Military Service Members, Recovery, and Sober Living
This article has been created to introduce the struggles of military veterans and substance abuse to members of the sober living community, including recovery residence operators and those who live in or work in a sober house. Substance abuse affects around 1 in every 15 U.S. military veterans.
There are nearly 2.2 million active military personnel in the United States, as well as 23 million military veterans. Approximately one in every seven U.S. soldiers is actually on an opioid prescription. Military personnel have a higher risk of developing substance use disorder than the general public (age-adjusted), and this alarming connection is exacerbated by deployment and combat exposure.
While the usage of illegal drugs by military personnel has decreased over time, the use of alcohol and prescription opioids has remained high. The prevalence of drug use disorder among military veterans varies by conflict, with rates varying from 3.7 percent among pre-Vietnam veterans to 12.7 percent among veterans of the more recent wars in Iraq and Afghanistan.
Multiple medical conditions and other co-occurring mental health issues (e.g., depression) are linked to substance use disorder, as are elevated problems at home and work, challenges in readjustment to civilian life, and higher rates of injury, suicide, and morality. Aside from the personal toll, drug abuse has a significant overall effect and financial cost on US defense operations.
It is estimated that the United States lost $1.2 billion in 2016 due to reduced productivity and medical costs arising from excessive alcohol use by military personnel.
Sensitivities Unique to Military Service Members
Deployment
A history of deployment and battle exposure has been linked to an increased risk of developing a drug use disorder. Service members are often exposed to the death or destruction of others, threats to themselves or others, and unknown atrocities while in combat.
One study found that witnessing war, self-defense threats, or atrocities is linked to alcohol abuse, even three and six months after deployment. Military deployments and fighting exposure have been linked in studies from Iraq and Afghanistan to increased risk of excessive alcohol intake, binge and heavy drinking, alcohol-related disorders, drug use disorder, and depression. Sober living homes can offer a strong support network to those in recovery with a background in military service.
Pain Management
“Chronic pain is such a devastating issue. It profoundly affects Veterans, not just physically, but emotionally. It’s strongly associated with depression. It interferes with work, recreational activities and a patient’s social life.” – Dr. Mathew Bair, U.S. Department of Veterans Affairs
Compared to just 30% of people, almost 60% of veterans returning from the Middle East and 50% of older veterans suffer from chronic pain.
In a 2012 survey of over 141,000 Iraq and Afghanistan veterans, those with chronic non-cancer pain as well as a mental health condition (e.g. PTSD) were more likely to have an active opioid prescription and to be receiving riskier opioid and other medication combinations.
Veterans were more prone to overdose and other opioid-related negative outcomes in this report, which is unsurprising.
Until recently, the Veterans Affairs Department in the United States treated chronic pain almost entirely with opioid prescriptions.
In 2011, the Journal of Pain and Symptom Management reported that a significant number of veterans exchanged pain-management medications.
Alcohol or non-prescription medications is used to relieve pain by 29% of veterans.
To relieve pain, 35% of veterans used a mixture of alcohol and non-prescription medications.
PTSD
Post-traumatic stress disorder (PTSD) is a mental and emotional stress disorder caused by an accident or a severe psychological shock, and it is characterized by sleep disturbances, frequent vivid memory of the experience (flashbacks), and severe anxiety.
- About a quarter of veterans with PTSD still have a substance abuse issue.
- PTSD affects almost one out of every three veterans seeking care for drug abuse.
According to the US Department of Veterans Affairs, PTSD affects:
- Vietnam veterans make up 31% of the population.
- Veterans of the Gulf War (Desert Storm) make up 10% of the population.
- Veterans of the Afghan war make up 11% of the population.
- Iraqi war veterans make up 20% of the population.
Personal factors such as past traumatic exposure, age, and gender can all influence whether or not a soldier develops PTSD as a result of a traumatic event.
TRAUMA OF SEXUALITY
Military sexual trauma (MST) is another way for service members to be exposed to physical and psychological trauma, which can lead to PTSD. According to the United States Department of Veterans Affairs, 55% of female veterans and 38% of male veterans witnessed sexual assault while serving in the military.
Military Culture & Stigma in Sober Living
Military veterans and their families have culturally distinct mental healthcare needs that could go unnoticed by the general public.
Military culture is generally viewed as accepting of alcohol use, but stigmatized when it comes to the use of other substances and the production of substance use disorder as a result of alcohol or other drugs.
Heavy drinking has long been a part of military work culture, used to encourage relaxation, reward hard work, reduce interpersonal tensions, and promote teamwork and camaraderie.
On military bases, there is a lot of cheap alcohol available, which is linked to binge drinking and underage drinking.
The military’s workplace culture is also a source of concern, especially in terms of the stigma associated with problem drug use and the fear of negative repercussions for seeking support.
Despite the fact that active duty troops and their families are entitled for treatment from the US Department of Defense and the Department of Veterans Affairs, many do not seek it out for fear of stigma, prejudice, or possible consequences that could jeopardize their military careers.