Substance Abuse in the Military
The military is not just a job or a career but a way of life. Most people who sign up for military service work long hours, sometimes irregular shifts. They are also required to move frequently, often uprooting their entire family. Military personnel tend to spend all of their time with others in the military, working, eating, living and socializing.
Our service members suffer from daily work-related stress unlike any other job. Unfortunately, those who become reliant on substances as a way to deal with these stressors often feel they have nowhere to turn. A perceived stigma of weakness, the lack of confidentiality and zero-tolerance substance abuse policies cause many service members to avoid getting the addiction treatment they need, according to NIDA. In addition, the greater the commitment to dangerous zones, the greater the risk; those who deploy multiple times in active combat areas are more likely to suffer from behavioral problems, such as addiction, depression and anxiety. Smoking, drinking and abusing prescription medications are all common among these troops.
The military can be a very supportive environment and provides needed structure for those who have trouble focusing. It is also a great career choice, especially in certain fields where the military has access to innovative technology not available to civilians. However, the military life also presents pressures that most of us never have to face.
Military units often operate far from home for long periods of time among cultures that are very different from their own. People in the military are more likely to encounter life-and-death situations, risk extreme physical harm on a regular basis, or witness the horrors of war and poverty. It is no surprise that the military is not immune from drug abuse.
Drug Use in the Military Statistics
The military actually lags behind the rest of the population in illicit drug abuse. According to a survey conducted by the Department of Defense (DOD) in 2008, only 2.3 percent of military personnel used illicit drugs in the past month compared to 12 percent in the general population. If we look specifically at the age group responsible for a majority of the drug abuse, ages 18-25, the gap is even wider. In that age group, 17.2 percent of civilians are illicit drug users compared to 3.9 percent of military.
Reports of alcohol abuse among service members in that same year show a bigger crisis. At least 20 percent of active-duty military members reported heavy drinking in 2008 and 47 percent reported binge drinking, according to an Institute of Medicine report commissioned by the DOD. The report also noted binge drinking in the military increased more than 10 percent from 1998 to 2008.
Prescription drug abuse in the military is also reaching crisis proportions. Between 2002 and 2005, the rate of prescription drug abuse in the military doubled, and from 2005 to 2008 it almost tripled. Among the civilian population, prescription drug abuse was at about 5 percent in 2008, while in the military the rate of abuse for the same year was 11 percent. Prescription drug abuse is up in both sectors, but it is rising faster in the military.
Drug of Choice for Military Personnel
There are stereotypes about the typical military person, but many of them come from movies, not real life. To understand the drug abuse crisis in the military, you have to know the demographics of its population. We like to think of the military as just a microcosm of society, but it actually has its own unique makeup. Here are the facts:
- 16 percent of active-duty military personnel are women
- 70 percent of military personnel are white, 17% are black
- 5 percent of people serving in the military reserves are white
- 49 percent of active military personnel are under the age of 25
- The smallest age group on active duty, 5.6 percent, are 41 or older
- 7 percent of reservists are over 40 while 39% are under 25
- 6 percent of active-duty enlisted personnel have a high school diploma or equivalent
- 6 percent of active-duty officers have only a high school diploma or equivalent
- 3 percent of active-duty personnel are married
- 6 percent of military personnel have children
The substance of choice for military personnel varies, but in some ways matches drug trends among civilians. Although they live and work together and are sometimes deployed to distant places for several months at a time, military personnel keep contact with the folks back home. They know what is trending in the U.S, and the drug subculture is global now. Military personnel have the opportunity to tap into trade routes in various substances.
The substances that present the greatest problems in the general population are the same for the military. Alcohol and tobacco are legal and easy to access in most places, making them the most prominent substances of choice for abuse. Marijuana is popular because it is easily accessible and most people don’t believe it is very dangerous, although it is an illegal drug. Cocaine and heroin are some of the most addictive drugs out there, so they present a big problem because people who start using them cannot stop.
Prescription Drug Abuse in the Military
Just like in civilian life, the military is facing a rise in prescription drug abuse. Also, as in civilian life, access to drugs is one of the biggest factors effecting drug abuse. Prescription drugs have become much more accessible to everyone in the last decade, and the strength and potency of prescription drugs has increased, as well.
The most abused prescription drugs in the military are opioids for pain. Many military jobs have a stringent physical component. Men and women are pushed to their limits to achieve the physical conditioning required for combat and near-combat situations. Extreme physical conditioning comes with strains and pains and the occasional serious injury. Pain-relieving medicine can help get people back to work quicker and help them work through the pain.
The military is also on the front line of combat injury medicine and pain management. Military doctors see a large proportion of patients who are severely injured. Managing pain from surgeries and chronic pain conditions involves opioid pain medicines. The more military personnel who are prescribed opioids, the more likely abuse is to happen because opioids are very addictive.
Prescriptions for pain relievers quadrupled in the military between 2001 and 2009. The need for these pain relievers might stem from an increase in combat-related injuries, carrying heavy equipment and multiple deployments breaking people down, but the fact is there are more opioids in play every year.
Once opioid prescriptions are issued, there is little control over them. Military personnel develop tight bonds with each other and many openly admit they would do anything to help their colleagues. Sharing a few pain pills with a buddy in need seems like an innocent infraction of overly stringent rules, but it can lead to a serious addiction problem.
History of Drugs in the Military
Just like there has always been drug abuse and addiction in society, the military is no exception. As we’ve learned more about the effects of drugs and the concept of addiction, society has become more vigilant with attempts to stop recreational drug use. Awareness of the problem is the beginning of recovery and rehabilitation.
These are some key points in the history of drugs in the military:
1971 – A military drug urinalysis program was instituted by President Nixon to identify military personnel coming back from the Vietnam War who needed drug treatment.
1972 – When they knew they couldn’t get in trouble, 16,000 military members admitted having a drug abuse problem.
1973 – Military personnel serving in Vietnam were using opioids at a rate of 42 percent.
1980 – According to a DOD survey 27.6% of military personnel used an illegal drug.
1981 – Drugs were determined to be a contributing factor in a major aircraft accident aboard the USS Nimitz.
1983 – More than 10,000 military personnel discharged for illegal drug use were offered their jobs back.
1984 – DOD redefined its drug testing standards for marijuana, cocaine, heroin, amphetamines, barbiturates and PCP. Testing for methaqualone was dropped because use was low.
1985 – 8.9 percent of military personnel used illegal drugs according, to a DOD survey.
1986 – All federal civilian employees were mandated to undergo drug testing by President Reagan.
1987 – LSD was added to the list of drugs military personnel were tested for.
1988 – 4.8 percent of military personnel used illegal drugs, according to a DOD survey.
1998 – 2.7 percent of military service personnel used illegal drugs, according to a DOD survey.
2002 – Military expands drug testing for Reserves and National Guard.
2003 – Military established a zero tolerance policy for prohibited drug use.
2004 – Mandatory random drug testing order issued for all military personnel in Afghanistan more than 60 days.
2012 – Hydrocodone and hydromorphone testing are initiated.
The military didn’t invent drug abuse, but it does have a history of struggling with addiction. Like any organization, the military has learned more about the problem and made different attempts to fix it over the years. Its system of dealing with drug abuse continues to evolve.
Consequences for Drug Use in the Military
The Department of Defense enforces its zero-tolerance illicit drug policy with frequent random testing and severe consequences for positive results, including criminal prosecution and dishonorable discharge. Prescription drugs with a powerful potential for abuse are permitted, however, and the military population’s rate of addiction to these substances is higher than among the general population. The number of service members who admitted to abusing a prescription drug rose has nearly tripled since 2005.
The military operates on a different set of laws than civilian jurisdictions. When a person joins the military, he is immediately subject to the Uniform Code of Military Justice (UCMJ). This set of laws applies to all military personnel in any branch, including the Reserves, the National Guard and retired military personnel.
Chapter 912a, Article 112 of the UCMJ clearly prohibits the use, possession, manufacture, distribution, importation, exportation or introduction of a controlled substance to any installation, vessel, vehicle or aircraft. The controlled substances referenced are:
- lysergic acid diethylamide
- barbituric acid
In addition to these named substances, the UCMJ prohibits anything that is listed a Schedule I through V by the Federal Food and Drug Administration (FDA) and any other drug the president chooses to put on the list. Violators of the military drug policy are subject to court-martial.
A court-martial is a military court proceeding involving a panel of anywhere from one to five members, including a military judge. The court-marital decides on guilt or innocence and also imposes a penalty when applicable. The UCMJ rules on court-martial dictate the severity of the punishments they can impose based on certain ranges, like mandatory sentencing guidelines in civilian law.
Penalties for drug possession are based on a number of variables: the substance, the amount and the circumstances. However, no military drug charge is lenient, since the military claims a zero tolerance for drug abuse. Penalties handed down by court-martials can include a reduction in rank, forfeiture of pay, confinement and/or hard labor, or a discharge.
Alcohol abuse is only mentioned in the UCMJ with respect to driving and performing official duties. Drunk driving is punishable by court-martial, as is being drunk on duty. Military law is silent on the abuse of alcohol while off duty or on military property, except where military operations are carried out in countries where alcohol is prohibited. In these cases, the importation or possession of alcohol on a military base is strictly forbidden.
PTSD and Drug Addiction
In civilian life, addiction often coexists with mental illness, but whether there is a cause-and-effect relationship of the two or more conditions seems unrelated. Military personnel are not different from the rest of the population when it comes to addiction and mental illness. People with mental illnesses are more likely than others to seek escape in drugs and alcohol, and extreme drug abuse can lead to mental illness.
Another factor that can lead to mental illness is military service in combat zones. The incidents of Post-Traumatic Stress Disorder (PTSD), depression and suicide are startling.
- PTSD is diagnosed in soldiers returning from combat at a rate of 40 percent
- An average of five soldiers on active duty attempt suicide each day
- 245 military personnel committed suicide in 2009
- Among combat veterans, two out of three marriages fail
- One of every four combat veterans is diagnosed with PTSD
According to the U.S. Veterans Administration, people with PTSD are at an increased risk of developing a drug addiction, even if they did not have a problem before. Often people with PTSD try to escape the pain or cope with their situation by taking drugs. Mental illness in general can leave people with a sense of hopelessness and despair.
PTSD and drug abuse both have negative effects on behavior and brain chemistry producing similar symptoms. Someone with PTSD may think he is soothing his symptoms, but in fact he is complicating them. With co-occurring PTSD and drug addiction, causes and symptoms can get very confusing.
Here are some of the ways that drug abuse can actually worsen PTSD symptoms:
- Sleep problems are common with PTSD. Taking drugs may make you feel like you can relax and fall asleep, but actually drugs alter sleep patterns, as well.
- PTSD can be accompanied by increased anger, irritability and depression. These are also common side effects of drug abuse. By taking drugs on top of suffering with PTSD, these symptoms are worsened.
- The basis of PTSD is a traumatic incident that the brain cannot process. Drugs and alcohol are ways of avoiding thoughts and feelings that are too painful to deal with. Substance abuse will prolong the PTSD by not allowing the brain to work on the trauma.
- People with PTSD cannot enjoy their lives because of the anxiety and stress of repressed memories. At first, alcohol and drugs make life seem enjoyable and carefree, but after a while they become a distraction, as well. Drug addicts are unable to concentrate or be productive.
PTSD and addiction are often linked, but they can also be treated together. Both conditions require serious therapy to overcome.
Treatment for PTSD and Addiction
Since PTSD and drug abuse share common side effects and symptoms, treating them at the same time is possible and can be very effective. The basic treatment for PTSD, addiction and many mental illnesses is cognitive behavioral therapy.
PTSD and addiction involve brain functions. Due to trauma or chemical intervention, your brain has built some thought pathways that are keeping you stuck in a bad place. Cognitive behavioral therapy is a way of examining those unproductive thoughts and remapping them in your brain. Therapists use this form of therapy to suggest new ways of looking at information to help you move in a positive direction.
Exposure therapy is another method for dealing with PTSD and addiction. It is based on the principal that certain thoughts about the past illicit extreme feelings. Memories of a trauma, for instance, trigger anxiety, depression or a craving for drugs. When your nervous system is continually exposed to a sensation, like hot water, eventually the sensation is minimized. When you get into a tub of hot water, it doesn’t feel so hot after a few minutes. By exposing you to thoughts of that trauma in a safe and controlled environment, therapists can guide you through a desensitization.
Another means of desensitizing traumatic experiences to treat PTSD and the accompanying addiction is Eye Movement Desensitization Reprocessing (EMDR). This is a newer therapy designed to take the edge off those extreme feelings so you can work through them and release the extreme emotions. As the name suggests, EMDR involves eye movements that are directed by a therapist.
Co-occurrence of PTSD and addiction is not unusual for military personnel, especially those exposed to combat situations. Work-related traumas seem to have a cumulative effect on military personnel, so those who serve multiple deployments are at greater risk. Survival of the initial exposure is not a guarantee that a person is desensitized to these types of traumas.
Binge Drinking and Suicide
The statistics tell a clear story: nearly half of all service members report binge drinking. Almost 30 percent of combat troops binge drink every week. Military physicians write more and more painkiller prescriptions every year, and opioid painkillers account for the majority of the prescription drug substance abuse problems in the armed services. Most alarmingly, the number of suicides has increased in lock step with the number of service members reporting substance abuse issues.
To address the problem, the Institute of Medicine recommended evidence-based treatment, limiting access to alcohol and enhanced screening procedures that will help service members get the support services they need before spinning out of control. What may be more difficult is shifting the culture of fear and stigma to one of treatment and confidentiality.
If you or someone you love has served in the military and is exhibiting signs of PTSD or addiction, you need to get help right away. Many military personnel who are discharged or retired do not seek help, perhaps because of the pride and individual strength that goes along with a successful military career. Sometimes active personnel are reluctant to report having a problem for fear that treatment would interrupt their service or possibly leave a mark on their record.
PTSD and addiction are both serious, life-threatening conditions that require treatment. There is no shame in seeking help so you can go back to living a comfortable, productive life. At 12 Keys, we are experienced in helping people from all walks of life overcome addiction, PTSD and other mental illnesses. Our confidential treatment center provides all of the therapies and services necessary to turn your life around, whether you are in the middle or at the end of your patriot service to our country.
The programs at 12 Keys are individualized to meet each person’s needs and employ whatever combination of therapies are right for him or her. Everyone’s situation is unique, which is why we offer a number of different therapies including the newest ones like EDMR. Our compassionate staff is committed to reaching a positive outcome with each person who comes through our door.
If you or a loved one are suffering the effects of PTSD or addiction, imagine a place where you can be comfortably cared for as you work through the issues that haunt you. That place, 12 Keys, should be your next stop on the road to recovery. We can help end your suffering and guide you on your journey to a happy, healthy life. Contact us to get your life back.