessness
Sleep disorders
Social relationship problems
Aggression
Self-destructive behavior (self-harm or substance abuse)

These symptoms may be triggered by anything that is a reminder of the traumatic incident. Many veterans turn to substance abuse numb their recollection of the incident. More than 20 percent of veterans with PTS also suffer from an addiction or dependence on drugs or alcohol.

People with PTS have a more difficult time overcoming addiction than those without it. The symptoms of withdrawal combined with PTS amplify negative feelings and emotions that may lead to a relapse.

Addiction treatment programs that focus on PTS and addiction simultaneously are most successful for veterans. Veterans with PTSD are often prescribed anxiety medications, most of which are highly addictive. To curb the risk of addiction, some doctors prescribe non-addictive antidepressant medications such as Paxil or Zoloft. Even veterans without PTSD can become addicted to painkillers prescribed for combat-related injuries.

Common addictive medications prescribed to veterans include:

Painkillers (Lortab, Vicodin, OxyContin)
Benzodiazepines (Ativan, Valium, Xanax)
Sedatives (Ambien, Lunesta)

Veterans taking these drugs may develop a dependence on them, meaning tolerance to their effects and symptoms of withdrawal when quitting. As time goes on, veterans may spiral into full-blown addiction, which is characterized by compulsive drug-seeking behavior.

To mitigate drug abuse among service members and veterans, some advocates are pushing for tighter regulations on how long addictive medications can be prescribed.

For additional information, visit http://www.ptsd.va.gov/understand/related/substanceabusevet.asp