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Beyond Trauma: Empowering Veterans in Their Recovery Journey from Self-Medication

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In the realm of recovery, veterans facing trauma and self-medication embody strength, resilience and the pursuit of healing. According to the U.S. Department of Veterans Affairs, approximately 7% of military veterans live with post-traumatic stress disorder (PTSD) at some point in their lives. Exposure to combat, traumatic incidents and life-threatening situations render veterans more susceptible to behavioral and mental health challenges linked to trauma compared to the general population.

Regrettably, a profound connection exists between trauma and self-medication. Studies indicate that nearly 50% of individuals diagnosed with PTSD also battle a co-occurring substance use disorder. Many experts theorize that this correlation stems from the inclination to self-medicate, resorting to substances as a temporary escape from the haunting memories and emotions associated with traumatic events.

However, as the efficacy of substances wanes, self-medication can transform into a full-fledged substance use disorder. Left unaddressed, this dual challenge of trauma and substance use worsens both the mental and behavioral aspects of an individual’s health.

To provide holistic care, clinicians often embark on a dual mission to address both trauma and substance use. Treatment programs may incorporate veteran support groups, enhancing personalization in the treatment journey. Fortunately, there exists a spectrum of evidence-based treatments across various modalities that offer unwavering support to self-medicating veterans as they navigate their path to recovery.

The Complex Interplay of Trauma and Self-Medication

Veterans grappling with trauma often experience a spectrum 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 concerning the traumatic event or an inability to remember it accurately
  • Mood swings or outbursts of anger

To cope with these symptoms, veterans may turn to drugs and alcohol. Initially, substances may offer short-term relief by aiding sleep, providing comfort in specific situations or serving as a temporary distraction from issues arising from PTSD, such as strained relationships or professional setbacks. However, self-medication merely perpetuates the cycle of avoidance.

While self-medication may seem to offer momentary solace, PTSD symptoms typically 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.

A Veteran’s Journey to Healing from Trauma and Co-Occurring Substance Use Disorders

Veterans embarking on the road to recovery often engage in a comprehensive continuum of care, meticulously tailored to their unique needs. Assessments for substance use and psychiatric concerns play a pivotal role in determining 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 include vocational training, ongoing medication management to address psychiatric symptoms and participation in veteran support groups.

Illuminating the Path to Recovery: Evidence-Backed Strategies for Self-Medicating Veterans

Throughout different stages of care, clinicians utilize a variety of treatments to address both substance use and trauma-related challenges.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) has emerged as a potent tool for treating co-occurring trauma-related disorders. During CBT sessions, clinicians help patients explore maladaptive thinking patterns that may contribute to veterans’ self-medication. These trauma-focused psychotherapy sessions also aid veterans in processing traumatic events and the associated emotions.

Exposure Therapy

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-Centric 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 allowing them to be a part of 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 related to behavior, thinking and emotions.

View Sources

U.S. Department of Veterans Affairs. “How Common is PTSD in Veterans?”><[…]pa[…] in Veterans?” Accessed November 8, 2023. 

McCauley, Jenna; Killeen, Therese; Gros, Daniel; Brady, Kathleen; & Back, Sudie. “Posttraumatic Stress ” Clinical Psychology (New York), 2012. Accessed May 24, 2023. 

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.