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Opening April 2019

A Veterans Guide to Navigating Addiction Treatment in the United States

Many veterans struggle with an addiction. In 2015 alone, the VA estimates that 68,000 veterans struggled with an opioid addiction. This doesn't account for addictions to other types of prescription and illicit drugs. It also doesn't factor in the vast amount of veterans with an alcohol addiction.

The hardships associated with war often lead to the use of various substances. It also leads to heavy drinking and binge drinking.

With substance abuse having such a huge stronghold on the military and among veterans, it's time to strip away the stigma. More veterans and active duty military personnel will seek help if addiction issues are more frequently addressed. This veteran’s guide to navigating addiction treatment in the U.S. will give you all the information you need.

A Veterans Guide to Navigating Addiction Treatment in the United States

Why Is Addiction So Common Among Veterans?

Veterans are among some of the most likely people to develop an addiction. The high incidence of veteran substance abuse disorders is most likely caused by:

  • A high incidence of PTSD and other mental health disorders
  • Combat exposure, particularly ones that lead to traumatic brain injuries
  • A high incidence of substance misuse during active service
  • Injuries that cause chronic pain
  • An altered mechanism for coping with stress
  • A reluctance to seek help due to embarrassment or other issues
  • An inability to recognize and acknowledge the presence of a problem

Veteran substance abuse disorders are usually linked to poor mental health. Those struggling with PTSD or suicidal thoughts are more likely to use illicit drugs, prescription drugs or alcohol to escape their reality.

The Relationship Between Substance Abuse and Suicide

To deal with their pain, many turn to alcohol or drugs. Studies show that a third of all alcohol abusers and over half of all drug abusers struggle with a mental illness. To achieve a healthy mental state, both conditions must be treated and diagnosed at the same time.

If the suicidal thoughts are not treated, it will only exacerbate the addiction. On the other hand, if only the addiction is treated, suicidal thoughts can amplify and magnify. Both conditions play off of each other.

The cycle between suicide and addiction is vicious. The use of substances mask the effects of a mental illness. Drugs and alcohol boost feel good hormones in the body to relieve anxiety and depression. Veterans who attempt to quit experience withdrawal symptoms and are tormented by mental issues. This makes it incredibly difficult to stop the use of any substances. Many believe that self-medicating is what keeps them sane.

How to Recognize Suicidal Thoughts and Addiction

To get a loved one help, you must first be able to recognize common symptoms and signs of suicide and addiction. Someone struggling with both will tend to:

  • Feel hopeless and worthless
  • Display signs of panic, fear and anxiety for no reason
  • Be fatigued throughout the day
  • Experience mood swings, and be particularly irritable
  • Be incapable of maintaining a conversation due to racing thoughts

Pay close attention to their actions. Don't overlook any side comments they may make, especially if it concerns suicidal thoughts.

It's because suicide is not dealt with properly that 22 veterans a day commit suicide. That works out to almost one suicide each hour of the day. Veterans experience a 50% higher suicide rate than those who did not serve our country.


The Relationship Between Substance Abuse and PTSD

There's nothing pretty about war. Veterans see some pretty horrifying and terrifying events unfold before their eyes. As a result, many develop post-traumatic stress disorder (PTSD).

The numbers are shocking. According to the U.S. Department of Veteran Affairs, PTSD affects:

  • Nearly 31% of Vietnam vets
  • About 10% of Gulf War (Desert Storm) vets
  • Approximately 11% of those who fought in Afghanistan

In addition, between 36% and 50% of veterans seeking help for a substance use disorder also have PTSD. The correlation between the two is strong. It's evidence that veterans tend to rely on substances to deal with their condition.

PTSD has a physical effect on brain chemistry. After experiencing traumatic events, there's a drop in endorphin levels in the brain. Endorphins are hormones that make people feel good. A significant drop in endorphin levels lead to depression and anxiety.

Usually, endorphin levels replenish on their own. For veterans struggling with PTSD, the endorphin levels never recover. This leads to constant depression and anxiety. Substances help deal with this mood change by temporarily elevating endorphin levels. It also elevates levels of other important chemicals that makes veterans feel like themselves again. Since the elevation in chemistry levels is temporary, those who stop using the substances will be back at square one.

Many veterans are too proud to admit that they struggle with PTSD. Because of this reason, many fail to seek help. Symptoms of PTSD include:

  • Anger
  • Anxiety
  • Attention Deficit Disorder
  • Depression
  • Difficulties concentrating
  • Feeling detached
  • Feeling on edge
  • Flashbacks
  • Nightmares
  • Sleeplessness or insomnia
  • Suicidal thoughts

When dealing with both PTSD and an addiction, an integrated treatment plan is vital. The treatment plan should include several critical elements like:

  • An individual cognitive behavioral therapy
  • A tailored drug or alcohol treatment plan
  • Mechanisms utilized to avoid triggers
  • A relapse prevention treatment or an aftercare program

A successful recovery involves managing co-treatment of both conditions under one roof.

Which Veterans Are Most Susceptible?

Veterans of all ages and from all military branches are susceptible to substance abuse. However, studies have found that young adult veterans are most likely to get addicted to substances.

From 2004 to 2006, 25% of veterans between the ages of 18 and 25 struggled with a substance use disorder. This is more than double the rate of veterans between the ages of 25 and 54. Even more shockingly, this is more than 5 times the rate of veterans who are 55 years of age and older. The younger the veteran, the higher their susceptibility is.

The higher susceptibility is attributed to a poorer ability in dealing with stress. While on active duty, enlisted members witness events that lead to psychological wounds. 1 in 4 veterans who returned from Iraq or Afghanistan struggled with a mental or cognitive disorder. 1 in 6 struggled with PTSD.

Most Commonly Abused Substances

Veterans have access to all the same drugs as civilians. While deployed, active duty members are more likely to misuse prescription opioid painkillers and to abuse alcohol. Military physicians are quick to prescribe opiates to treat pain. The use of opioids can quickly lead to an addiction problem.

Once out of the military, veterans bring the addiction problem home with them. Those who no longer have access to prescription opioids are more likely to seek relief through street drugs, like heroin. Both illicit drugs and prescription opioids affect brain chemistry is similar ways.

Some veterans only start misusing prescription opioids upon retiring from active duty. The VA has continued to prescribe prescription opioids to more veterans. In 2001, the VA prescribed 1,130 patients the opioid painkiller hydrocodone. By 2012, 47,586 patients received prescriptions for the same opioid. That's a 4,100% increase!

1,130

In 2001, the VA prescribed 1,130 patients the opioid painkiller hydrocodone.

47,586

By 2012, 47,586 patients received prescriptions for the same opioid.

While prescription opioids are often prescribed for legitimate purposes, tolerance for these drugs build quickly. Tolerance easily leads to addiction and overdoses.

Recognizing the signs of an addiction is the first step in getting help for those you love. If you suspect that a veteran has an addiction, pay close to their actions. Common signs include:

  • Feeling fatigued all the time. They may start nodding off even during the middle of a conversation.
  • Becoming anti-social or having new friends with similar interests to them.
  • Having different sleep patterns. Addicts may, at times, sleep for the entire day or not sleep for days depending on the substance they are using.
  • Losing weight. The use of almost all substances typically affect one's metabolism.
  • Having financial difficulties. Drugs are expensive!

If you’re worried that you might be addicted, complete our addiction quiz and find out. You’re likely addicted if you have troubles quitting, experience withdrawal symptoms or continue to use the substance even when it is harming your life.

Types of Addiction Treatment Programs for Veterans

The government recognizes the toll that addiction has on veterans. As a result, more government-funded and privately-funded programs have emerged in past years. VA, in particular, offers many inpatient and outpatient treatment programs. They offer access to renowned recovery centers, and services like:

  • One-on-one counseling
  • Family counseling
  • Group therapy
  • PTSD treatment
  • Inpatient rehab programs
  • Outpatient rehab programs
  • Medications for withdrawal, or replacement therapy

These services are directly accessible at VA centers. Privately-funded recovery centers offer the same type of treatments, if not more. They offer a more detailed treatment plan and a higher level of care with more resources.

A Look at the Insurance Coverage

Veterans interested in privately-funded recovery centers will pay out of their own pocket. It's important to figure out whether the health insurance covers any of the cost. One of the most common types of health insurance is TRICARE. TRICARE usually covers:

  • Detox services for 7 days
  • Inpatient rehab for 21 days
  • Acute inpatient psychiatric care for anywhere from 30 to 45 days
  • Up to 60 group therapy sessions
  • Up to 15 outpatient family visits

TRICARE covers a wide range of treatments. It, however, does not cover aversion therapy and unproven treatments. Many veterans may have different health insurance policies. To determine whether the treatment is covered by your insurance plan, use an online insurance verification.

Eligibility for Veteran’s Health Insurance, or TRICARE

TRICARE is an insurance policy available to active duty service members and veterans. Veterans, who have this type of veteran’s health insurance, will find that the policy extends to their family members too. To be eligible for TRICARE, you have to be either:

  • A retired active-duty member
  • A retired member of the reserves or the National Guard and be 60 years of age and older
  • Ex-military personnel who has served for any length of time and was awarded the Medal of Honor

You are also entitled and eligible for TRICARE benefits if you are:

  • The spouse or a child of an eligible veteran
  • The surviving spouse of an enlisted soldier who died on active duty
  • A divorced spouse of a veteran who has served for over 20 years, as long as the marriage lasted at least 15 of the 20 years

Children must be single and under the age of 21. Children who are 23 years of age and attending college under the support of their parents are also eligible. TRICARE benefits expire three years after the death of an active-duty service member, and one year after a divorce.

Addiction Therapies

Frequently Recommended Addiction Therapies

Depending on the drug of choice and length of use, various modifications is made to the treatment plan. Withdrawing from substances can be just as deadly as misusing it. For example, alcohol withdrawals can lead to a chemistry imbalance in the body. This imbalance can be fatal. Physicians assess each patient using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). This determines how dangerous the alcohol withdrawals may be.

To help patients reach sobriety, most recovery centers offer the following types of therapies:

  • Opioid Replacement Therapy (ORT), which uses medications to curb cravings specifically for opioids
  • Medications for dealing with addictions with alcohol, cocaine and meth
  • Individual therapy for focusing on improving oneself and identifying underlying causes behind addictions
  • Group therapy for finding and receiving support from others going through similar situations
  • Behavioral modification therapy for identifying triggers and developing better reactions and responses -Mindfulness therapy for becoming more aware of one’s sensations and emotions when handling addictions
  • Nutritional therapy for learning how to eat more healthy; getting the right nutrients can curb cravings
  • Physical fitness therapy, which incorporates exercises in achieving sober living
  • Music therapy or art therapy for tapping into one’s creative mind and finding alternative solutions when dealing with stress
  • Motivational Enhancement Therapy, which establishes motivations for becoming sober

Physicians may prescribe several different types of medications to lessen the intensity of withdrawal symptoms. Physicians may prescribe several different types of medications for withdrawal symptoms. Let's take a look at popular options below.

When withdrawing from alcohol, the most common concern is to prevent severe symptoms like delirium tremens. These symptoms can be deadly. In fact, the mortality rate for patients who experience this symptoms is about 8%. Commonly prescribed medications when withdrawing from alcohol include:

  • Acamprosate, which works by targeting neurons affected by alcohol abuse
  • Benzodiazepine, which reduces the severity of alcohol withdrawal symptoms and prevents severe symptoms like seizures and delirium tremens
  • Disulfiram, which is used in “aversion” therapy to make a person to feel ill if they consume alcohol
  • Naltrexone, which decreases alcohol cravings by blocking the neurotransmitters in the brain

Opioid withdrawals are often less dangerous than alcohol withdrawals. However, the withdrawal symptoms can still be very intense. When withdrawing from opioids, the most prescribed medications include:

  • Buprenorphine, which acts like an opioid to prevent the onset of withdrawal symptoms
  • Methadone, which blocks cravings although it is equally addictive itself
  • Naltrexone, which blocks cravings and prevents the onset of withdrawal symptoms

The dosage prescribed and frequency of use will vary with each patient.

Treatment length is dependent on the type of drugs used and the length of the addiction. At a minimum, patients need medical attention until the withdrawal symptoms disappear.

The withdrawal timeline will vary with each substance. When withdrawing from opiates, withdrawal symptoms tend to kick in approximately a day after quitting. The symptoms reach their peak intensity on day 3, and will typically disappear by day 10. On the other hand, alcohol withdrawal symptoms usually last only a week; however, they can kick in as early as 6 hours after quitting.

Many recovery centers recommend staying in treatment even after physical withdrawal symptoms are gone. This is largely because the emotional symptoms can be just as taxing. Rehab not only deals with the physical symptoms, but also the emotional ones as well. Many treatment programs work because they help patients identify triggers and learn how to deal with them. They help patients become more aware of their feelings, and learn how to make better choices.

All of this helps reduce the chances of relapsing. Unfortunately, minor relapses are quite common, and is a part of the recovery process. The key is to not get bogged down by relapses, and to keep going.

Don’t Go At Sobriety Alone

After serving our country, veterans should not have to deal with addictions alone. If you or someone you love is dealing with an addiction, there's plenty of resources at your disposal.

Here at Northpoint Washington, we offer some of the best rehab programs available. Our goal is to help you achieve and maintain sobriety, and you'll always get the attention you need from us. We're here to help!

If you have any further questions or if you're interested in us, contact one of our counselors today to get started on your journey to recovery.

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