Veterans Substance Abuse

The SMVTA Center works with states to bolster and support the behavioral health systems for active duty military service member, reservists, veterans and their families. They act as a liaison between agencies and the service members, specifically federal, state, territorial, tribe, local community, public, and private agencies. This organization monitors trends in behavioral health issues in relation to prevention, treatment and recovery support, and provides consultation, training and technical assistance to these agencies to provide the latest and best treatment

With the end of the conflicts in Iraq and Afghanistan, many veterans are returning home suffering from Post-Traumatic Stress and Traumatic Brain Injuries (TBI). For various reasons, instead of seeking help, many self-medicate through drugs and alcohol, and lash out at loved ones. When this happens, a large percentage find themselves caught up in the already flooded legal system, further perpetuating their issues and overwhelming the system. Veteran's Treatment courts offer an alternative to traditional court procedures, closely resembling the already proven model of the Drug Courts, taking the individuals out of the legal system, and getting them the help they need to treat their problems and reintegrating back into the civilian world, instead of just pushing them through the system time and again.

Rates of trauma and mental illness are reported to be disproportionately higher among American veterans, especially those of the recent wars in Iraq and Afghanistan. The barriers to care after civilian reentry further disadvantage this already vulnerable population. The wars in Iraq and Afghanistan have been the longest sustained US military operations since the Vietnam era, sending more than 2.2 million troops into battle and resulting in more than 6,600 deaths and 48,000 injuries. Veterans are at risk mental health challenges, as well as family instability, elevated rates of homelessness, and joblessness. Veterans have disproportionate rates of mental illness, particularly posttraumatic stress disorder (PTSD), substance abuse disorders, depression, anxiety, and military sexual trauma.

There are several barriers to rural veterans receiving quality of care. These include the rural and military stigma against mental health services, the insufficient timeliness of receiving care, the lack of skilled professionals in positions to serve veterans, and the tangible challenge of access to care. These barriers cause many veterans to not receive services at all. At best, it causes major hindrances for rural veterans resulting in sporadic treatment, low quality of care (Buzza, et al., 2011) and financial concerns (Gayle & Heady, 2011).

Alcohol use and abuse is prevalent among members of the United States military as well as among the veteran population. Binge and heavy drinking is commonplace among the military and veterans. Veterans and members of the active duty military face a unique set of challenges when compared to the civilian population. There is a trend of combat exposure leading to a higher risk to abuse alcohol. For over a decade the United States military was involved in combat operations in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). This has lead to a generation of service men and women as well as veterans with a host of physical and mental injuries as a result multiple combat deployments. There are many veterans and active duty personnel suffering from post-traumatic stress disorder (PTSD) as well as traumatic brain injuries (TBI) as a result of their deployment in support of OIF and OEF. There is a link between post-traumatic stress disorder (PTSD) and traumatic brain injuries (TBI) and a higher potential for the abuse of alcohol. Veterans and members of the armed forces deal with a host of psychological injuries related to the stresses of combat which can lead to the abuse of alcohol as a coping mechanism.

Therefore, Spelman, Hunt, Seal, & Burgo-Black (2012) recommend that the best practices for care should consist of an interdisciplinary approach involving integrated teams of primary care, mental health, and social work providers which can normalize and de-stigmatize mental health treatment. Recognizing that co-located, interdisciplinary care may not be feasible for many providers, they suggest utilizing local resources and facilitating interagency collaboration with local Veteran Centers or with the VA (Spelman et al., 2012).

Substance abuse is a recurring problem in the military. The USA Today news article; “Ex-soldier Returns to Fight Substance Abuse in Military” talks about Frank L. Greenagel Jr., who opened up a counseling center for substance abuse. He also served in the military and agreed that there are many individuals who are dealing with substance addiction while serving the country. It is clear that these individuals need help before things could potentially become fatal.

This disorder leads the veterans to substance abuse to calm their nerves and help them feel more at ease. The substance abuse, in turn, leads the veterans to be more hostile, aggressive, and violent to those people around them, especially their families. A study found in The American Journal of Psychiatry revealed, "Increases in alcohol and substance abuse closely paralleled the increase in PTSD symptoms seen in the period during and immediately after the war. Patients reported that alcohol, heroin, marijuana, opiates, and benzodiazepines (but not cocaine) were beneficial for their symptoms of

Substance abuse among our veterans is much greater than our civilian populations. This is largely caused by post-traumatic stress disorder, associated from combat, and who have endured multiple deployments. In most cases, veterans who have turned to alcohol or drugs have a dual diagnosis. They not only have a problem with alcohol or drugs, but they also suffer from a mental or mood disorder that has a major impact on these issues. In most cases the mood disorder is post-traumatic disorder(PTSD), which results from being in combat. According to

Post-Traumatic Stress Disorder (PTSD) treatments may be the first step in solving alcohol abuse in veterans as these two are closely related. Jennifer Olson-Madden states that roughly twenty percent of veterans suffering from substance (alcohol) abuse have

Greetings, I am Dexter Bolding I recently earned a Bachelor of Arts degree in Psychology from California State University, Dominguez Hills. Prior to this, I spent nearly two decades in the United States Marine Corps. In the Marines I had an opportunity to manage at different levels, which included the managing of a thirty-three Marine Aircraft Firefighting Section, managing a five man Marine Corps Recruiting Office, culminating in me spending the last seven years directing the Marine Corps Substance Abuse Program as the Substance Abuse Control Officer and Insructor aboard the Marine Corps Air Station Miramar.

The Department of Veterans Affairs (VA) is a health care system that offers programs to benefit veterans and their families. Benefits include, but are not limited compensation payments for disabilities or death related to military service, pensions, education, health care and rehabilitation. The Department of Veteran Affairs functions as the nation’s largest integrated health care system, with more than 1,700 hospitals, clinics, community living centers, domiciliary, readjustment counseling centers, and other facilities. The mission of the VA is to “care for him who shall have borne the battle, and for his widow, and his orphan" by serving and honoring the men and women who are America 's veterans (The Department of Veteran Affairs, 2011). This mission statement is based off of President Lincoln 's promise to service members. For the addiction treatment program (ATP), which is part of the mental health division of the VA, their mission statement is to provide person centered and driven assessments, clinical programming, plan of care, treatment plan reviews, transition planning and outpatient and after service to promote the rehabilitation, recovery, health maintenance, quality of life and community integration goals identified by persons served (The Department of Veteran Affairs, 2011, p. 27).

Each of these veterans carry the physical and emotional scars of war. Most of these veterans have some form of Post-Traumatic Stress Disorder (PTSD) or some level of Psychophysiological Pain. The current Veterans Affairs (VA) system is limited to treating these symptoms with opioids or moderately effective mental therapy. 34 Much of the opioid use leads to addiction, overdose, or even suicide. 35 Many veterans that have begun using marijuana, under the threat of losing all of their VA benefits, have reported marijuana is a much more effective, and less addictive, treatment in coping with nightmares, flashbacks, depression, and pain. 36 According to the VA approximately 31% of Vietnam Veterans, 10% of Gulf War Veterans, 11% of Afghan War Veterans, and 21% of Iraq War Veterans suffer from PTSD. 37 According to other reports, some 22 veterans commit suicide per day due to PTSD or pain. 38

John is a 54-year-old while male that was referred by the VA to VHN due to his homelessness. The veteran has limited income from SSD and VA disability. The veteran acknowledges his mental health conditions, his struggles with addiction, and his need for treatment. The veteran is aware that addiction negatively impacts his interpersonal relationships. The veteran does not appear to fully accept the impact of his childhood on his interpersonal relationships or his mental health concerns.

Many of the veterans experience a multitude of issues linked to PTSD. Some of these can include depression, employment, increase demands on healthcare services, and social impairment. Physical health issues associated with PTSD can include respiratory, hypertension, skin, hearing and deafness, stomach, urinary and even musculoskeletal complications (Benyamini and Solomon, 2005:1271; Boscarino, 2006:253-254; Hoge, et al., 2006:1023; O’Toole and Catts, 2008:34). A number of soldiers in these studies reported an increase in substance abuse. This misuse of substances is either through alcohol, cigarettes, prescription medications, or other drugs (Benyamini and Solomon, 2005:1268; Browne et al., 2008:628; Hanwella, et al., 2014:4-6; Smith, et