What Predicts Substance Abuse in Veterans?

Like the rest of the adult U.S. population, people who have served in the military sometimes develop serious problems with drugs and/or alcohol. In a study published in July 2014 in the Journal of Studies on Alcohol and Drugs, a group of American researchers investigated the factors that can potentially predict whether a veteran who starts experiencing substance problems will continue to experience those problems over time. These researchers concluded that several things make ongoing substance problems among military veterans more likely, including the presence of post-traumatic stress disorder (PTSD).

Veterans and Substance Abuse

Certain forms of substance abuse increased quite dramatically among active military personnel in the first decade of the 2000s, according to figures compiled by the National Institute on Drug Abuse. For instance, the rate of prescription medication abuse increased by roughly 100 percent between 2002 and 2005, then increased again by almost 200 percent between 2005 and 2008. Despite this steep rise, alcohol abuse is still the most common substance problem for active military personnel. For example, in the aftermath of active duty in Iraq, roughly one-quarter of all Army personnel qualified for a diagnosis of alcohol abuse (which forms part of a more comprehensive diagnosis called alcohol use disorder).

In 2012, the Substance Abuse and Mental Health Services Administration released a report that examined the types of substance abuse most likely to occur in military veterans between the ages of 21 and 39, and also compared the rates of abuse for veterans and non-veterans. While roughly 51 percent of veterans seeking treatment for substance abuse outside of the Veterans Administration system named alcohol as the primary source of their problems, only about 34 percent of non-veterans seeking treatment named drinking as their primary problem. Interestingly, non-veterans were more likely to have problems with all other substances except opioids (excluding heroin).

Veterans and PTSD

Post-traumatic stress disorder is linked to exposure to highly disturbing events that either seem life-threatening or pose an actual threat of a lethal outcome. While most people who go through such events don’t develop the condition, substantial numbers of men and women do develop PTSD symptoms. One of the best known underlying causes for post-traumatic stress is exposure to active combat. People who witness combat or live in combat zones also have increased odds of developing PTSD. Practically speaking, these facts mean that military personnel who serve in times of war have significant chances of developing PTSD-related problems while on active duty or in the aftermath of their service. Typically, doctors can effectively address post-traumatic stress in military personnel, veterans and other people through a combination of psychotherapy and medication.

What Predicts Ongoing Problems?

In the study published in the Journal of Studies on Alcohol and Drugs, researchers from the University of California San Diego, the National Center for PTSD, the Naval Health Research Center and the Institute for Behavioral and Community Health used an examination of 1,599 military veterans to explore the factors that make it more likely that a veteran will experience ongoing substance problems. All of these study participants were asked to self-report the presence of significant problems upon leaving the military, as well as over the course of the following year.

Out of the 1,599 participants, 742 indicated that they had substance problems when they first left military service. One year later, 42 percent of these initially affected individuals still reported the presence of substantial substance-related issues. When they compared the behaviors of these individuals to the rest of the study group, the researchers found that the veterans with ongoing substance problems had a harder time getting used to life after military service and were also more likely to act in aggressive ways and drive after consuming alcohol. A detailed analysis showed that three factors helped predict the presence of ongoing substance problems one year after leaving the military. These factors were having a relatively high overall number of PTSD symptoms, using avoidance behaviors to cope with unwanted situations (a classic PTSD symptom) and having a tendency to seek out highly stimulating experiences.

Based on their findings, the study’s authors concluded that knowledge of the predictors for ongoing substance problems is critical for effective efforts to prevent such problems in military veterans. In turn, successful prevention is critical in helping veterans avoid experiencing serious difficulties in the aftermath of their service.

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