Veterans’ Journey from Self-Medicating Their Trauma to Addiction Recovery
The path to recovery for veterans grappling with trauma and self-medication is often fraught with challenges. According to the U.S. Department of Veterans Affairs, approximately 7% of military veterans contend with post-traumatic stress disorder (PTSD) during their lifetime. Exposure to combat, traumatic events and life-threatening situations can leave veterans more susceptible to trauma-related behavioral and mental health issues than the general population.
Unfortunately, the link between trauma and self-medication is profound. Studies indicate that nearly 50% of individuals diagnosed with PTSD also struggle with a concurrent substance use disorder. Many experts believe this connection arises from the inclination to self-medicate, using substances as a temporary escape from the haunting memories and emotions associated with traumatic events.
However, as the efficacy of substances diminishes, self-medication can evolve into a full-fledged substance use disorder. When left unaddressed, the co-occurring conditions of trauma and substance use exacerbate both the mental and behavioral health challenges of the individual.
To provide effective care, clinicians often embark on a dual mission to address both trauma and substance use. Treatment programs may incorporate veteran support groups to further personalize the treatment plan. Fortunately, there are evidence-based treatments encompassing various modalities that offer invaluable support to self-medicating veterans on their journey to recovery.
The Complex Interplay of Trauma and Self-Medication
Veterans grappling with trauma often experience an 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, thoughts or emotions
- Distorted thoughts regarding the traumatic event or an inability to remember it accurately
- Mood swings and inability to experience positive moods
To cope with these symptoms, veterans may turn to drugs and alcohol. Initially, substances may offer temporary relief by improving sleep, providing comfort in specific situations or serving as a distraction from issues stemming from PTSD, such as strained relationships or professional setbacks. However, self-medication merely perpetuates the cycle of avoidance.
While self-medication may appear to provide momentary relief, PTSD symptoms generally worsen over time. This deterioration disrupts sleep, alters mood and diminishes the effectiveness of prescribed psychiatric medications. Evidence underscores the most effective approach, which entails addressing both PTSD and substance use disorder concurrently.
Veterans Confronting Trauma and Co-Occurring Substance Use Disorders
Veterans embarking on the journey to recovery often engage in a comprehensive continuum of care tailored to their specific needs. Assessments for substance use and psychiatric concerns help determine the most suitable level of care. In cases where veterans require structured and supervised recovery, clinicians may recommend residential or inpatient facilities.
If deemed medically necessary, individuals may undergo supervised detox to safely withdraw from substances. Many detox facilities incorporate 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 Strategies for Self-Medicating Veterans Overcoming Trauma
Throughout different stages of care, clinicians deploy a spectrum of treatments to address both substance use and trauma-related challenges.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) has emerged as a highly effective tool for treating co-occurring trauma-related disorders. During CBT sessions, clinicians explore unhealthy thinking patterns that may contribute to veterans’ self-medication. These trauma-focused psychotherapy sessions also aid veterans in processing traumatic events and the emotions associated with them.
Prolonged exposure therapy aims to diminish the emotional “triggers” linked to trauma. These sessions may involve repeated exposure to detailed images or virtual reality programs designed to evoke fear, distress and other negative emotions. The aim is to create a controlled, secure environment for veterans to systematically confront their emotional reactions.
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 often proves effective in altering veterans’ memories of traumatic events, thereby reducing their emotional connection to these memories.
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 Post-Treatment Support
In addition to counseling and psychoeducation, veterans may continue to receive medication to address symptoms associated with PTSD and substance use. Post-treatment plans typically encompass ongoing medication management and follow-up appointments with prescribing clinicians.
Alternative Therapeutic Approaches
Treatment for veterans may also include individual counseling and group therapy with other veterans or individuals who have experienced similar traumatic events. One intervention tailored specifically for those with PTSD and co-occurring substance use disorders is Seeking Safety therapy. This evidence-based approach aims to reduce trauma and substance use symptoms while enhancing coping skills associated with behavior, thinking and emotions.
U.S. Department of Veterans Affairs. “How Common is PTSD in Veterans?”><[…]pa[…] in Veterans?” Accessed November 8, 2023.
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American Psychiatric Association. “What is Posttraumatic Stress Disorder (P[…]order (PTSD?)” November 2022. Accessed November 8, 2023.
Norman, Sonya; Wilkins, Kendall; Tapert, Susan; Lang, Ariel; & Najavitsd, Lisa. “A Pilot Study of Seeking Safety Therapy […]/OIF Veterans.” Journal of Psychoactive Drugs, March 2010. Accessed November 8, 2023.
Thompson-Hollands, Johanna; Rando, Alora; Stoycos, Sarah; Meis, Laure; & Iverson, Katherine. “Family Involvement in PTSD Treatment: Pe[…]n Clinicians.” Administration and Policy in Mental Health and Mental Health Services Research, 2022. Accessed November 8, 2023.
Tapia, Geraldine. “Review of EMDR Interventions for Individuals With Substance Use Disorder With/Without Comorbid Posttraumatic Stress Disorder.” Journal of EMDR Practice and Research, November 2019. Accessed January 24, 2024.