Empowering Self-Medicating Veterans on the Path to Healing from Addiction

The complex interplay between trauma and substance use presents a formidable challenge for military veterans. According to the U.S. Department of Veterans Affairs, around 7% of veterans will experience post-traumatic stress disorder (PTSD) during their lives. The exposure to combat, traumatic events and life-threatening situations often leaves veterans more vulnerable to trauma-related behavioral and mental health issues than the general population.

Tragically, there exists a significant correlation between trauma and self-medication. Research indicates that nearly half of those diagnosed with PTSD also struggle with co-occurring substance use disorders. Many experts attribute this connection to the inclination to self-medicate, using substances as a temporary respite from the haunting memories and emotions tied to traumatic experiences.

However, as the efficacy of substances diminishes, self-medication can escalate into a full-fledged substance use disorder. Left untreated, the co-occurring disorders of trauma and substance use continue to worsen both the mental and behavioral health of the affected person.  

To provide effective care, clinicians often address both trauma and substance use concurrently. Treatment programs may incorporate veteran support groups to tailor treatment plans further. Fortunately, there are evidence-based treatments available across various modalities to support self-medicating veterans on their journey to recovery.

The Complex Nexus of Trauma and Self-Medication

Veterans grappling with trauma often experience a wide array of symptoms. As per the American Psychiatric Association, PTSD symptoms can include:

• Intrusive thoughts, including distressing dreams and vivid flashbacks
• Avoidance of people, places or situations that may trigger distressing memories, events or emotions
• Distorted thoughts regarding the traumatic event or an inability to remember it accurately
• Mood swings

To cope with these symptoms, veterans may turn to drugs and alcohol. Substances may initially provide a temporary reprieve by aiding sleep, offering comfort in specific situations or acting as a distraction from issues arising from PTSD, such as strained relationships or occupational challenges. However, self-medication merely perpetuates the cycle of avoidance.

While self-medication may seem like a quick fix, PTSD symptoms generally worsen over time. This deterioration disrupts sleep, alters mood and reduces the efficacy of prescribed psychiatric medications. Evidence advocates for the most effective approach, which entails addressing both PTSD and substance use disorder concurrently.

A Comprehensive Approach to Care for Veterans Facing Trauma and Co-Occurring Substance Use Disorders

Veterans embarking on the journey to recovery typically engage in a continuum of care tailored to their unique needs. Assessments for substance use and psychiatric concerns help determine the most appropriate level of care. In cases where veterans require structured and supervised recovery, clinicians may recommend residential or inpatient facilities.

If medically necessary, individuals may undergo supervised detox to safely withdraw from substances. Many detox facilities employ medication-assisted treatment (MAT) to ensure a safe and comfortable experience. These acute care levels aim to stabilize individuals and prepare them for transitions into less intensive care.

While the specifics of each care plan depend on the veteran’s needs, residential treatment may be followed by a partial hospitalization program (PHP), an intensive outpatient program (IOP), regular outpatient programs and aftercare services. For veterans, these aftercare services may encompass vocational training, ongoing medication management to address psychiatric symptoms and participation in veteran support groups.

Evidence-Based Interventions for Self-Medicating Veterans Struggling with Trauma

Throughout various stages of care, clinicians employ an array of treatments to address both substance use and trauma-related issues.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) has proven highly effective in treating co-occurring trauma-related disorders. During CBT sessions, clinicians delve into distorted thinking patterns that may contribute to veterans’ self-medicating behaviors. These trauma-focused psychotherapy sessions also help veterans process traumatic events and the associated emotions.

Exposure Therapy

Prolonged exposure therapy aims to reduce the emotional “triggers” associated with trauma. These sessions may involve repeated exposure to detailed images or virtual reality programs designed to evoke fear, distress and other negative emotions. The objective is to create a controlled, safe environment for veterans to confront their emotional reactions progressively.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR, a trauma-focused psychotherapy, involves inducing eye movement in veterans while discussing traumatic events. Thought to simulate REM sleep, EMDR is often effective in altering veterans’ memories of traumatic events, thereby reducing their emotional reactions to these memories.

Family Counseling

Family counseling sessions include loved ones in the treatment process. This approach helps loved ones understand the symptoms of trauma and substance use disorders while actively participating in aftercare planning. Research suggests that family involvement in treatment can enhance treatment outcomes among veterans.

Medication Management and Aftercare

In addition to counseling and psychoeducation, veterans may continue to receive medication to address symptoms associated with PTSD and substance use. Aftercare plans typically encompass ongoing medication management and follow-up appointments with prescribing clinicians.

Alternative Treatment Approaches

Veterans’ treatment may also include individual counseling and group therapy with other veterans or individuals who have experienced similar traumatic events. One intervention specifically designed for those with PTSD and co-occurring substance use disorders is Seeking Safety therapy. This evidence-based approach aims to reduce trauma and substance abuse symptoms while enhancing coping skills related to behavior, thinking and emotions.