Substance Use in Military: Prevalence and Challenges

Substance use among military personnel is considerably low in comparison to civilian rates of current use. Probable factors that contribute to such low numbers are due to a zero-tolerance policy and stigma present in the military culture. These factors result in difficulties in identifying and treating substance use problems as well as a lack of confidentiality that deters many who would seek treatment (NIDA, 2013). Though the number of reported incidents of military personnel are low for use of illicit drugs, more socially acceptable substances like alcohol, nicotine, and even prescription medications are more prevalent. The personal need for substance use can be brought on by both the rigid military conditioning as well as deployment to

Though it may seem beneficial to the client to address the substance use before any mental malady, the necessity toward treatment of co-occurring disorders is crucial to the success of the clients’ recovery. Treatments such as contingency management, cognitive-behavioral therapy, motivational interviewing, and computerized therapies for substance use disorders may have significant roles in treating substance use in dually diagnosed patients with PTSD in specialized intensive PTSD programs (Coker, Stefanovics & Rosenheck, 2016). As many of these treatment approaches are often commonly practiced throughout the mental health field, there are continued studies as to efficiency of treatment within the veteran population. The National Academies Press (2012) note that the use of exposure therapies reduce PTSD symptoms and related problems such as anger, depression, and guilt by helping the client to confront their trauma-related situations, memories, and feelings. Though studies have not concluded the efficiency of exposure therapies in treating substance use, the correlation to Cognitive-Behavioral Therapy (CBT) approaches can be utilized in order to deliver treatment simultaneously. One such example is the utilization of Cognitive-Processing Therapy (CPT), as a method to treat PTSD and associated symptoms while

Treatment for co-occurring disorders can be addressed in both individual therapy, group, and family counseling. Through group and family counseling, the client will be able to establish a support system that can be utilized post-treatment. The Veterans Health Administration (VHA) handbook states that the continuum of care makes it possible for the unique needs of the patient be matched with the intensity and setting of care initially, as well as for the patient to move to more or less intense level of care as needed (United States Department of Veterans Affairs, 2012). This provides veterans with options for out-patient care, continued residential care, and support groups to aid in the transition of treatment to a recovery based process of change. Support groups are encouraged methods of working a program of recovery post-treatment through peer support and can address specific needs such as PTSD with fellow survivors that share common traumatic experiences. Veterans will also find support in more anonymous groups tailored toward their addictive behaviors and in many cases a community of veteran survivors’ network can be established within these larger groups. The responsibility of change remains with the individual’s continued care, yet services are still provided to allow the client to return for further treatment whenever it is deemed