Alcohol is at the top of the list of substances abused by veterans.1 Illicit drug use in the military tends to occur less often than in the civilian population due to zero-tolerance policies; however, alcohol is used and abused at high rates.
According to the National Institute on Drug Abuse, military service members drink alcohol at higher rates than civilians.2 Veterans who suffer from alcoholism may have begun abusing alcohol while still in active duty as a way to cope with problems like stress or isolation.3 Approximately 10% of veterans returning from Iraq and Afghanistan suffer from problems with alcohol or other drugs, with alcohol use disorders (AUDs) being the most prevalent substance use disorders among military personnel.4
Exposure to traumatic events, such as combat and death, may contribute to high rates of alcohol abuse. In fact, military personnel with more exposure to combat tends to have higher rates of heavy and binge drinking than their peers. 1
Unfortunately, many veterans who need treatment for alcoholism do not receive it. This is troubling because alcohol use among veterans leads to higher rates of interpersonal violence, health problems, and early mortality. 1
Alcohol Use & Military Service
Per the National Institute on Alcohol Abuse and Alcoholism, just serving in the military tends to increase drinking.3 A 2004 study that followed young adults in their first 3 years of military service found that they increased their alcohol use while serving.3
Men may be particularly at risk. In all 4 military branches, rates of heavy drinking among young men are 4x higher than those of young women.3
There may be many reasons behind increased alcohol consumption in the military, including workplace culture. People who work closely together sometimes begin to share beliefs and practices around alcohol. Peers may begin to develop drinking rituals, such as drinking before, after, or during work.
Interviews with Navy service members showed that there were established rituals around drinking and that heavy alcohol use was a common coping mechanism in the service. Interviews also revealed that binge drinking after work and during deployment was also seen as a cultural tradition by service members.3
Another factor that may play into increased drinking in the military is the ease of accessing alcohol. During deployment to foreign countries, the minimum age may be lower. Alcohol is also easily accessed on base. Navy recruits report not having much trouble getting alcohol at establishments such as bars and hotels near base.3
Service members also report using alcohol regularly to combat stress or loneliness, or simply to have something to do when other recreational activities are lacking.3
Alcohol use disorders are the most common form of substance use disorder (SUD) among military personnel.1 For some people, the problematic drinking patterns that begin during their military service may extend past active duty and continue to cause problems in their life as a veteran.
However, it’s not only veterans who drank heavily during active service who are at-risk of alcohol use disorder after returning home. Veterans may begin to abuse alcohol for numerous other reasons such as attempting to cope with the symptoms of post-traumatic disorder, or PTSD.
Why Are Veterans at Higher Risk of Alcoholism?
There are numerous stressors associated with military service that increase the risk of SUDs in both active duty personnel and veterans, including:
- One survey found that of 6,527 U.S. Army personnel returning from deployment in Iraq, nearly 30% screened positive for alcohol misuse. 1,5
- Combat experience. Those with more combat experience tend to have higher rates of both heavy and binge drinking than their counterparts with less combat experience.1
- Problems reintegrating into civilian life. The major culture shift from military life to civilian life may be incredibly challenging and contribute to substance abuse in veterans.1
Addiction risk is also related to mental health challenges that may arise from these and other stressors. In fact, it’s rare that a veteran seeking treatment only has an SUD. It’s much more common for them to have co-occurring disorders, which means an addiction plus another mental health condition. One mental health issue that impacts many veterans is post-traumatic stress disorder (PTSD). 1
Nearly 1/3 of veterans seeking treatment for a substance use disorder also has PTSD, and more than 20% of veterans with PTSD have an SUD. Veterans of war who misuse alcohol and who suffer from PTSD tend to engage in binge drinking, which is a risk factor for developing an alcohol use disorder.4,6
Trauma in childhood or adolescence can also contribute to both PTSD and SUDs, and it is known that some people join the military to escape troubled home environments.1
Symptoms of PTSD include:
- Scary thoughts.
- Avoidance of reminders of the trauma.
- Feeling hypervigilant.
- Negative mood.
Veterans who suffer from PTSD may turn to alcohol to alleviate these symptoms. This is called “self-medication.” Alcohol may help in the short term to cope with symptoms, but it may worsen them in the long run. Self-medication is associated with a higher risk of suicide and lower quality of life.7 Continued use of alcohol as a coping mechanism may also lead to alcoholism.8
What Is Alcoholism?
Symptoms of an alcohol use disorder are outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). You may have a problem with alcohol that requires treatment if you meet any 2 of the following criteria in a one-year period: 9
- Drinking more or for longer than you intended.
- Attempting to cut down drinking more unsuccessfully.
- Spending a great deal of time drinking or recovering from hangovers.
- Craving alcohol.
- Finds that drinking too much, or being sick from drinking, interferes with working, taking care of family members, or other obligations.
- Continuing to drink despite harm done to relationships, work, etc.
- Giving up or cutting back on enjoyable activities specifically to drink more.
- Putting yourself in dangerous situations while intoxicated (e.g., driving drunk).
- Continuing to drink despite feeling depressed, anxious, or developing another health problem.
- Needing more and more alcohol to feel the desired effects.
- Feeling withdrawal symptoms when cutting back or quitting, including shaking, anxiety, nausea, sweating, and insomnia.
Veterans experiencing the symptoms of an alcohol use disorder require treatment.
Treatment for Veterans Struggling with Alcohol Abuse
The VA provides treatment options through the Veterans Alcohol and Drug Dependence Rehabilitation Program.
Some veterans may not have access to a nearby VA hospital, and others may choose to get treatment outside the VA. It’s important to find a program that understands veterans’ unique needs and perspectives, so they provide the best quality treatment. Today, many private treatment programs also specialize in addiction and mental health treatment for veterans.
Recovery First offers a specialized treatment program for veterans, where vets struggling with addiction and co-occurring disorders such as depression or PTSD can receive treatment alongside others who understand what they’re going through.
Many of those who work in the veteran program are also vets in recovery, allowing a shared perspective between counselor and patient. Military veterans who attend Recovery First also have the opportunity to participate in group therapy comprised entirely of veterans, creating a safe space among people who have experienced many of the same experiences and traumas.
Whether choosing a program through the VA or a program like Recovery First’s, know that help is out there for you or your veteran loved one.
- Teeters, J. B., Lancaster, C. L., Brown, D. G., & Back, S. E. (2017). Substance use disorders in military veterans: prevalence and treatment challenges. Substance abuse and rehabilitation, 8, 69–77.
- National Institute on Drug Abuse. (2013). Substance Abuse in the Military.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use and Preventing Alcohol-Related Problems Among Young Adults in the Military.
- U.S. Department of Veterans Affairs. (n.d.). PTSD and Substance Abuse in Veterans.
- Santiago PN, Wilk JE, Milliken CS, et al. (2010). Screening for alcohol misuse and alcohol-related behaviors among combat veterans. Psychiatr Serv.
- Rehm J. (2011). The risks associated with alcohol use and alcoholism. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 34(2), 135–143.
- Leeies, et al. (2010). The use of alcohol and drugs to self‐medicate symptoms of posttraumatic stress disorder. Depression and Anxiety, 27(8), 731-736.
- Lazareck, S., Robinson, J. A., Crum, R. M., Mojtabai, R., Sareen, J., & Bolton, J. M. (2012). A longitudinal investigation of the role of self-medication in the development of comorbid mood and drug use disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The Journal of clinical psychiatry, 73(5), e588–e593.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder.