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Veterans, Substance Abuse and Treatment

A veteran is considered any person who served in the United States Armed Forces (i.e., Army, Navy, Marines, Air Force, Coast Guard) and those retired from the Public Health Service Commissioned Corps. Due to their military experience, research suggests that some veterans have issues that are not as commonly found among nonveterans, including substance abuse problems. For example, according to the National Survey on Drug Use and Health, veterans were overrepresented proportionally in regard to recent marijuana use, heavy alcohol use, and alcohol and drug abuse treatment.

To better understand veterans with substance abuse problems, it is helpful to examine their experiences while serving in the military. Veterans who abuse alcohol or other drugs may have problems stemming from multiple and often overlapping causal factors, such as cultural reassignment, stress, combat-related post-traumatic stress disorder (PTSD), and homelessness. The role of each of these factors in the etiology of substance abuse problems among veterans is presented.

Cultural Reassignment

Cultural reassignment refers to the process in which new members of the military are thrust into a situation in which they must learn a new vernacular, a new way to dress, and new everyday rituals. When joining the military, new members are displaced from their homes of origin and family environments. For many young recruits, this is their first experience away from home. Basic training strips the new recruits of their civilian cultures and reassigns them to the military environment. This process is achieved by redressing them in uniforms and providing extensive training in policies and norms, many of which are quite foreign relative to their past experiences. New recruits are often psychologically dispirited and then retrained for toughness, survival, and uniformity during basic training. After all of the arduous training, new recruits feel a tremendous sense of pride and patriotism. This process culturally reassigns them to the military environment.

Once personnel complete training and are stationed at their new base, they may be introduced to new social norms of alcohol and drug use. These new soldiers may abuse alcohol because they are reinforced to do so by social recognition and acceptance in the new environment. Although illegal drug use is not tolerated in the military, drinking is often an accul-turated norm. This pattern of alcohol use far too often carries over into the veteran's civilian world—that is, due to experiences in the military where consumption of alcohol in large quantities may have been the norm, veterans may continue this behavior when they leave the military. Therefore, potential alcohol and drug addictions may have developed in veterans well before release from duty, and these addictions are carried into the civilian world.

Stress

Stress is one of the most commonly cited reason for substance use and abuse in the general population. The same holds true for military personnel, where the chronic nature of stress can take a remarkable toll. There are unique stress factors within the military, such as deployments, death of service personnel, frequent moves, and retirement from service. To cope with these multiple Stressors, personnel may use alcohol and other drugs to mitigate these feelings. This phenomenon is commonly known as self-medication in that people may abuse drugs and alcohol to relieve stress and anxiety. Though self-medication is not necessarily a universal coping mechanism within the military, data do suggest that both active military and veterans engage in substance abuse behavior more often than their nonmilitary counterparts. Indeed, multiple Stressors related to past military experience and combat in particular are most often cited by veterans in treatment for substance-related disorders.

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