Signs of Alcoholism in Veterans

Military service creates many hazards that affect the physical and mental health of servicemen and women. The risks continue when service ends, as many veterans find themselves experiencing the effects of psychological and substance use disorders. Fortunately, there is help through VA alcohol rehab for veterans as well as alcohol rehab programs in the community.

Alcohol in the Military

Veteran with bottle at dinner

In the military, alcohol and heavy alcohol consumption are entrenched in the culture, making it challenging to regulate use.  In a variety of military settings, alcohol is regularly used for:1

  • Stress reduction.
  • Recreation.
  • A way to socialize/bond.

Alcoholism in veterans is a problem today, just as it was a problem in the past. Since the mid-1980s, the U.S. military has had programs and policies in place to moderate alcohol use among active-duty military and veterans, but they have been administered inconsistently and alcohol use remains a problem for active servicemembers and veterans alike.1

Binge drinking, a risk factor for alcohol use disorders, is high in the military service. In 2015, data showed that about 1/3 of servicemembers were binge drinkers.2 Even more (over 1/3) met the criteria for hazardous drinking or potential alcohol use disorder.2

Active-duty servicemembers report more substance use disorders linked to alcohol than any other drug, and this trend continues for veterans.2  Veterans were more likely than their civilian counterparts to use alcohol within the last month and to report heavy alcohol use.2

With time, increased drinking can lead to alcoholism and a need for substance abuse treatment. Almost two-thirds of the veterans seeking help for addiction point to alcohol as the main problematic substance, nearly double the rate of civilians.2 

Alcohol, PTSD, and Veterans’ Mental Health

Alcohol and veterans’ mental health issues share a bidirectional relationship. That is, alcohol use has the potential to create new mental health symptoms or make existing symptoms worse, and someone with a mental health issue might use alcohol to cope with their symptoms.Alcohol may reduce symptoms at first, but it tends to worsen the problem over time.3

People who experience traumas are more prone to have issues with alcohol, and people who abuse alcohol are more likely to endure traumas.

One mental health condition linked to high rates of alcohol use is post-traumatic stress disorder (PTSD). People who experience traumas are more prone to have issues with alcohol, and people who abuse alcohol are more likely to endure traumas.3 With the elevated risk of experiencing trauma and culture of alcohol in the military, PTSD and alcohol abuse in veterans is a serious problem in the U.S.

The connection between PTSD and alcohol abuse is strong. Consider that:3

  • As many as 80% of Vietnam veterans seeking treatment for PTSD also have alcohol use disorders.
  • Men who suffer from PTSD are twice as likely to have alcohol use problems than men who don’t.

PTSD symptoms that may get worse with alcohol use include:3

  • Sleep problems – both PTSD and alcohol abuse will result in poorer quality and quantity of sleep.
  • Anger and irritability.
  • A constant feeling of being “on edge.”
  • Tendency to isolate/cut off contact with others.
  • Emotional numbness.
  • Depression.

Co-occurring PTSD and substance use disorders can make daily functioning feel nearly impossible. Of course, PTSD is not the only mental health risk in veterans. In fact, the VA states that veterans who have PTSD and drink excessively are likely to have other mental health issues including:3

  • Anxiety and panic attacks.
  • Compulsions, like having to check that the stove is off over and over.
  • Depression.
  • Harmful behaviors.
  • Attention problems.
  • Substance use problems.

Alcohol’s Effect on Traumatic Brain Injury in Veterans

Doctors looking at brain xray

Unfortunately, alcohol use and PTSD are prevalent among servicemembers and veterans, but there is another risk: traumatic brain injury (TBI). In recent years, TBIs have been occurring at very high rates. During the first 12 years of the conflicts in Iraq and Afghanistan, 250,000 servicemembers were diagnosed with TBI or mild TBIs (mTBIs), or concussions. The number of TBIs may be higher due to problems with identifying, diagnosing, and reporting head injuries.4

For a person with a TBI, alcohol use can:5,6

  • Slow the recovery from the TBI.
  • Increase the risk of developing seizures.
  • Further increase the risk of having another brain injury due to alcohol’s effects on balance and coordination.
  • Worsen new symptoms of depression linked to the TBI.
  • Decrease sexual desire, performance, and satisfaction.
  • Lessen the effectiveness of medication.

The recovery period from a TBI can last for years, and alcohol may pose barriers to progress and limit the outcomes.7

Veterans who continue drinking after incurring even a mild TBI may suffer from:7

  • Problems with impulsivity.
  • Inability to concentrate.
  • Depression.
  • Suicidal thoughts/behaviors.
  • Problems with executive functioning in the brain (leading to issues with memory, decision-making, and self-control).

Sadly, aside from headaches, alcohol and other substance use disorders are the most common problems reported by military members with TBIs. Veterans with a history of TBIs suffer from substance use disorders at double the rate of those without TBIs.7

Signs of an Alcohol Use Disorder

Alcohol in woman's hand

With the high rates of substance use disorders among active-duty military and veterans, it is important to recognize the signs of an alcohol use disorder in yourself or a loved one.

A person may have an alcohol use disorder if they:8

  • Spend a lot of time getting alcohol, drinking, and recovering from their use.
  • Set limits on their drinking but end up drinking more or for longer than they meant to.
  • Repeatedly try to cut their drinking back or stop drinking entirely without succeeding.
  • Experience powerful cravings to drink.
  • Develop problems with their ability to manage issues at home, work, or school due to their drinking.
  • Still drink even though it negatively impacts relationships with friends and family.
  • End engagement in fun and healthy activities because they got in the way of drinking
  • Repeatedly find themselves engaging in dangerous situations during/after drinking.
  • Continue drinking even when the alcohol seems to make mental or physical health issues worse.
  • Need to drink more alcohol or stronger alcohol to feel intoxicated.
  • Experience withdrawal symptoms when the effects of alcohol wear off.

All of the above are the criteria mental health professionals use to determine if someone has an alcohol use disorder, or AUD, but there are other signs you can look for. You or your loved one may have a problem with alcohol if they:9

  • Cannot maintain their responsibilities at work or school.
  • Keep getting into accidents, conflicts with friends, and/or trouble with the law.
  • Appear nervous, fearful, or paranoid.
  • Begin acting more secretive.
  • Have changed their eating and sleeping habits.
  • Experience frequent and unexpected mood changes, angry outbursts, or erratic behaviors.
  • Appear to be unusually energetic or happy.
  • Seem to lack any motivation.
  • Have a dramatic increase or decrease in weight.
  • Stop taking care of their appearance.
  • Smell of alcohol regularly.
  • Show signs of poor motor coordination and slur their speech.
  • Unexplained or suspicious bumps, cuts, and bruises.

VA Rehab Benefits

Alcohol use disorders are serious conditions, but the symptoms can improve with professional substance abuse treatment. Fortunately, there are many paths for vets hoping to access professional mental health and/or substance abuse treatment. Vets who choose VA substance abuse counseling or VA rehabilitation can contact their local Vet Center or call the general information hotline at 1-800-827-1000.

Other vets will want an alternative because of issues within the VA or because they are too far from a facility to receive the VA alcohol treatment or VA rehab care they need. These people may benefit from VA Community Care, a program that allows veterans access to local providers operating outside of the VA system.

Desert Hope’s Treatment for Veterans

Veterans who are eligible to receive community care with the VA may be able to receive specialized treatment at Desert Hope in our Salute to Recovery program.

As an approved community provider, Desert Hope offers treatments specifically designed for the unique needs of veterans. Here, vets receive treatment and live with other veterans and first responders to enjoy a supportive community focused on recovery.

As an approved community care provider, Desert Hope will bill the VA directly. Veterans may be responsible for a copay and may be able to utilize any extra benefits, such as TRICARE coverage, to help cover the cost.

FAQs about Alcohol Treatment

Does alcohol rehab for veterans really work?

Evidence-based substance use disorder treatment has been shown to reduce symptoms of AUD and restore a person’s functioning. Effective treatments will often offer a combination of behavioral therapy and medications.2

If I’ve already tried rehab, isn’t trying again a waste of time?

No. Recovery is a lifelong process that often involves many attempts at treatment. Relapse is a relatively common experience and doesn’t indicate a failure of treatment but rather indicates a need to reassess and refocus on appropriate treatment options. There are successful treatments that can address substance use and co-occurring mental health disorders simultaneously, so a veteran with an alcohol use disorder and PTSD can find lasting recovery from programs that include trauma-based therapies, education, support groups, and new coping skills.10 Addiction is a long-term problem that requires long-term solutions.

Is addiction a sign of weakness?

There is no connection between addiction and weakness, although there is a perceived stigma within military culture that may reinforce harmful beliefs like this. In reality, ignoring the negative influences of drug or alcohol addiction only makes problems worse with time. Though stigmas about seeking treatment persist to this day, the truth is that asking for help is a sign of strength and bravery.2

Is a VA alcohol rehab the only place for veterans to get treatment?

Depending on the veteran’s location, insurance coverage, and specific medical needs, there are more options than only the VA. As noted above, anyone interested in seeking treatment outside options can contact the VA to learn more about community care.

References: 

  1. Teeters, Jenni B., Lancaster, Cynthia L., Brown, Delisa G., and Back, Sudie E. (2017). Substance Use Disorders in Military Veterans: Prevalence and Treatment Challenges, Substance Abuse and Rehabilitation.
  2. National Institute on Drug Abuse. (2019). Substance Use and Military Life.
  3. U.S. Department of Veterans Affairs. (n.d.). PTSD and Problems with Alcohol Use.
  4. Weil, Z. M., Corrigan, J. D., & Karelina, K. (2018). Alcohol Use Disorder and Traumatic Brain InjuryAlcohol research : current reviews39(2), 171–180.
  5. Model Systems Knowledge Translation Center. (2011). Alcohol Use After Traumatic Brain Injury.
  6. Herrold, A.A., Sander, A.M., Wilson, K.V. et al.Dual Diagnosis of Traumatic Brain Injury and Alcohol Use Disorder: Characterizing Clinical and Neurobiological Underpinnings. Curr Addict Rep 2, 273–284 (2015).
  7. Department of Defense. (2017). The Alcohol Use Disorder and Comorbid PTSD/TBI Landscape.
  8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
  9. gov. (2019). Mental Health and Substance Use Disorders.
  10. U.S. Department of Veterans Affairs. (n.d.). PTSD and Substance Abuse in Veterans.
About The Contributor
Ryan Kelley, NREMT
Medical Editor
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More