Alcoholism in Veterans: Risk Factors and Treatment


Alcoholism is prevalent among veterans, especially among those also suffering from post-traumatic stress disorder, or PTSD. Military servicemembers face significant stressors that can put them at risk for substance use problems. Fortunately, there are ways for veterans to get help for alcoholism.

Alcohol Use in the Military

Veteran drinking

Alcohol use is common in the military, and military servicemembers are more likely to abuse alcohol when compared to civilians.1 Approximately one-third of servicemembers engage in binge drinking and experience problems because of it. In comparison, just under one-quarter of civilians engage in binge drinking .1 Problem drinking among veterans specifically is related to interpersonal violence, health problems, and early morality.5

Military servicemembers face unique stressors that can increase their risk of heavy drinking. Military members may experience traumatic events during deployment, combat, and training.3 Experiencing combat is regarded as a highly stressful event that can lead to the development of PTSD.3 Veterans who have participated in combat or experienced any type of trauma are at higher risk for both PTSD and alcohol abuse.3

Much has been said about the drinking culture in the military and how it contributes to heavier alcohol use among active-duty military.4 Moderate alcohol use is sometimes encouraged to foster bonding between servicemembers.4 Alcohol use has been historically widely accepted in the military and has served as a way for servicemembers to bond, ease interpersonal tensions, and relieve boredom on off-duty days.5

Heavy alcohol use can lead to serious problems. Alcohol abuse can increase the risk of physical health issues, like liver disease, heart problems, and cancer.4 It can also contribute to and worsen mental health issues like depression and PTSD.  Heavy alcohol use in servicemembers is also associated with drunk-driving arrests, violence, and poor performance on the job.4

Statistics on Alcoholism in Veterans

Veterans are more slightly more likely than civilians to experience problems with drugs and alcohol.1 Over 10% of veterans meet criteria for a substance use disorder, the clinical diagnosis for addiction.1

Alcohol, specifically, is one of the most problematic substances for veterans.1 In fact, alcohol is the most commonly abused substance, other than tobacco, among vets.2 Alcoholism is more common among male (10.5%) than female veterans (4.8%).2 The higher prevalence of alcoholism among veterans may be related to stresses like exposure to trauma, combat,  deployment, and reintegrating back into civilian life.2

PTSD and Alcohol Abuse in Veterans: A Common Pair

Woman drinking at bar

Post-traumatic stress disorder is the most common mental health issue that veterans face when returning from combat.3,6 Between 14% and 22% of veterans returning from Iraq and Afghanistan and over 30% of Vietnam veterans currently meet or have met criteria for PTSD.3,6

PTSD can develop after exposure to a traumatic event where a person’s safety, life, or the life of someone they care about is threatened.7 Symptoms of PTSD include:7

  • Reliving the event in some way, such as through nightmares or flashbacks.
  • Avoiding reminders of the trauma.
  • Changes in a person’s emotional state, such as feeling down, isolating from others, and being unable to experience pleasure.
  • Feeling more on-edge, irritable, and easily startled.

For veterans, PTSD often develops because of exposure to trauma during combat or deployment.3 However, exposure to other types of trauma, such as childhood abuse, sexual assault, or training accidents, can also lead to PTSD.3

There is a strong link between PTSD and alcoholism. One large survey of adults in the United States found that around 20% of surveyed people with PTSD used drugs or alcohol to cope with and relieve their symptoms.8

 This may play a part in the high rates of substance use among veterans. More than 1 in 5 veterans with PTSD struggle with a substance use disorder.9 Among veterans returning from Iraq and Afghanistan, approximately 10% have problems with drugs or alcohol.9 Of the 30% of Vietnam veterans who met criteria for PTSD, 70% also struggled with alcoholism.6 Veterans who have experienced combat trauma have higher rates of heavy drinking after returning home compared to before their deployment.6

Alcohol may provide a quick relief from some PTSD symptoms, which can lead to heavier and more frequent alcohol use, which may eventually lead to an alcohol use disorder.3 For example, alcohol withdrawal can intensify arousal symptoms from PTSD.6 Not only can PTSD symptoms intensify, but as the alcohol use increases the many issues that inevitably arise as alcoholism develops and worsens can add to the veteran’s troubles.

 Veterans who are struggling with PTSD and alcohol abuse can receive simultaneous treatment for both disorders in a high-quality treatment program. Unfortunately, many veterans may fear getting the help they need due to stigmas about mental illness and even simply asking for help. 

Veterans’ Mental Health: How Stigma Hurts

Man feeling stigmatized

In the case of veterans and active-duty military, stigma may play a role in failing to get treatment for substance use or mental health issues.10 One study of veterans found that severity of PTSD was related to perceived stigma to get help and that perceiving stigma was linked to more alcohol problems.10

Veterans may worry that acknowledging a mental health or substance use problem and getting help will lead to being viewed as weak. Active-duty service members may fail to seek help for fear that their careers will be harmed; however, waiting to ask for help may end up hurting their careers in the end, whereas getting help early may help keep them in good standing.17

Stigma surrounding mental health in the military makes it difficult to estimate the number of veterans suffering from PTSD, since many may not report it.6 The prevalence of PTSD among veterans is likely much higher than currently estimated.6

Signs of Alcoholism in Veterans: When To Ask For Help

While some people can drink alcohol in moderation, others may have a hard time controlling their use. If you experience problems in your life because of your drinking, you may have an alcohol use disorder. Signs of an alcohol use disorder include:11

  • Drinking more or for longer than planned.
  • Being unable to cut back on your drinking.
  • Getting into dangerous situations while drinking (such as driving under the influence).
  • Spending significant time getting alcohol, drinking, or being hungover.
  • Being unable to keep up with responsibilities at home, work, or school because of alcohol use.
  • Continuing to drink even though it causes or worsens physical or mental health problems.
  • Experiencing strong urges to drink.
  • Giving up activities that were once enjoyable because of alcohol.
  • Continuing to drink despite problems with family and friends.
  • Needing to drink more alcohol to feel the desired effects.
  • Experiencing withdrawal symptoms, such as nausea, sweating, fever, hallucinations, and seizures, when you stop drinking or cut back.

The U.S. Department of Veterans Affairs (VA) offers a free online screening tool that assesses for an alcohol use disorder. While the screening tool cannot formally diagnose you with an alcohol use disorder, it can help you identify if you have a problem. If you screen positive, you should see your doctor or another medical or mental health professional for an assessment.

If you have an alcohol use disorder, quitting drinking cold turkey can be dangerous. You may need professional treatment to help you quit safely.

Using the VA for Alcohol Rehab

VA Healthcare Form

The VA healthcare system serves approximately 9 million veterans at over 1,200 locations throughout the United States.12 Services are available in different care settings:12

  • VA medical centers offer hospital-based services, like inpatient detoxification and treatment.
  • Community-based outpatient clinics provide outpatient services, like addiction counseling and therapy.
  • Vet centers also offer counseling specifically for veterans who have served in combat.

VA medical benefits provide coverage for treatment for substance use and mental health disorders.13 Veterans can also use Medicare, Medicaid, or other private insurance along with their VA benefits.

The VA offers evidence-based substance abuse treatment for veterans suffering from alcoholism.14 Treatment at the VA can address both addiction and any other mental health problems that a veteran may be facing, such as PTSD or depression. There are several different options for types of treatment and levels of care at the VA, including inpatient/residential, intensive outpatient, and standard outpatient. Veterans can access individual, group, and/or family therapy, mutual help groups, and medications to treat alcoholism.

For more information on alcohol treatment through the VA, contact your current VA healthcare provider or local VA medical center or vet center, or call the VA’s information hotline at 1-800-827-1000.

Accessing Private Treatment with VA Community Care

There is a high demand for VA services across the country. Unfortunately, in some areas there are not enough VA providers to serve the needs of the community. In these cases, the VA offers the community care program, which allows access to services through local providers.15 In order to access community care, the VA must first confirm your eligibility. Once you receive approval, the VA will help you schedule an appointment with an in-network provider.

Greenhouse Treatment Center is part of a larger portfolio of treatment centers owned by American Addiction Centers (AAC). While Greenhouse is not currently an approved community care provider, AAC does have two facilities that are approved for community care by the VA:

  • Desert Hope in Las Vegas, Nevada provides treatment to veterans and first responders, (including firefighters, emergency medical service providers, and law enforcement) through the Salute to Recovery Program. The program offers co-occurring disorder treatment for substance use and mental health issues, like PTSD, depression, and anxiety. The Salute to Recovery Program at Desert Hope utilizes evidence-based treatments like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
  • Recovery First in Hollywood, Florida offers an inpatient rehab program specifically for veterans and first responders. The program provides medical detoxification and individual, family, and group therapy utilizing a variety of therapy approaches, including CBT, DBT, acceptance and commitment therapy, and family systems.

For more information on whether you’re eligible for community care, consult with a member of your VA care team. For a list of local VA community care providers, see the VA facility locator.

Mutual Help and 12-Step Support Group Meetings for Veterans and Families

12-Step meeting

Twelve-step groups are free mutual support for people dealing with addiction. They take a spiritual approach to recovery and use the 12 steps as a guide. There are different 12-step groups available for veterans struggling with alcoholism and their families:

  • Alcoholics Anonymous (AA) is a group for anyone who wishes to stop drinking. It encourages members to admit their powerlessness over alcohol, connect with a higher power (as defined by the individual), create an alcohol-free life, and help others who are struggling with alcoholism. Meetings are held around the world and are open to anyone with a desire to quit drinking.
  • Al-Anon/Alateen are support groups for people that have been affected by a loved one’s drinking. Al-Anon is open to people of all ages, but Alateen is a meeting specifically for teens. Using the 12-step philosophy, members work toward accepting and coping with a loved one’s alcoholism.
  • Adult Children of Alcoholics/Dysfunctional Families (ACA) is a group for people who were raised in dysfunctional homes that may have involved addiction. Through participation in this group, members learn how their past impacts them today and how to live a healthier life.

Studies on AA have found that attending meetings can help people maintain their sobriety.16 Studies on Al-Anon, Alateen, and ACA have found that these groups help improve family functioning and are associated with less substance use among members, lower depression, and higher self-esteem.16 Mutual help groups aren’t limited to 12-Step groups. There are other options that follow a more secular approach, such as SMART Recovery. Any type of recovery meeting, 12-Step or not, can offer you vital support in your recovery.

There are many mutual help group meetings available in the Dallas and Fort Worth area. The Grand Prairie Group is a local organization affiliated with AA that offers over 30 meetings each week. The meetings are held at:

921 W Pioneer Parkway, Suite 0
Grand Prairie, Texas 75052

For a list of local meetings, see the Dallas AA Central Office. You can find SMART Recovery meetings with their locator tool.

References:

  1. National Institute on Drug Abuse. (2019). Substance use and military life.
  2. Teeters, J. B., Lancaster, C. L., Brown, D. G., & Back, S. E. (2017). Substance use disorders in military veterans: Prevalence and treatment challengesSubstance Abuse and Rehabilitation8, 69–77.
  3. Schumm, J. A., & Chard, K. M. (2012). Alcohol and stress in the military. Alcohol Research: Current Reviews, 34(4), 401.
  4. Waller, M., McGuire, A. C., & Dobson, A. J. (2015). Alcohol use in the military: Associations with health and wellbeingSubstance Abuse Treatment, Prevention, and Policy10, 27.
  5. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The Asam principles of addiction medicine, sixth edition. Philadelphia: Wolters Kluwer.
  6. Carter, A. C., Capone, C., & Short, E. E. (2011). Co-occurring posttraumatic stress disorder and alcohol use disorders in veteran populationsJournal of Dual Diagnosis7(4), 285–299.
  7. U.S. Department of Veterans Affairs. (2020). PTSD basics.
  8. Leeies, M., Pagura, J., Sareen, J., & Bolton, J. M. (2010). The use of alcohol and drugs to self?medicate symptoms of posttraumatic stress disorderDepression and Anxiety27(8), 731-736.
  9. U.S. Department of Veterans Affairs. (2019). PTSD and substance abuse in veterans.
  10. Miller, S. M., Pedersen, E. R., & Marshall, G. N. (2017). Combat experience and problem drinking in veterans: Exploring the roles of PTSD, coping motives, and perceived stigmaAddictive Behaviors66, 90–95.
  11. U.S. National Library of Medicine. (2020). MedlinePlus, Alcohol use disorder (AUD).
  12. U.S. Department of Veterans Affairs. (2019). Where you’ll go for care.
  13. U.S. Department of Veterans Affairs. (2019). About VA health benefits.
  14. U.S. Department of Veterans Affairs. (2019). Treatment programs for substance use problems.
  15. U.S. Department of Veterans Affairs. (2019). Community care.
  16. Moos, R., & Timko, C. (2008). Outcome research on twelve-step and other self-help programs. In M. Galanter, & H. O. Kleber (Eds.), Textbook of substance abuse treatment (4th ed. pp. 511-521). Washington, DC: American Psychiatric Press.
  17. National Alliance on Mental Illness. (n.d.). Veterans & Active Duty.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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