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Addressing Opioid Misuse Among Veterans: Risks, Signs, and Solutions

Last Updated: December 26, 2023

Editorial Policy | Research Policy

Upon returning home, veterans face various challenges, including adapting to civilian life and coping with the aftermath of deployment stress. Opioid misuse is a concern for some veterans, but it's encouraging to know that support and treatment options are available.

Understanding Opioid Misuse in Veterans

An ongoing opioid epidemic has gripped the veteran community, with concerning statistics reported in a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • In the year before the survey, 2.5% of veterans misused opioids, encompassing prescription painkillers and heroin.
  • Among veterans, approximately 490,000 misuse prescription painkillers, while 57,000 are heroin users, and 53,000 misuse both heroin and prescription painkillers.
  • Among opioid misusers, oxycodone is the most abused substance, chosen by 9.4% of veterans.
  • Opioid use disorder (OUD), or opioid addiction, affects 0.5% of veterans aged 18 and older.

Veterans face a two-fold risk of dying from accidental opioid overdoses compared to the general population, highlighting the severity of the issue.

Factors Contributing to Opioid Addiction and Overdose in Veterans

Veterans, due to their unique risk factors, are especially vulnerable to the adverse effects of opioid misuse. Their military service combined with the challenges of transitioning to civilian life increases the likelihood of opioid addiction.

Co-Occurring Mental Health Disorders

Opioid addiction in veterans can often be linked to co-occurring mental health conditions like PTSD and depression. Veterans, particularly those with addictions, may turn to opioids as a coping mechanism for emotional pain. For example, almost one-third of veterans seeking substance use disorder treatment also have PTSD. Furthermore, opioids can temporarily alleviate depression, making them appealing to veterans facing both depression and suicidal thoughts.

Chronic Pain

Injuries sustained during military service can lead to chronic pain, potentially leading to opioid dependency. Research indicates that combat-wounded veterans are at higher risk of opioid misuse compared to civilians, emphasizing the connection between injuries, pain, and addiction.

Military Sexual Trauma

Veterans, both male and female, who have experienced military sexual trauma (MST) are at an increased risk of opioid addiction. Substance use may serve as a coping mechanism for the emotional distress caused by MST. Studies show that veterans with a history of MST are 50% more likely to develop opioid addiction.

Social Isolation and Homelessness

Veterans are more susceptible to social isolation and homelessness, which can elevate the risk of opioid misuse. Isolated veterans lack social support and may develop chronic loneliness, increasing the likelihood of opioid misuse. Homeless veterans are at even higher risk due to limited access to help during emergencies.

Barriers to Healthcare

Limited access to healthcare services is a significant concern for veterans, potentially leading to opioid addiction. Underutilization of healthcare means veterans lack consistent medical oversight, reducing their access to education and information about opioid medications' side effects, risks, and proper usage.

Recognizing Signs of Opioid Addiction in Veterans

Identifying opioid addiction in veterans is crucial. Signs may include:

  • Mood swings
  • Secretive behavior
  • Not taking medications as prescribed (using larger doses than prescribed, crushing and snorting pills)
  • Letting relationships and hobbies fall by the wayside because of preoccupation with opioids
  • Being unable to cut back on opioid use
  • Developing a high tolerance so that larger quantities of opioids are needed to achieve the same desired effects
  • Showing withdrawal symptoms when not using

Veterans' Path to Recovery: Treatment and Support

Various treatment options are available to veterans dealing with opioid use disorder (OUD). These may include therapy, psychiatric medication, naloxone access, support groups, involvement of friends and family, and comprehensive drug rehab programs.

Therapy and Psychiatric Medication

Veterans often participate in therapy and may use medications to address co-occurring mental health conditions. Cognitive behavioral therapy (CBT) is particularly effective for those with PTSD and OUD. Cognitive processing therapy (CPT) and prolonged exposure (PE) are two CBT forms beneficial for veterans.

Access to Naloxone

Veterans at risk of opioid overdose can obtain naloxone, a life-saving medication, for free. This access is crucial in emergency overdose situations. Veterans can request a naloxone prescription from their VA provider.

Support Groups and Family Involvement

Support groups play a vital role in veterans' addiction treatment, providing a safe space for discussing recovery challenges. Friend and family involvement offers social support, reducing the risks of isolation and improving communication within the family.

Comprehensive Drug Rehab

Veterans with OUD may benefit from drug rehab programs, which can be either inpatient or outpatient. Inpatient programs offer intensive support, while outpatient programs provide flexibility. Treatment usually begins with medical detox and includes various therapy types, medication management, and support groups.

Seeking Help for Veterans

Veterans seeking addiction treatment can find support at The Recovery Village Kansas City Drug and Alcohol Rehab, a member of the VA Community Care Network. We offer a range of services and have staff trained to assist veterans.

Sources

Substance Abuse and Mental Health Services Administration. “2020 National Survey on Drug Use and Health: Veteran Adults“>2020 Nat[…]eteran Adults.” July 2022. Accessed November 10, 2023.

Bennett, Alex; Watford, J. Alexander; Elliott, Luther; Wolfson-Stofko, Brett; & Guarino, Honoria. “Military Veterans’ Overdose Risk Behavior: Demographic and Biopsychosocial Influences“>Military[…]al Influences.”Addictive Behaviors, December 2019. Accessed November 10, 2023.

U.S. Department of Veterans Affairs. “PTSD and Substance Abuse in Veterans“>PTSD and[…]e in Veterans.” Accessed November 10, 2023.

Riblet, Natalie; Kenneally, Lauren; Shiner, Brian; Watts, Bradley. “Healthcare processes contributing to suicide risk in veterans during and after residential substance abuse treatment“>Healthca[…]use treatment.” Journal of Dual Diagnosis, 2019. Accessed November 10, 2023.

Dembek, Zygmunt; Chekol, Tesema. “The Opioid Epidemic: Challenge to Military Medicine and National Security“>The Opio[…]onal Security.” Military Medicine, 2020. Accessed November 10, 2023.

National Center for PTSD. “Effective Treatments for PTSD:“>Effectiv[…]nts for PTSD:

Consider Cognitive Behavioral Therapy (CBT) as First Line Treatment“>Consider[…]ine Treatment.” January 2015. Accessed November 10, 2023.

U.S. Department of Veterans Affairs. “Academic Detailing Services – Opioid Overdose Education & Naloxone Distribution (OEND)“>Academic[…]bution (OEND).” Accessed November 10, 2023.