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Alcoholism in the Military

Learn about the prominence of alcoholism in the military and how mental health and workplace issues can affect the development and course of alcohol abuse in members of the armed forces.

Alcohol abuse in the military is a relatively common problem. Current and former military members face many stressors and situations that most people never need to deal with, and these stresses and challenges can increase the chances of developing alcoholism or other substance use issues.

Learn more below about substance abuse in the military and how mental health and workplace issues can affect the development and course of alcohol abuse in members of the armed forces. If you are struggling with alcohol abuse, you will learn how you can seek help for alcoholism and any co-occurring mental health disorders, such as depression, anxiety, or post-traumatic stress disorder (PTSD).

Alcohol Use in the Military

Substance misuse, often referred to as “substance abuse,” means that a person uses substances, such as drugs or alcohol, in an unhealthy way that causes dysfunction and leads to problems, including negative mental health, social, and physical issues.1Alcoholism, also known as an alcohol use disorder (AUD), means that a person uses alcohol in a way that leads to distress and harm; you are no longer able to control your alcohol use and you continue to misuse it despite the negative impact it has on your life.2

military and alcoholism

According to the National Institute on Drug Abuse (NIDA), AUD is the most common form of substance use disorder among active-duty military members.3 In 2015, 5.4% of military personnel were heavy drinkers, compared with 6.7% of the general population.3 However, binge drinking was more prevalent in military members, with a rate of 30%, compared with 24.7% of the general population.3 Additionally, more than 1 in 3 active-duty military members met the criteria for possible AUD.3

According to the 2019 National Survey on Drug Use and Health (NSDUH), an estimated 26,000 veterans aged 18-25 and 1 million veterans aged 26 and older met the criteria for AUD in the past year.4

When it comes to veterans, studies show that they have a higher risk of developing AUD than civilians. One study of 88,235 veterans returning from Operation Iraqi Freedom found that 12% to 15% experienced problematic alcohol use in the 3 to 6 months following their return from combat.5

A study in Substance Abuse & Rehabilitation reports that being male and single increases the risk of a substance use disorder (SUD) in both the veteran and civilian populations.6 However, these demographics are more prevalent in the military, which could, at least in part, help explain the higher rate of SUDs in veterans.6

Alcoholism Risk Factors for Active-Duty Military & Veterans

Several risk factors can affect alcoholism in active-duty military and veterans. NIDA points out that the unique culture associated with military life can influence the development of SUDs. In both active-duty personnel and veterans, combat exposure, post-deployment civilian and reintegration challenges, and the experiences of deployment can be serious risk factors for alcoholism.3 Other risk factors include:

PTSD and Trauma

Post-traumatic stress disorder is a common mental health issue experienced by military personnel and veterans, with exposure to trauma increasing the risk of alcoholism. The U.S. Department of Veterans Affairs explains that people with PTSD are more likely to abuse alcohol, and people who abuse alcohol often have PTSD.7 In addition, each problem can worsen the other. Regardless of whether you are a veteran or not, around three-quarters of the population who have experienced a traumatic event develop drinking problems.7

The prevalence of PTSD can vary somewhat by service era; for example, 11-20 out of every 100 veterans who served in Operations Iraqi Freedom and Enduring Freedom developed PTSD, while 15 out of every 100 Vietnam veterans developed PTSD.8 Generally speaking, veterans who have SUDs are 3 to 4 times more likely to have PTSD.3

Traumatic experiences are correlated with problematic alcohol use among military members. This may be for several reasons, such as trying to self-medicate mental health symptoms or drinking as a way to deal with chronic pain.5 However, one of the most under-researched traumatic experiences that can impact alcoholism is killing in a combat setting.5 A clinical review in Alcohol Research reports that this can be a significant, yet often an unrecognized risk factor for both PTSD and alcoholism in veterans.5

Gender is also a factor when it comes to PTSD and alcoholism. Women who have PTSD are 2.5 times more likely to abuse alcohol than women without PTSD, whereas men with PTSD are twice as likely to have alcohol problems than men without PTSD.7

Veterans with PTSD may drink as a way to cope with re-experiencing—or flashbacks—and to manage hyperarousal symptoms of PTSD.5 However, it’s important to note that alcohol abuse is associated with worsening of PTSD symptoms and is a significant impediment to recovery.5

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Depression

Depression is another common mental health disorder in active-duty military personnel and veterans.9 According to the 2015 Health Related Behaviors Survey (published in 2018), the U.S. Department of Defense’s screening method for evaluating health in service members, 9.4% of service members reported probable depression.9 Furthermore, depression was more common among members of the Marine Corps, Army, and Navy than in the Air Force and Coast Guard.9

Depression can lead to alcohol misuse just as alcohol misuse can lead to depression.10 Regardless of which comes first, alleviating depressive symptoms with alcohol can exacerbate symptoms of both. Alcohol is a depressant, which means that it makes you feel worse and can increase the number of times you experience a major depressive episode.11

Studies have been unable to pin down the rate of co-occurrence alcohol dependency and depression, but one clinical review estimates that is somewhere between 16-68%.10

Co-Occurring Disorders

The 2019 NSDUH reports that 481,000 veterans had a co-occurring disorder.4 The term co-occurring disorders means that a person has a substance abuse disorder and another mental health disorder, such as PTSD, depression, or anxiety.

PTSD and AUD appear to be two of the most common co-occurring disorders in military personnel and veterans.12 And each disorder can worsen the other; one study reports that having an AUD can increase the likelihood of PTSD, and vice versa.12 NIDA reports that veterans with SUDs such as AUD are between 3-4 times more likely to receive a PTSD or depression diagnosis.3

Workplace Culture

The unique workplace culture of the military can be a risk factor for the development of AUD in military members. Ideas about acceptable levels of alcohol use, shared experiences, cultural norms, drinking “rituals” that may serve as bonding experiences, and expectations about the positives or negatives of alcohol use can impact alcohol use and misuse in the military.13

One study reported that military members may be more likely to view alcohol use as an appropriate coping mechanism for dealing with issues like stress, boredom, loneliness, and lack of other recreational activities in the workplace.13

Another study found that in the Navy, respondents felt that heavy and binge drinking behavior after work or while on deployment was just a part of the normal cultural traditions.13 Additionally, these behaviors were not considered inappropriate unless sailors were unable to return to the ship at the designated time.13

Self-Medicating with Alcohol

As previously mentioned, many people use alcohol to alleviate symptoms of pre-existing or emerging mental health disorders (i.e., “self-medicate”), whether they’re in the military or are civilians. Since traumatic experiences may lead to depression or PTSD, symptoms of these disorders can be extremely distressing, and people may attempt to alleviate their symptoms with alcohol (or other substances).

alcoholism in navyWhile this is commonly referred to as “self-medicating,” a medication should help a person get better—not worse. “Self-medication” of PTSD with alcohol actually can worsen PTSD as well as other mental health disorders, and it usually impedes recovery.5

This is because, to overcome PTSD or trauma, mental health practitioners believe that you need to be able to stop avoiding unpleasant and traumatic memories and experiences that keep causing distress in the present but are actually safe in reality.5 For some people, this might mean being in crowds or experiencing challenging emotions without pushing them away or dissociating.5

In this sense, recovery means that a person can make contact with the things that cause distress and realize that they are safe. Since alcohol may be used as an avoidance mechanism, it might not only prolong PTSD, it can worsen it because it prevents you from dealing with the underlying issues.5

Alcoholism and Veteran Suicide

There is a connection between alcohol abuse and suicide among vets. Alcohol abuse, depression, and PTSD have been shown to increase the risk of suicide in vets.14 This may be because alcohol use decreases inhibitions, increases feelings of aggression, and impairs judgment, perhaps making it more likely that a person will take action on thoughts of self-harm that they have when they are sober or increase the likelihood that they will attempt to harm themselves in the first place.15 Around 25-30% of suicides are reported to involve a diagnosis of AUD.15, 16

The rate of suicide in active-duty and veterans surpasses the rate for civilians. NIDA reports that, in 2016, the suicide rate in veterans was 1.5 times higher than in civilians.3 A study comparing different psychiatric diagnoses and suicide in veterans found that among males, veterans with bipolar disorder had the greatest risk of suicide, while among females, veterans with substance use disorders were associated with the greatest risk.16 It’s important to note that alcoholism and bipolar disorder are correlated, and suicidal behavior appears to be more likely in both men and women struggling with these co-occurring disorders.17

Treatment for Alcoholism in the Military

If you are a member of the military or a veteran and you are struggling with alcoholism or a co-occurring disorder, it’s important to seek treatment so you can recover and prevent the problem from potentially worsening. You can seek treatment through the VA or a VA-approved facility providing a variety of services to veterans, including:18

  • Screening, which helps determine the extent of the problem, evaluates your overall health, and screens for co-occurring disorders.
  • Short-term outpatient counseling, which can help increase your motivation to seek treatment for alcoholism.
  • Medical detox, which helps you stop drinking safely and comfortably while undergoing alcohol withdrawal so you can become medically stable.
  • Intensive outpatient treatment, which means you live at home but attend treatment most days of the week.
  • Residential treatment, which means you live at a rehab facility and receive round-the-clock care, monitoring, and support.
  • Continuing care and relapse prevention, which are designed to help you stay sober after you have completed formal treatment.
  • Marriage and family counseling, which can help repair your relationships and help your loved ones more fully understand what you’ve been going through.
  • Self-help groups like Alcoholics Anonymous (AA), which provide mutual support from other veterans who know what it’s like to be in your shoes.
  • Medication therapy, which can help with withdrawal symptoms, cravings, and help you stay stable.

You may also participate in different types of psychotherapy in individual and group settings while in rehab. Two of the most common therapies used to treat SUDs in veterans include:19

  • Cognitive-behavioral therapy (CBT), which helps you identify and change unhealthy thoughts and behavior patterns.
  • Motivational interviewing, which is an approach designed to help increase your motivation to make positive changes in your life.

Taking control of your mental health by starting the path to recovery is one of the best moves you can make to regain a sense of wellbeing, start living a healthier life, and overcome addiction. Don’t hesitate to reach out for help if you feel that you need it, as PTSD and addiction can become worse if left untreated.

Seeking Alcoholism Treatment as a Veteran

If you’re a veteran ready to seek treatment for alcoholism, American Addiction Centers (AAC) can help. Alcohol.org is a subsidiary of AAC, a nationwide provider of addiction treatment centers.

alcoholism and marines

We offer specialized tracks designed for veterans at our Desert Hope facility in Nevada and Recovery First in Florida called Salute to Recovery. Our program caters to veteran and first responders battling addiction and co-occurring mental health issues.

Each facility offers specialized programming via a 4-week cycle and “battalions” tailored specifically to your unique experiences. During treatment, all veterans are in a group with only other veterans and first responders to allow individuals to bond with people who have similar life experiences. Within these facilities, you’ll also work with a therapist who is a veteran.

Call our hotline today at 1-888-685-5770 to speak with an admissions navigator about your treatment options. We’re available 24/7 and all calls are 100% confidential. We know making the step toward recovery can be scary but you’re not alone; we’ll be with you every step of the way as you begin to live a life free from alcohol. Fill out the form below to see if your insurance covers treatment at our facilities.

Sources
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[1]. Office of Disease Prevention and Health Promotion. (2021). Substance Abuse.

[2]. U.S. National Library of Medicine. (2021). MedlinePlus, Alcohol Use Disorder (AUD).

[3]. National Institute on Drug Abuse. (2019). Substance Use and Military Life DrugFacts.

[4]. Substance Abuse and Mental Health Services Administration. (2019). 2019 National Survey on Drug Use and Health: Veteran Adults.

[5]. Schumm, J. A., & Chard, K. M. (2012). Alcohol and stress in the military. Alcohol Research: Current Reviews, 34(4), 401–407.

[6]. Teeters, J. B., Lancaster, C. L., Brown, D. G., & Back, S. E. (2017). Substance use disorders in military veterans: prevalence and treatment challenges. Substance Abuse and Rehabilitation, 8, 69–77.

[7]. U.S. Department of Veterans Affairs. (2019). PTSD and Problems with Alcohol Use.

[8]. U.S. Department of Veterans Affairs. (2018). How Common is PTSD in Veterans?

[9]. Rand. (2018). 2015 Health Related Behaviors Survey.

[10]. Kuria, M. W., Ndetei, D. M., Obot, I. S., Khasakhala, L. I… & Kamau, J. (2012). The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence. ISRN Psychiatry, 2012, 482802.

[11]. R. Kathryn McHugh, Roger D. Weiss. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, Vol 40(1), pg. 1-8.

[12]. Dworkin, E. R., Bergman, H. E., Walton, T. O., Walker, D. D., & Kaysen, D. L. (2018). Co-Occurring Post-Traumatic Stress Disorder and Alcohol Use Disorder in U.S. Military and Veteran Populations. Alcohol Research: Current Reviews, 39(2), 161–169.

[13]. Ames, G., & Cunradi, C. (2004). Alcohol Use and Preventing Alcohol-Related Problems Among Young Adults in the Military. Alcohol Research & Health, 28(4), 252–257.

[14]. Kachadourian, L. K., Gandelman, E., Ralevski, E., & Petrakis, I. L. (2018). Suicidal ideation in military veterans with alcohol dependence and PTSD: The role of hostility. The American Journal on Addictions, 27(2), 124–130.

[15]. Olsen-Madden, J. (2016). Substance Use Disorders and Suicide.

[16]. Ilgen, M. A., Bohnert, A. S., Ignacio, R. V., McCarthy, J. F…& Blow, F. C. (2010). Psychiatric diagnoses and risk of suicide in veterans. Archives of General Psychiatry, 67(11), 1152–1158.

[17]. Oquendo, M. A., Currier, D., Liu, S. M., Hasin, D. S…& Blanco, C. (2010). Increased risk for suicidal behavior in comorbid bipolar disorder and alcohol use disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The Journal of Clinical Psychiatry, 71(7), 902–909.

[18]. U.S. Department of Veterans Affairs. (2019). VA Services: Substance Abuse Programs.

[19]. Teeters, J. B., Lancaster, C. L., Brown, D. G., & Back, S. E. (2017). Substance use disorders in military veterans: prevalence and treatment challenges. Substance Abuse and Rehabilitation, 8, 69–77.