by Thurston S. Smith

According to the 2006 U.S. National Survey on Drug Use and Health (NSDUH), an estimated 22.6 million persons across the country were classified with substance dependence or abuse during the past year. The same survey also suggests that a significant number of persons seeking treatment and recovery from chemical dependency were veterans. The transition home is often a difficult one, particularly if complicated by chemical dependency. With the state-side return of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OIF) veterans who suffer
with substance use disorders, the need for structured treatment programming and access to social supports remains evident.

On the Frontlines

Since the September 11th Tragedy there has been an influx of returning veterans seeking assistance for a host of conditions that were either caused or exacerbated during their military experience. Commonly, these conditions include a variety of psychosocial problems: posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), homelessness; and a host of other medical and mental health disorders. However, these conditions are frequently accompanied by alcohol and other drug abuse, as substance use disorders are among their predominant health care complaints and are on the “frontline” of problems presented by today’s veterans. Health care research concludes that veterans make up a large number of persons who repeatedly receive and seek access to substance abuse treatment.

Scope

As those of us who work in the substance abuse treatment profession would agree, treatments for addictive illnesses require a broad range of therapeutic interventions and adjoining services that comprehensively meet the varying needs of the persons served, while simultaneously assisting them in overcoming the plights of their emotional and psychological conditions. Although veteran and non-veteran substance abusers often require treatment, there are both clinical and cultural issues that are unique to the veteran population. For example, veterans present for treatment at higher ages than that of their non-veteran counterparts and are often homeless at time of admission. They are also less likely to have existing social and family supports in place, and frequently have co-occurring medical and psychiatric conditions at the presentation for services. Thus, the need for strategic health care planning on behalf of the veteran service population is of great importance.

In this respect, substance abuse treatment for veterans requires a full-range of counseling and collateral service coordination. The coordination of care often involves intensive case management, as most veterans with substance abuse problems have a long list of needs that require attention during treatment. As Dr. Wendy Merrill cites (2004), “to be meaningful and realistic, treatment must consider both the availability of supports and the unique relapse prevention liabilities faced by the client, in context with concerns related to access, economics, interpersonal relationships, day-to-day living environment, and cultural and historical factors surrounding the addiction.

The scope of treatment services provided should include the following:

• Screening and assessment for PTSD

• Evaluation for employment readiness

• Psychiatric evaluation

• Referrals to community-based support groups, i.e., AA/NA, faith-based social service entities, etc.

• Family-systems counseling, support systems development

• Aftercare treatment

As the transition from overseas and abroad of our nation’s veterans continues, the need for concomitant addictions treatment resources becomes apparent. With substance use disorders prevailing as one of America’s most troublesome health care problems, coupled with the additional challenges of homelessness, unemployment, co-occurring disorders, our nation’s veterans who have sacrificed much for our health and well-being, require our committed service to them. Let’s ensure that they have full access to the resources they need!

Resources

Alcoholics Anonymous - 1-212-870-3400
AMVETS - 1-877-726-8387
Mental Health - 1-877-877-3647
National Alliance on Mental Illness - 1-800-950-6264 (NAMI)
Narcotics Anonymous - 1-818-773-9999
Suicide Prevention - 1-800-273-TALK (8255)
TRICARE - 1-877-874-2273 (TRICARE)
Veterans Health Administration - 1-877-222-VETS

Miller, W. (2004). Substance use disorders and the veterans population. Resource Links, 5, 7

Smith, T. (2004). Substance use disorders and the veterans population. Resource Links, 2 – 4

Suchinsky, R.T. (2007). Issues facing returning veterans. Resource Links, 6, 7-8.

National Survey on Drug Use and Health (2006). SAMHSA’s National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, Rockville, MD.

Thurston S. Smith is a nationally recognized behavioral health care consultant and trainer. He is a long-time advocate for persons suffering with alcohol and other drug abuse disorders and is employed as a case manager with the Veterans Health Administration. His email address is: teesmith1@hotmail.com