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Thursday, January 23, 2014

Substance Abuse and Veterans


Substance abuse is an ugly word among some.  But, it is a reality our veterans and military service members are facing.  Many of these veterans don't realize they are abusing the drug(s) just from the fact that they are struggling with PTSD and/or pain.  These situations should be handled delicately and there are many programs that will assist in the recovery process.  The first step is not denying the situation which is easier said than done.  Just remember this...the quote for the day:

"From this day to the ending of the world, but we in it shall be remembered - We few, we happy few, we band of brothers. For he who sheds his blood today with me shall be my brother" - Henry V, William Shakespeare.

...in other words, you are not alone.



First the facts.  They might help put things into perspective:

  • Prescription drug abuse doubled inbetween 2002 and 2005.  It tripled in 2005 to 2008.

  • 27% of military service members who returned from a deployment meet the criteria of alcoholism, but it is suspected that these numbers are considerably low since this is only reported numbers.

  • 30% of all suicides that were reported among active duty military were associated with alcohol from 2003 to 2009.

  • More than 45% of non-fatal suicide attempts of military personnel had alcohol involved.

  • The younger the soldier, the more chances of alcohol abuse is occurring.  (My personal note: I believe this is due to the frontal lobe not being fully developed and more susceptible to considerable changes from trauma exposure and/or head trauma).

The VA is very cryptic of what veterans are facing when in comes to substance abuse.  But here is the known facts:

  • If you were injured in war, you are more susceptible to substance abuse.
  • If you suffered a head injury, you are more susceptible.
  • If you suffer from PTSD, you are more susceptible.
  • If you are under the age of 30, you are more susceptible.
  • If you are a chronic pain patient, you are more susceptible.
  • Military recently back from deployment are more susceptible.
  • Military previously deployed and facing another deployment are more susceptible.

Basically, it is a vicious cycle and many veterans have experienced this.  The military has also stated that over 50% of soldiers returning from war are participating in binge drinking, it's probably much more than that.  The reality is that this occurs within the military culture as it is....before deployment and after deployment is when it increases dramatically.  My word of advice, just be safe.  I can't tell you how many times I had to stick someone with an IV because they drank way too much, usually right before deployments.

What is hard is for others to understand why substance abuse occurs so much within the military and veteran community.  To drown the pain, memories, etc.  Everyone has a reason.  These are the facts to these "uses":

  • Alcohol is a depressant.  
  • It makes the memories worse.
  • Prolonged, excessive alcohol exposure generates a painful small fiber peripheral neuropathy, the most common neurologic complication associated with alcoholism
  • Withdrawals from chronic alcohol exposure will create more pain.
  • Alcohol with prescription drugs increases the effects of the drug that can cause the inability to wake up, internal bleeding, and liver failure.
  • When alcohol reduces the pain, it has reached an excessive amount that can induce the previous facts listed.
Because of the issues with abusing prescription medication, it has made it nearly impossible to get these drugs within the VA and military.  This can be a problem for those who really need the medication to function daily.  But, I have seen how easily it is to start abusing the medication once you receive them and how often overdoses occur.  For chronic pain patients, here are my tips on how to prevent substance abuse:


  • Build a relationship with a local pharmacist.  The VA and the military have been known to prescribe medication that are deadly mixed together.  Talking to your pharmacist about medications prescribed can ease the apprehension of taking multiple medications and confirm that you are getting the adequate care you deserve.
  • If the pain medication isn't work, try to contact your doctor about your concerns.  The VA and military providers are sometimes hard to get to so you may want to talk to your pharmacist again, call a nurse on staff, or ask another medical professional.  Worse case scenario, if the pain is unbearable, go to the VA Emergency Room.  They will straighten things out until you can see your provider.  DO NOT take more than prescribed!
  • If you begin to build a tolerance to a medication you are taking, talk to your provider.  Physical therapy, another drug, or any other service might be available to help.
  • Keep track of what you are taking, when, and how much.  If someone lives with you, ask them to help with this process.  I know asking for help is a horrible feeling sometimes, but it is better than overdosing!
  • Try to see an occupational therapist if you haven't already.  Occupational therapist have many great tools, tricks, and advice on how to keep the pain a minimum.  They are all about YOU and helping you live an independent life.  
  • Keep track of how many drinks you have.  It's okay to have the occasional drink but you will be surprised how you forget how much you drink within a week.  Keep track of this and reflect if this is "normal".  Having a psychologists or a peer mentor reflect with you will help.  The first step is overcoming denial.

For family members:
  • Do not yell, get angry, start the name calling game, or frustrated at your family member.  This causes abuse to happen more frequently and can be deadly.  Be understanding.
  • Show your support and concern.  But, don't be too pushy.  Do research and talk to someone who is experienced in substance abuse within veterans. 
  • Reflect on why your family member/friend is doing this.  There are plenty of valid reasons.  The key is to understand why they are doing it.  That way you know what they need to get help for.
  • Offer your family member/friend to have a guy's/girl's night out with others that deployed with them or other veterans.  They feel comfortable talking about what they went through with others who have "been there and done that".  You would be surprised how much it helps talking to other veterans and just hanging out with them.
  • The biggest thing you can do for your veteran is support them.  They are going to have to realize for themselves their problems and how to overcome them. 
If you think really hard, you know why you are abusing prescription drugs or other substances.  This is when the "overcoming denial" is essential.  Realize what the problem is, and seek out help to overcome it.  You are not alone in this.  Find resources, talk to people you trust, and overcome.  One thing that got me through the recovery of my injures at Brooks Army Medical Center was what my father (retired Vietnam veteran) always told me and still does to this day.....Adapt and Overcome.  Repeat it to yourself and it will help. 

Here are the following resources to find help or more information about substance abuse of veterans:

VA Substance Abuse Programs
Wounded Warrior Project - they have many programs that are listed and phone numbers are available to contact different departments for wounded warrior project alumni, family members, or more information to join.  A few different programs they offer is peer support, therapy in certain areas, and information for other resources.
Substance Abuse and Mental Heath Service Administration - Military/Veteran Programs

Other sources are listed on the side of this blog that can further assist in overcoming this situation.  I will post more programs if I come across them.  Comments, questions, cuss words???

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