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The Intersection Between Veteran Addiction, Self-Medication and Trauma

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Navigating the terrain of trauma and substance use, veterans face a formidable challenge. According to the U.S. Department of Veterans Affairs, approximately 7% of veterans struggle with post-traumatic stress disorder (PTSD) at some point in their lives. Exposure to combat, frightening experiences and life-threatening situations can render veterans more susceptible to trauma-related behavioral and mental health issues compared to the general population.

Regrettably, a profound connection exists between trauma and self-medication. Studies suggest that nearly 50% of individuals diagnosed with PTSD also grapple with a concurrent substance use disorder. Many experts posit that this relationship stems from the tendency to self-medicate, using substances as a fleeting escape from the haunting memories and emotions associated with traumatic experiences. 

However, as the effectiveness of substances declines, self-medication can evolve into a full-blown substance use disorder. When left unaddressed, the co-occurring conditions of trauma and substance worsen a person’s behavioral and mental health. To deliver effective care, clinicians often embark on a dual journey to address both trauma and substance use at once. Treatment programs may integrate veteran support groups to further personalize the treatment plan. Fortunately, there are evidence-based treatments spanning various modalities that offer invaluable support to self-medicating veterans on their quest to recovery.

The Complex Picture of Trauma and Self-Medication

Veterans grappling with trauma often encounter a spectrum of symptoms. As per the American Psychiatric Association, PTSD symptoms can include:

  • Intrusive thoughts, including distressing dreams and vivid flashbacks
  • Avoidance of people, places or situations that may trigger distressing memories, events or emotions
  • Distorted thoughts regarding the traumatic event or an inability to remember it accurately
  • Mood swings or a persistently negative mood

To cope with these symptoms, veterans may turn to drugs and alcohol. Initially, substances may offer temporary relief by aiding sleep, conferring comfort in specific situations or serving as a distraction from issues arising from PTSD, such as strained relationships or professional setbacks. However, self-medication merely perpetuates the cycle of avoidance.

While self-medication may appear to be a quick fix, PTSD symptoms generally deteriorate over time. This decline disrupts sleep, alters mood and diminishes the effectiveness of prescribed psychiatric medications. Evidence underscores the most effective approach, which entails addressing both PTSD and substance use disorder concurrently.

Veterans Dealing with Trauma and Co-Occurring Substance Use Disorders

Veterans embarking on the journey to recovery often engage in a comprehensive continuum of care tailored to their specific needs. Assessments for substance use and psychiatric concerns help determine the most suitable level of care. In cases where veterans require structured and supervised recovery, clinicians may recommend residential or inpatient facilities.

If deemed medically necessary, individuals may undergo supervised detox to safely withdraw from substances. Many detox facilities incorporate medication-assisted treatment (MAT) to ensure a safe and comfortable experience. These acute care levels aim to stabilize individuals and prepare them for transitions into less intensive care.

While the specifics of each care plan depend on the veteran’s needs, residential treatment may be followed by a partial hospitalization program (PHP), an intensive outpatient program (IOP), regular outpatient programs and aftercare services. For veterans, these aftercare services may encompass vocational training, ongoing medication management to address psychiatric symptoms and participation in veteran support groups.

Evidence-Informed Strategies for Self-Medicating Veterans Confronting Trauma

Throughout different stages of care, clinicians deploy an array of treatments to address both substance use and trauma-related challenges.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) has emerged as a highly effective tool for treating co-occurring trauma-related disorders. During CBT sessions, clinicians help patients to correct maladaptive thinking patterns that may contribute to veterans’ self-medication. These trauma-focused psychotherapy sessions also aid veterans in processing traumatic events and the associated emotions.

Exposure Therapy

Prolonged exposure therapy seeks to diminish the emotional “triggers” linked to trauma. These sessions may involve repeated exposure to detailed images or virtual reality programs designed to evoke fear, distress and other negative emotions. The aim is to create a controlled, secure environment for veterans to systematically confront their emotional reactions to trauma triggers. 

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR, a trauma-focused psychotherapy, involves inducing eye movement in veterans while discussing traumatic events. Thought to simulate REM sleep, EMDR often proves effective in altering veterans’ memories of traumatic events, thereby reducing their emotional connection to these memories.

Family-Centric Counseling

Family counseling sessions include loved ones in the treatment process. This approach helps loved ones understand the symptoms of trauma and substance use disorders while actively participating in aftercare planning. Research suggests that family involvement in treatment can improve treatment outcomes among veterans.

Medication Management and Post-Treatment Support

In addition to counseling and psychoeducation, veterans may continue to receive medication to address symptoms associated with PTSD and substance use. Post-treatment plans typically encompass ongoing medication management and follow-up appointments with prescribing clinicians.

Alternative Therapeutic Approaches

Treatment for veterans may also include individual counseling and group therapy with other veterans or individuals who have experienced similar traumatic events. One intervention tailored specifically for those with PTSD and co-occurring substance use disorders is Seeking Safety therapy. This evidence-based approach aims to reduce trauma and substance abuse symptoms while enhancing coping skills related to behavior, thinking and emotions.

View Sources

U.S. Department of Veterans Affairs. “How Common is PTSD in Veterans?”><[…]pa[…] in Veterans?” Accessed November 8, 2023. 

McCauley, Jenna; Killeen, Therese; Gros, Daniel; Brady, Kathleen; & Back, Sudie. “Posttraumatic Stress ” Clinical Psychology (New York), 2012. Accessed May 24, 2023. 

American Psychiatric Association. “What is Posttraumatic Stress Disorder (P[…]order (PTSD?)” November 2022. Accessed November 8, 2023. 

Norman, Sonya; Wilkins, Kendall; Tapert, Susan; Lang, Ariel; & Najavitsd, Lisa. “A Pilot Study of Seeking Safety Therapy […]/OIF Veterans.” Journal of Psychoactive Drugs, March 2010. Accessed November 8, 2023. 

Thompson-Hollands, Johanna; Rando, Alora; Stoycos, Sarah; Meis, Laure; & Iverson, Katherine. “Family Involvement in PTSD Treatment: Pe[…]n Clinicians.” Administration and Policy in Mental Health and Mental Health Services Research, 2022. Accessed November 8, 2023. 

Tapia, Geraldine. “Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder.” Journal of EMDR Practice and Research, November 2019. Accessed January 24, 2024.