Who Alcohol Use Disorder Affects - Veterans

Alcohol use disorder (AUD) is pervasive in veterans, especially those with post-traumatic stress disorder (PTSD) and depression. Military service members face unique and considerable stressors that put them at risk for alcohol and drug abuse problems during and after their service.

Despite the immense difficulties that substance abuse and addiction imply for veterans and their families, many options exist for treatment and recovery within the US Department of Veterans Affairs (VA) and individual treatment centers.

What Are the Symptoms of Alcohol Use Disorder (AUD)?

AUD is a diagnosable medical condition that occurs when someone drinks excessively to the point that it interferes with their daily life. It impacts a person’s brain chemistry and alters its function in ways doctors do not fully understand.

Signs and symptoms of AUD include:

• A strong desire to use alcohol
• The inability to control alcohol consumption following persistent attempts to quit
• Drinking alone
• Difficulty consuming less alcohol during drinking sessions
• Diminishing school and job performance due to the after-effects and hangovers from alcohol
• Conflict with interpersonal relationships
• Neglecting needs, including purchasing and eating food, hygiene, etc.
• Losing interest in work, recreational activities, or social activities
• Using alcohol in situations where it’s not safe, such as driving or while operating machinery
• Developing a tolerance and needing more alcohol to feel its effects
• Experiencing alcohol withdrawal symptoms while sober

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Risk Factors of AUD Amongst Veterans

Veterans face higher rates and risk of alcohol use disorder than civilians. Different factors contribute to this.

These factors include:

• Drinking culture in the military
• Traumatic experiences during service
• Mental health conditions due to unprocessed trauma

Cultures of Alcohol Consumption in the Military

Prolonged alcohol use during military service can contribute to continued use and addiction during and after active service.

The stresses of deployment and military culture create unique pressures for active service members to partake in binge drinking and alcohol misuse. Historically, heavy alcohol consumption has been widely accepted in the military as a way for service members to bond, ease interpersonal tensions, and relieve boredom on off days.⁶

Co-occurring Depression and Alcohol Abuse Among Veterans

Most military veterans with substance use disorder (SUD), including alcoholism, also have co-occurring mental health issues. For example, depression is one of the leading mental health conditions in the military.

After military service, symptoms associated with depression can intensify alcohol misuse, increasing the risk for addiction and other mental health issues.

Co-occurring PTSD and Alcohol Abuse Among Veterans

Post Traumatic Stress Disorder (PTSD) is the most common mental health disorder veterans face upon returning from service. These are the findings from different surveys:

• Around 20% of surveyed people with PTSD used drugs or alcohol to relieve their symptoms⁷
• Of the 30% of Vietnam veterans who met the criteria for PTSD, 70% struggled with alcoholism⁸

Although alcohol can temporarily relieve PTSD symptoms, overconsumption can lead to addiction. In contrast, unregulated withdrawal can intensify PTSD symptoms.

Military Sexual Trauma and Alcohol Abuse Amongst Veterans

Alcohol misuse is a significant clinical concern among military and veteran populations who have experienced military sexual trauma (MST).

MST, which refers to sexual assault or harassment experienced during military service, can lead to mental health conditions like PTSD and depression. Substance abuse disorders such as alcohol addiction often develop as a coping strategy for MST-related distress.⁹

How Common is Alcohol Abuse Amongst Veterans?

Alcohol abuse and binge drinking are common among active-duty military personnel, and this behavior may evolve into alcoholism after retiring. The following statistics highlight the prevalence of alcoholism and substance abuse among veteran populations:

• Alcohol is the most commonly abused substance among military personnel.¹
• More than 1 in 3 active duty service members are binge drinkers.
• Twenty-two percent of all service members report heavy alcohol use (i.e., five or more drinks per typical drinking occasion at least once per week in the past 30 days).²
• Over 65% of veterans who entered drug or alcohol addiction treatment programs reported alcohol as their primary substance of misuse.³
• Alcohol was the most common substance involved in nonfatal overdoses among homeless veterans.⁴
• Twenty-nine percent of Army suicides between 2005 and 2010 involved alcohol or drug abuse.⁵

Co-occurring Disorders Amongst Veterans

Besides alcoholism, veterans are at a high risk of being diagnosed with a co-occurring disorder. It is a diagnosis of two interrelated conditions: substance use disorder and mental health.

Co-occurring disorders diagnoses can include mood disorders such as:

• Depression or bipolar disorder
• Anxiety disorders such as panic disorder or PTSD
• Schizophrenia

Substance use disorders can also be co-occurring disorders, such as:

• Alcohol use disorder (AUD)
• Opioid addiction
• Prescription drug use disorder
• Stimulant use disorder

Identifying how mental health issues and substance abuse disorders overlap among veterans is critical to finding the proper treatment programs for their condition.

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The Impact of Alcohol Abuse on Veterans

Uncontrollable drinking doesn’t just harm the drinker’s health. If left untreated, AUD can take a massive toll on a veteran’s interpersonal life, career, and well-being.

The most common consequences of alcohol abuse on veterans include:

Veteran Homelessness

The U.S. Department of Housing and Urban Development (HUD) estimates that 33,129 veterans experienced homelessness in 2023. While this number has declined by 55.3% since 2010, veterans still experience homelessness at rates exceeding their representation in the general population.¹⁰

Homelessness in the veteran population is attributed to these factors:

• The life-altering impacts of AUD
• Insufficient government aid
• Lack of affordable housing
• Inadequate access to healthcare

Suicide Among Veterans

Since 2010, suicide rates have been consistently higher among veterans than nonveteran adults.¹¹ Veterans who had multiple deployments or faced life-threatening circumstances have the most significant risk of harming themselves.

The risk of suicidal ideation, suicidal attempts, and completed suicide is drastically higher among those with AUD than the general population.¹²  Because veterans have higher rates of AUD than the general population, they’re at higher risk of alcohol-induced death by suicide than the general population.

Interpersonal Challenges Among Veterans

AUD can increase the risk of domestic violence, assault, and child neglect or abuse.

Rates of domestic or intimate partner violence are higher among veterans than the general population, likely because of the high rates of AUD co-occurring with factors like PTSD, depression, and the unique pressures that military life places on intimate relationships.

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How Are Military Families Affected by Alcohol Abuse?

Substance use disorders and mental health disorders can negatively impact veterans’ family dynamics when they return to civilian life.

This can affect the following family members:

Spouses or Partners of Veterans

Partners of veterans with a co-occurring substance use disorder tend to experience lower satisfaction in relationships the first year after a veteran returns home.

Lower relationship satisfaction can come from:

• Intimacy issues
• Less communication
• Lower sexual interest
• Symptoms AUD

Children of Veterans

Children of veteran parents with AUD may suffer mental and emotional distress that impacts them for a lifetime.

Children may respond by:

• Experiencing sadness, anxiety, or worry for the parent
• Taking on a caregiving role for their parent
• Struggling in school and extracurricular activities
• Experiencing difficulty in relationships with friends, family members, and romantic partners
• Displaying symptoms of PTSD or depression

Children whose parents abuse alcohol are less likely to receive the care they need, which can contribute to compounded problems, including mental health and substance abuse disorders later in life.

AUD Treatment for Veterans

When planning and researching treatment for alcohol addiction, people should discuss their options with a healthcare professional. Especially in the case of co-occurring disorders, treatment must include a combination of methods to see long-term acceptance and results with sobriety.

Most people with an alcohol use disorder can benefit from some form of therapy, including:

Medications

Three medications are currently FDA-approved to treat alcohol use disorder, namely naltrexone, acamprosate, and disulfiram. These medications are non-addictive and help manage alcohol cravings and withdrawal symptoms.

Behavioral Treatments

Working with a healthcare professional to identify and change behaviors contributing to uncontrollable drinking can prove pivotal to a veteran recovering from AUD. They may suggest cognitive-behavioral therapy (CBT), motivational enhancement therapy, or mindfulness-based interventions.

Mutual Support Groups

Mutual support groups allow veterans and civilians recovering from alcohol use disorder to build a community around recovery.

Options include joining:

• Twelve-step programs (i.e., Alcoholics Anonymous)
• Secular non-twelve-step programs (i.e., SMART Recovery)
• Religious groups

Most meetings are at low or no cost and offer convenient times and locations. 

Does VA Health Care Cover AUD Treatment?

The VA offers several treatment options for veterans suffering from substance use problems. The services offered depend on the veteran’s specific needs and include¹³:

• Medically managed detoxification to safely stop substance abuse
• Short-term outpatient counseling
• Intensive outpatient counseling
• Marriage and family counseling
• Self-help groups
• Residential care
• Continuing care and relapse prevention
• Treatment programs for specific veterans groups (i.e., female veterans, returning combat veterans, homeless veterans)

The VA also offers treatment and support for health conditions related to alcohol use disorder, such as PTSD and depression.

VA Medical Centers

Veterans can get medical and mental health care for AUD at their local VA Medical Center.

The Veterans Health Administration is the most extensive integrated healthcare system in the United States. It consists of 172 VA Medical Centers and 1,138 outpatient sites.

VA Medical Centers offer a range of services for enrolled veterans, including:

• Surgery
• Mental health care
• Critical care
• Specialty services

The VA Community Care Network (CCN)

The VA Community Care Network (CCN) is the VA’s direct link with licensed community health care providers, covering all U.S. states and territories.

Healthcare services through CCN include:¹⁴

• Medical health
• Behavioral health
• Drug and alcohol rehab
• Surgical care
• Dental services
• Complementary and integrative health services (CIHS)

The veteran’s VA provider and VA medical facility staff members will work with the veteran to determine their eligibility for community care. Once eligibility is confirmed, the veteran can make an appointment with a provider from the CCN network.

Is Alcoholism a Disability Under The VA?

The Veterans Affairs (VA) defines disability as the inability to secure and maintain substantially gainful employment due to service-connected disabilities. To be eligible for benefits, veterans must prove their disability developed during active military service.

If alcoholism results from willful misconduct (an intentional act disregarding a known risk), the veteran won’t be eligible for service connection and VA disability benefits.

However, if alcohol use disorder develops due to a service-connected condition such as PTSD, veterans may be eligible for VA benefits for their secondary illness.

What is the VA Disability Rating for Co-occurring PTSD and AUD?

The VA uses a disability rating that provides compensation coverage based on a disability severity rating scale ranging from 0 to 100%. The higher your disability falls on the scale, the more financial assistance you may claim for your treatment.

The VA typically rates alcohol use disorder co-occurring conditions at 70%.

Submitting a VA Disability Claim for Benefits

Submitting a claim for VA benefits can be a complicated and lengthy process. Contacting a veterans ' law attorney is the most effective way to ensure eligibility.

Veterans’ law attorneys assist by:

• Gathering sufficient evidence to prove a veteran’s claim, including statements from their family, friends, and peers explaining that the AUD developed after the veteran was injured or disabled.
• Collating medical evidence from healthcare providers such as therapists and doctors to prove that a veteran is physiologically addicted to alcohol.
• Guiding the veteran through the entire VA benefits application process to ensure they receive the care they need as quickly as possible.

Check out website resources such as the US Department of Veteran Affairs Website for more information on VA benefits or to find your local VA medical center.

Additional resources are available through the Department of Health and Human Services Website for Substance Abuse and Mental Health Services Administration or SAMHSA.

Summary

AUD among military veterans is a prevalent concern affecting themselves, their friends, and their family. It can come from mental health problems tied to a traumatic event, mental disorders, or chronic pain from sustained injuries.

Developing alcohol dependence may be an attempt to relieve other co-occurring disorders, which must be treated with the veteran’s alcoholism to recover fully.

Under the VA CCN or local treatment centers, a veteran may receive assistance with their addiction treatment to aid their recovery.