How the Opioid Epidemic Is Impacting Veterans

 

Common Risk Factors of Opioid Addiction Among Veterans

Veterans are at high risk of developing opioid addiction given the unique stressors they face during their service and after returning home.

 

Trauma Exposure

Serving in combat puts a person at risk of multiple types of trauma. For some, it could be serious injury, others may be traumatized from witnessing death of a fellow soldier. Experiences such as these can significantly increase one’s risk of posttraumatic stress disorder (PTSD). In fact, approximately 21% of Persian Gulf War Veterans and 29% of Iraq and Afghanistan Veterans have been diagnosed with PTSD.

Outside of combat, military sexual trauma (MST) can also occur. Women are more frequently victims of MST, but male soldiers have also experienced this trauma.  The 2018 Department of Defense Health Related Behaviors Survey (HRBS) reported that over 31% of women and 5% of men experienced unwanted sexual contact while serving in the military.

 Some Veterans may use opioids to self-treat PTSD symptoms, including emotional pain.

Injuries

Serving in combat can cause significant disabilities – about 1.8 million Veterans who served in Iraq and Afghanistan have suffered lost limbs, paralysis, or brain and spinal cord injuries. Sometimes, physicians prescribe opioids to manage the acute pain associated with these injuries or the severe chronic pain that results.

Because opioids are potent, there is a risk for overdose or addiction for anyone; thus it is important to take them carefully and according to provider’s directions.7 Furthermore, if opioids are taken for an extended period of time, tolerance can develop and higher doses are needed to feel the same effects, in turn increasing risk for an overdose.

Adjusting Back to Civilian Life

Returning to civilian life after deployment can be complicated and overwhelming in a number of ways, including:

Family dynamics. While the Veteran is away roles often get reassigned. Thus, there is a period of transition during which they reestablish their place within their families and communities.

Feeling isolated. Despite being surrounded by loved ones, experiences during combat are difficult to share and can cause feelings of loneliness, or loss of community.

Reentering the workforce. Veterans may have to learn or relearn how to write a resume, interview, and work in a professional setting. Further, transitioning one’s work concerns from life or death situations to non-life-threatening jobs may make it difficult to prioritize work urgency.

Self-discipline and new responsibilities. Military life is demanding, and requires discipline, but many services and daily schedules are provided. Having to manage and organize responsibilities such as doctor’s appointments, insurance, and bills may feel overwhelming at first.

Veterans may cope with such mental and emotional stressors with substance misuse, including opioids.

 

Warning Signs of Opioid Addiction in Veterans

If you are worried about your loved one’s use of opioids, there are some warning signs you can be on the lookout for:

Ignoring provider orders: They may take the medication in larger doses or more frequently than prescribed. They  may also crush, chew, or snort the opioid, or combine the opioid with other substances like benzodiazepines or alcohol.

Mood changes: Repeated misuse of opioids can lead to depression and irritability.

Preoccupation with obtaining opioids: They may spend less time engaging in activities they enjoy and instead focus on obtaining and using opioids.10 They may also seek opioids from multiple providers.

Unusual behavior: Taking opioids at higher doses can lead to confusion, agitation, or aggression.

Changes in sleep or appetite: They may eat more or gain weight. They may also sleep less or have disrupted sleep patterns.

Changes in relationships: You may notice having more conflict in your relationship with your loved one.

Other signs and symptoms of opioid use disorder are defined by the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5), and are used by mental health providers to diagnose substance use disorders.

 

 

Seeking Help for Veteran Opioid Addiction

It is hard to see a loved one struggle with opioid addiction and it can be hard to know what to do or how to encourage them to seek treatment. However, there are some specific things you can do to show your support:

Be empathic and compassionate: Giving your loved one a hug and saying something like, “This must be so hard – I’m here for you” goes a long way.

Express concern: If your loved one is reticent about seeking treatment, sharing your feelings with them may be helpful, like “I was so scared I might lose you.” However you express yourself, it is essential to be honest and genuine.

Provide logistical help: Because managing multiple life tasks can be overwhelming for your loved one, you can help them with small acts like scheduling an appointment. They may also be able to take comfort in your accompanying them to the appointment for moral support.

Be gentle with yourself: Seeing a loved one struggle with conditions like addiction and PTSD can be overwhelming and comes with various emotions like fear, sadness, and anger. Your feelings are valid, and know that your loved one’s behavior is not your fault.

Utilize resources: The Veterans Crisis Line is available 24/7, year-round. Dial 988, then press 1, or text 838255. Veterans’ Affairs (VA) also offers the Caregiver Support Program and you can call their support line at 855-260-3274.

Treatment for Opioid Use Disorder

Opioid addiction treatment often consists of medication and psychotherapy. Treatment that includes both is more likely to yield positive outcomes. Medications can help reduce cravings for opioids and help people stay in treatment. Counseling helps Veterans address conditions like PTSD and learn coping strategies needed for recovery.

The treatment process begins with a comprehensive assessment to help determine diagnoses, individual needs, the treatment setting, and an individualized treatment plan. For Veterans who have a physical dependence on opioids, stabilization though medical detoxification (detox) is likely recommended. Detox occurs under the supervision of medical professionals who may administer medications to help reduce uncomfortable withdrawal symptoms.

Inpatient Treatment

Inpatient, or residential, treatment is more of a fit for someone with a more severe OUD or co-occurring mental health conditions or serious medical conditions. Inpatient treatment involves living at the facility and receiving care 24/7. Treatment is provided by a multidisciplinary staff consisting of doctors, nurses, therapists, psychiatrists, and social workers.

In addition to medication management, individual, group, and family therapy, services in residential treatment include case management to help connect Veterans to resources such as financial aid or vocational rehab.

Outpatient Treatment

Outpatient rehab programs are ones in which Veterans live at home and commute to services. Outpatient services can be categorized into two main types: partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). Both types of programs are also comprehensive with a multidisciplinary team that provides therapy, medication management, and case management.

PHPs provide intensive and comprehensive treatment like inpatient programs, however, they are a fit for those who do not need round-the-clock care and have a supportive home environment. Treatment in PHPs occurs 20 to 40 hours of services per week.

IOPs are a fit for someone with a moderate OUD. They would attend treatment for 9 to 20 hours per week. IOPs tend to work best for those who are motivated to attend services regularly and have a stable home environment with supportive family and friends. IOPs can also be used as a step-down treatment from inpatient or PHP treatment to help people transition from intensive care to independent living.

Outpatient Counseling

Outpatient counseling or ongoing therapy is a good fit for someone with a mild OUD or for someone who has completed an inpatient or outpatient treatment program. As step-down treatment, outpatient counseling is generally recommended for at least one year post-rehab to sustain recovery and help prevent relapse. Sessions typically occur once or twice per week at a therapist’s office. For someone with mild OUD, outpatient counseling can help to reduce use and develop adaptive coping skills.

Aftercare Programs

Aftercare services help Veterans to maintain the progress made in rehab and work to prevent relapse.17 Outpatient counseling is one type of aftercare. Others include sober living homes and 12-step peer support groups like Narcotics Anonymous (NA).

Treatment for Veterans at Longbranch Recovery and Wellness

At Longbranch Recovery and Wellness we proudly serve our nation’s heroes by partnering with the VA and providing rehab programs dedicated to Veterans.

Our clinicians specialize in treating substance use disorders and other conditions in Veterans like PTSD, major depression, anxiety disorders, and bipolar disorders. They develop individualized treatment plans to meet each Veteran’s unique needs. We are proud to offer medication and case management, and inpatient and outpatient treatment using evidence-based therapies. We are also proud to offer a sober living house for Veterans and other aftercare services such as weekly support group and 12-step program meetings.

Drug Rehab Programs for Veterans