Is substance and alcohol abuse increasing among our returning veterans? Several studies have shown that soldiers returning from these wars are dealing with undiagnosed problems such as TBI, PTSD, and are unfortunately medicating themselves with alcohol and drugs.

An article in the New York Times last month captures some of this sentiment. In After the Battle, Fighting the Battle at Home (July 8, 2008), author Lizzie Alvarez describes the substance abuse problem in detail. “With the rising awareness of the problem has come mounting concern about the access to treatment and whether enough combat veterans are receiving the help that is available to them. Having cut way back in the 1990s as the population of veterans declined, the Veterans Health Administration says it is expanding its alcohol- and drug-abuse services. But advocacy groups and independent experts — including members of a Pentagon mental-health task force that issued its report last year — are concerned that much more needs to be done. In May, the House and Senate passed bills that would require the veterans agency to expand substance-abuse screening and treatment for all veterans.”

Many of these veterans are reservists who were activated for OEF and OIF. “For active-duty service members, the military faces a shortage of substance-abuse providers on bases across the country, while its health insurance plan, Tricare, makes it difficult for many reservists and their families to get treatment. And many soldiers are reluctant to admit that they have psychological problems, and often go undiagnosed. “Research has shown that the likelihood of mental health problems rises with the intensity of combat exposure. (In a recent RAND Corporation study, one in five veterans of Iraq and Afghanistan reported symptoms of combat stress or major depression.) In turn, service members with such problems more often report heavy drinking or illicit drug use (” It is true: more Iraq and Afghanistan veterans are suffering from PTSD and TBI than veterans from previous wars. “In part, this dynamic is rooted in the warrior code. Trained to be tough and ignore their fear, many combat veterans are reluctant to acknowledge psychic wounds. Or they worry that getting help will damage their careers.”

Although the military and the VA are developing new programs to combat substance abuse, they cannot do it alone. Hard core substance abusing offenders rarely receive comprehensive substance abuse treatment within the military. “The military generally discharges them, arguing that they can no longer do their jobs, and refers them to veterans clinics. However, some experts argue that the military should treat some who started using drugs after fighting in war.”

Consequently, “the Army has increased its substance-abuse budget from $38 million in 2004 to $51 million this year.” How this funding if being applied to the problem is the real issue at hand. Staffing for substance abuse treatment facilities is difficult in the civilian world, so the challenge for the military is even more pronounced. That is why it is important for all of us to ensure that our returning OEF/ OIF veterans receive the drug and alcohol treatment that they need.

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