Self-Medicating Veterans: Addressing Trauma and Substance Use
Last Updated: February 9, 2024
According to the U.S. Department of Veterans Affairs, approximately 7% of military veterans will grapple with post-traumatic stress disorder (PTSD) during their lifetime. The experience of combat, traumatic events and life-threatening situations can leave veterans more susceptible to trauma-related behavioral and mental health issues than the general population.
Regrettably, the connection between trauma and self-medicating is strong. Research suggests that nearly 50% of individuals diagnosed with PTSD also contend with a co-occurring substance use disorder. Many experts posit that this relationship arises from the inclination to self-medicate—using substances as a temporary escape from the memories and emotions linked to traumatic experiences.
Nonetheless, as the effectiveness of substances diminishes, self-medicating can transform into a full-blown substance use disorder. Untreated trauma and substance use disorders perpetuate a cycle of worsening mental and behavioral health challenges.
To effectively address these issues, clinicians often tackle both trauma and substance use concurrently. Treatment programs may even integrate veteran support groups to tailor treatment for individuals. Fortunately, evidence-based treatments, offered through various modalities, can effectively aid self-medicating veterans on their path to recovery.
Self-Medicating as a Response to Trauma
Veterans grappling with trauma may encounter a spectrum of symptoms. As per the American Psychiatric Association, PTSD symptoms can include:
- Intrusive thoughts, potentially involving disturbing dreams and vivid flashbacks
- Avoidance of people, places or situations that may trigger distressing memories, events or emotions
- Distorted thoughts of the traumatic event or difficulty accurately recalling it
- Mood fluctuations
To cope with these symptoms, veterans may resort to drugs and alcohol. Substances might offer temporary relief by aiding sleep, providing comfort in specific situations or serving as a distraction from problems resulting from PTSD, such as strained relationships or employment issues. However, self-medication only perpetuates the cycle of avoidance.
While self-medication may initially provide momentary relief, PTSD symptoms generally worsen over time. This can disrupt sleep, alter mood and reduce the effectiveness of prescribed psychiatric medications. Evidence supports the most effective approach, which involves concurrently addressing both PTSD and substance use disorder.
Comprehensive Care for Trauma and Co-Occurring Substance Use Disorders in Veterans
Veterans seeking treatment usually embark on a continuum of care tailored to their individual needs. They typically undergo assessments for substance use and psychiatric concerns to determine the most suitable level of care. In cases where veterans require structured and supervised recovery, clinicians may recommend residential or inpatient facilities.
If medically necessary, individuals may undergo supervised detox, safely withdrawing from substances. Many detox facilities employ 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. Aftercare for veterans can encompass vocational training, ongoing medication management to address psychiatric symptoms and participation in veteran support groups.
Effective Interventions for Self-Medicating Veterans Dealing with Trauma
Throughout different levels of care, clinicians may employ a variety of treatments to address both substance use and trauma-related issues.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) has demonstrated effectiveness in treating co-occurring trauma-related disorders. During CBT sessions, clinicians explore maladaptive thinking patterns that may contribute to veterans’ self-medicating behaviors. These trauma-focused psychotherapy sessions also help veterans process traumatic events and the associated emotions.
Prolonged exposure therapy may diminish the emotional “triggers” associated with trauma. These sessions may involve repeated exposure to detailed images or virtual reality programs that evoke fear, distress and other negative emotions. The goal is to create a controlled, safe environment where veterans can confront their emotional reactions and learn to cope with their triggers progressively.
Eye Movement Desensitization and Reprocessing Therapy (EMDR)
EMDR, a trauma-focused psychotherapy, induces eye movement in veterans while discussing traumatic events. Thought to simulate REM sleep, EMDR is often effective in altering veterans’ memories of traumatic events, reducing their emotional connection to these memories.
Family counseling sessions involve 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. Evidence indicates that family involvement in treatment has the potential to enhance treatment outcomes among veterans.
Medication Management and Aftercare
In addition to counseling and psychoeducation, veterans may continue to receive medication to address symptoms associated with PTSD and substance use. Aftercare plans may include ongoing medication management and follow-up appointments with prescribing clinicians.
Other Forms of Treatment
Treatment for veterans may include individual counseling and group therapy with other veterans or individuals who have experienced similar traumatic events. Seeking Safety therapy, an evidence-based approach designed for individuals with PTSD and co-occurring substance use disorders, aims to reduce trauma and substance abuse symptoms while enhancing coping skills in behavior, thinking and emotions.
U.S. Department of Veterans Affairs. “How Common is PTSD in Veterans?”><[…]pa[…] in Veterans?” Accessed November 8, 2023.
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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.
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