A Veteran’s Guide to Substance Abuse in the Reserve and National Guard

Key Takeaways

• Substance misuse in the Reserve and National Guard includes a range of substances, with alcohol, tobacco, and prescription drugs being the most prevalent.
• Unique stressors such as deployment, combat exposure, and transitioning between civilian and military life contribute to higher substance misuse rates in these groups.
• Substance misuse can lead to significant health issues, including mental health disorders like PTSD, and has operational impacts on readiness and effectiveness.
• Prevention strategies involve mandatory drug testing, education, and resilience training, while treatment includes VA programs and specialized residential programs.
• The 2024 NDAA reflects a commitment to addressing substance misuse, with $883.7 billion authorized for defense spending, including prevention and treatment.

A Veteran’s Guide to Substance Abuse in the Reserve and National Guard

Substance Abuse Prevalence 

Substance misuse is a significant issue within the Reserve and National Guard, influenced by unique factors such as deployment, combat exposure, and the transition to civilian life. Various statistics highlight the scope of the problem:

• Smoking rates among military personnel decreased from 24% in 2011 to 14% in 2015, with 7% being daily smokers.
• Veterans exhibit higher rates of tobacco use (nearly 30%) compared to non-veterans, contributing to substantial healthcare costs. This has led to significant healthcare costs, estimated at $2.7 billion for the Veterans Health Administration (NIDA).
• Alcohol misuse is prevalent, with 56.6% of veterans reporting use in a one-month period and 65% of treatment-seeking veterans citing alcohol as their primary misuse. The prevalence of SUDs and co-occurring mental health disorders like PTSD, depression, and anxiety is a concern, with about 11% of veterans seeking care for the first time within the Veterans Health Administration meeting criteria for an SUD diagnosis (NIDA).
• Over 4% of active-duty service members reported misusing prescription drugs in the past year. The number of prescriptions for pain medication written by military physicians quadrupled from 2001 to 2009. Still, more recent data suggests a decrease in the self-reported use of prescription opioids and sedatives (NIDA). 
• Studies have found that never-deployed service members exhibit similar mental health and substance use issues as those who have been deployed, with moderate risk scores for non-medical use of prescription sedatives and stimulants (NCBI).
• Prescription drug misuse among active-duty members has decreased, but concerns persist about sedative and stimulant misuse among never-deployed personnel.
• Ongoing surveillance, prevention, and treatment strategies are essential to address these challenges effectively.

Substance Abuse Trends 

Substance misuse remains a pressing concern within the Reserve and National Guard, exacerbated by the unique stressors and military culture experienced by service members:

• Alcohol misuse, including binge drinking, is common, with many veterans continuing such habits post-service.
• Tobacco use remains a significant health risk, with 45.5% of current smokers in the Reserve and National Guard attempting to quit.
• Marijuana is the most commonly used illicit drug, though underreporting due to stigma may affect reported rates.
• Co-occurring disorders, such as substance use disorders and mental health issues, are prevalent and complicate treatment efforts within the military population.

Contributing Factors to Substance Abuse: The Reserve and National Guard

Several factors contribute to substance misuse among Reserve and National Guard members, distinct from active-duty personnel:

• Military stressors like deployments, traumatic events, and transitioning between civilian and military life contribute to alcohol use disorders and substance misuse.
• The National Guard, facing the highest suicide rate among military branches, underscores the link between mental health struggles and substance misuse.
• Social support during deployment correlates with lower drug use rates, highlighting the role of resilience factors.
• Despite deterrents like drug testing, substance use rates often increase post-service, particularly marijuana use.
• Co-occurring disorders, such as PTSD and chronic pain, increase vulnerability to substance misuse.

Effective treatment programs like the Substance Abuse Residential Treatment Program and resources from the VA play crucial roles in supporting recovery efforts. However, barriers to accessing behavioral health care, including stigma and limited service capacity, remain challenges that need to be addressed comprehensively.

Consequences of Substance Abuse: The Reserve and National Guard

Substance misuse within the Reserve and National Guard has profound consequences that extend beyond individual health, impacting operational readiness and effectiveness. Key points include:

• Substance use disorders (SUDs) among service members can lead to mental health issues, decreased unit cohesion, and compromised mission capabilities.
• The National Guard reports the highest suicide rates among military branches, underscoring the urgency of addressing SUDs in this population.
• After leaving military service, rates of illicit drug use, particularly marijuana, tend to increase among veterans.
• Co-occurring disorders, such as SUDs and mental health conditions, are common and complicate treatment.

Health Consequences 

Substance misuse in the Reserve and National Guard can lead to significant physical and mental health impacts, including:

• High prevalence of alcohol use disorders, exceeding those in the general population.
• Increased risk of suicide within the National Guard, reflecting severe mental health consequences.
• Co-occurrence of substance misuse with conditions like PTSD and depression.
• Challenges in accessing recommended care for mental health and substance use disorders, particularly in remote areas.
• The physical health of service members can also suffer leading to nutritional deficiencies, sleep disturbances, and injury risks.

Access to behavioral health care is critical, yet research by RAND suggests that National Guard and Reserve members face disparities in receiving recommended care for mental health and substance use disorders, particularly those in remote areas. 

Operational Impact 

Substance misuse affects operational effectiveness in the Reserve and National Guard, impacting national security and domestic operations:

• Deployed Army National Guard (ARNG) soldiers show higher rates of heavy drinking compared to non-deployed members, potentially impairing performance.
• PTSD, combat trauma, and chronic pain increase substance misuse risks, further affecting operational capabilities.
• Substance misuse contributes to new-onset heavy drinking and alcohol-related problems, diminishing unit cohesion and morale.
• Comprehensive care programs and family engagement strategies are crucial to reducing relapse rates and ensuring continuous care.
• Strong family relationships and support during deployment are protective factors against post-deployment drug use, emphasizing the role of social and emotional support mechanisms.

Substance Abuse Prevention and Treatment: The Reserve and National Guard

The Reserve and National Guard face unique challenges related to substance misuse, necessitating tailored prevention and treatment strategies. Key points include:

• Risk assessment and urine screening for high-risk individuals, along with limitations on controlled substance prescriptions, are critical preventive measures.
• Education efforts emphasize healthy alternatives, responsible behavior, and the consequences of substance misuse, targeting service members, families, healthcare professionals, and officers.
• Resilience training programs like the Comprehensive Soldier Fitness (CSF) enhance coping skills across various dimensions and empower noncommissioned officers to support their units effectively.
• Treatment options for SUDs include outpatient services, hospitalization, and inpatient residential care, with a focus on continuity of care and family involvement.
• Drug testing and the fear of discharge or criminal charges act as deterrents, but rates of drug use often increase post-service, necessitating ongoing support and initiatives like the Suicide Prevention and Readiness Initiative.

Prevention Strategies 

Prevention strategies tailored to the Reserve and National Guard are essential for maintaining service member health and readiness. The National Guard’s substance misuse prevention community collaborates with leading prevention experts and policymakers to enhance these efforts. Key strategies include:

• Mandatory, random drug testing and the threat of discharge or criminal charges deter illicit substance use.
• VA programs offer comprehensive support for veterans with SUDs and co-occurring mental health disorders, emphasizing intervention and support.
• The CDC’s drug overdose prevention framework provides a strategic basis for reducing overdose deaths and informs prevention efforts within military settings.

Rehabilitation and Treatment Programs

Members of the Reserve and National Guard have access to a range of treatment and rehabilitation programs to address substance misuse. Key aspects include:

• VA programs offer both inpatient and outpatient services to veterans, including those in the Reserve and National Guard, focusing on recovery from SUDs. VA medical centers and community providers are equipped to handle these cases.
• Behavioral health initiatives through the National Guard Bureau support prevention and provide trauma-informed care for transitioning service members.
• Specialized residential programs like the Substance Abuse Residential Treatment Program in the National Capital Region offer intensive inpatient care and family engagement.
• Co-occurring disorder support ensures comprehensive care by addressing mental health issues alongside substance use disorders.
• Prevention and resiliency training initiatives, such as the Comprehensive Soldier Fitness program, equip service members and families with skills to manage stress and prevent substance misuse.

For immediate assistance, Reserve and National Guard members can contact the Veterans Crisis Line at 1-800-273-8255 or text 838255. Additionally, Military OneSource provides a range of substance misuse resources and non-medical counseling services to support the military community.

Policy and Legislation: Substance Abuse in the Reserve and National Guard

The National Defense Authorization Act (NDAA) for Fiscal Year 2024 underscores the United States’ commitment to addressing substance misuse within the military, including the Reserve and National Guard. This legislation, encompassing a total of $883.7 billion in funding, prioritizes policies and programs aimed at prevention and treatment across all branches of the military. Key points include:

• Establishment of Programs: The NDAA allocates resources to establish comprehensive programs specifically targeting substance misuse prevention and treatment among service members, including those in the Reserve and National Guard.
• Support for Military Construction: Funding provisions extend to military construction projects, potentially enhancing infrastructure for healthcare and rehabilitation facilities critical to addressing substance misuse.
• Bipartisan Commitment: Enactment of the NDAA reflects bipartisan support for prioritizing the health and readiness of military personnel, highlighting the federal government’s dedication to combating substance misuse in all military ranks.

Help for Veterans with Addiction at The Recovery Village at Baptist Health

The Recovery Village at Baptist Health is a leading treatment provider specializing in addiction and co-occurring mental health disorders, tailored specifically for veterans. Key features include:

• Specialized Care: Clinicians are trained in trauma-informed care and military culture, ensuring veterans receive specialized treatment that addresses their unique addiction and mental health needs.
• VA Community Care Network: As members of the VA Community Care Network, The Recovery Village accepts VA health benefits as payment at no cost to the veteran, facilitating accessible and comprehensive care.

If you’re a veteran struggling with alcohol or drug addiction, The Recovery Village at Baptist Health offers a physician-led private rehab program tailored to your needs. Call us today and request a specialized Veteran Advocate to assist you.