In the United States today, there are over 15 million veterans.
A veteran is anyone who has served in one of the branches of the U.S. military: the Army, the Air Force, the Navy, the Marines, the Coast Guard. These important citizens are now joined by over 6,000 members of the newly formed Space Force, as indicated in the budget released this year by the Department of Defense (DOD).
In 2019, The U.S. Department of Veterans Affairs published a report detailing our current knowledge about veterans and substance use disorder.
We’ll share that data in just a moment.
First, though, we have an important message for any veteran concerned about their drug or alcohol use.
In our articles, we typically focus on individuals with clinical diagnoses of alcohol use disorder (AUD) and substance use disorder (SUD). In light of the ongoing overdose and opioid crisis in the U.S., we also write a large number of articles on the topic of opioid use disorder (OUD) and the best available treatment for OUD, medication assisted treatment (MAT).
We focus on clinical diagnoses because most discussions of clinical AUD or SUD involve verified data and statistics. However, we want to take a moment now to speak to any of our veterans with alcohol or drug use issues or problems that don’t meet the clinical threshold for addiction or disordered use.
This is our important message:
It’s okay to seek support before you hit bottom, before you have a crisis, and before alcohol and/or drug use causes significant physical, psychological, or emotional problems.
To be honest, it’s more than okay.
It’s a very good idea.
Don’t let this phrase scare you off: it’s the definition of self-care. If you don’t like that phrase, think of seeking support for yourself the way you’d help out a fellow vet. It’s what you do: you take care of one another – except in this case, you take care of yourself, so that you may better care for your family, friends, loved ones, and fellow vets.
In that way, you can think of self-care – and seeking support – as a valuable, critical component of your service.
Therefore, if you think your drinking or drug use puts you at risk of developing AUD or SUD, or may negatively impact your family, your work, or your health, please contact the U.S. Department of Veterans Affairs (VA) and seek treatment and support.
What the VA Offers: Treatment Programs for Veterans
We’ll get to the data in a moment, we promise.
Right now, we need to extend this discussion of veterans seeking help – because help is available through the VA, all VA services are available to all veterans, and – as the data will show – millions of veterans need help and support.
The VA provides the following services related to alcohol and substance use:
- Medical detoxification and stabilization services
- Medication assisted treatment for opioid use disorder (OUD) or alcohol use disorder (AUD), including:
- AUD/SUD treatment:
- Outpatient therapy/counseling
- Intensive outpatient treatment programs (IOP)
- Residential treatment programs
- Click to learn more about VA treatment programs for substance use problems
- Self-help groups:
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
- Ongoing support/relapse prevention
- Special programs:
- Female veterans
- Combat veterans
- Homeless veterans
- Programs for posttraumatic stress disorder (PTSD) and depression
- Click to learn more about VA treatment programs for PTSD
- Click to learn more about VA treatment programs for depression
In addition to those services, which, we’ll repeat, are available to all veterans right now, this crisis support options is available:
- The Veterans Crisis Line
- Operates 24/7/365
- Veterans call 988, then select 1 for a specialist in veteran’s issues
- Or text 838255 for confidential chat
- Veterans with hearing loss, call TTY: 800-799-4889.
Finally, a non-crisis mobile app designed for veterans trying to quit alcohol, tobacco, or substances is available here:
We encourage any veterans reading this – or their friends and families – to remind the veteran in their life that support is available now through the VA.
Now let’s get to that data.
How Many Veterans Have SUD, AUD, or a Mental Health Disorder?
In 2020, the National Institute of Health (NIH) included a special supplement to their annual National Survey on Drug Use and Health (NSDUH) called the 2020 National Survey on Drug Use and Health: Veteran Adults (2020 NSDUH – Veterans). A typical annual NSDUH includes data from over 70,000 U.S. citizens and includes detailed information of alcohol use, drug use, alcohol and drug treatment, and other behaviors that impact the general health and wellbeing of the populace. This special iteration offers something new: detailed analysis on the prevalence and treatment of SUD, AUD, and mental health disorders among U.S. veterans. Note: when an individual receives a diagnosis for AUD/SUD and a mental health disorder, they have co-occurring disorders and receive a dual diagnosis.
Here’s the data:
Prevalence of Alcohol, Substance Use, and Mental Health Disorders Among U.S. Military Veterans
- Veterans who meet clinical criteria for SUD:
- 2. 4 million, or 12%
- Received treatment for SUD: 199,200
- Did not receive treatment: 2,200,800
- Veterans who meet clinical criteria for AUD:
- 1.7 million, or 8.4%
- Treatment data not available in NSDUH (see additional information below)
- Veterans who meet clinical criteria for mental health disorder:
- 3.9 million, or 19.7%.
- Engaged in treatment: 1,907,1000
- No treatment: 1,992,900
- Presence of clinical co-occurring SUD and mental health disorder, or dual diagnosis:
- 1.1 million, or 5.7%
- Treatment figures not available
There are two key takeaways from this data:
- 91.7% of veterans with SUD did not receive SUD treatment
- 51.1% of veterans with a mental health disorder did not receive mental health treatment
Those percentages – 91.7 and 51.1 – represent what we call the treatment gap: the difference between the number of people who need treatment for a specific disorder and the number of people who receive treatment for that disorder.
As you can see, the treatment gap for veterans with SUD is shocking, while the treatment gap for veterans with a mental health disorder is cause for alarm. In other words, both are far too large, and we owe it to our veterans to help close the gap in any way possible.
With all of that said – and all that information provided – we’ll shift gears and discuss a study we found called “Veterans in Recovery.”
Veterans In Recovery: Trajectories of Recovery for Veterans with Alcohol Use Disorder
In 2020, the science journal Frontiers in Psychiatry published a long-range study called “The National Health and Resilience in Veterans Study: A Narrative Review and Future Directions.” That study is exactly what it sounds like: an examination of the overall state of health and wellbeing among veterans of the U.S. armed forces. As a subtopic for that study, a team of researchers extracted and examined data on veterans in recovery from AUD, then published their findings in the paper we introduce immediately above, “Veterans in Recovery.”
For that subtopic, researchers administered surveys to 1,200 veterans who reported a diagnosis for clinical AUD at least once in their lives. They divided participants into three categories:
- Veterans with past AUD diagnosis who are now abstinent (consume no alcohol at all)
- Veterans with past AUD diagnosis whose drinking is considered subthreshold, and currently does not meet clinical criteria for AUD
- Among veterans with past AUD diagnosis, those whose drinking is considered hazardous, and currently meets clinical criteria for AUD.
Let’s take a look at what they found.
Veterans Diagnosed With AUD: Abstinence, Subthreshold Drinking, and Hazardous Drinking
- 76.2% no longer met clinical criteria for AUD
- 28% reported complete abstinence
- 48.2% reported consuming alcohol below levels that meet clinical criteria for AUD
- 23.8% reported consuming alcohol at hazardous levels that meet clinical criteria for AUD
- Compared to veterans who consume alcohol at subthreshold levels, abstinent veterans reported:
- Older age
- Lower levels of education
- Higher likelihood of PTSD
- Higher likelihood of SUD
- More general health problems
- Lower levels of social engagement
- More involvement in religion/religious activities
- Compared to abstinent veterans, those who consume alcohol at subthreshold levels reported:
- Higher income
- Lower rates of SUD
- Fewer general health problems
- Lower levels of social engagement
This data tells us something that’s not obvious at first glance: total abstinence is no longer the only criteria used to determine whether an individual is in recovery or actively engages in the disordered use of alcohol or substances. This aligns with the recent harm reduction movement in treating OUD. The goal of treatment and recovery is to mitigate the harm caused by disordered substance use. Treatment professionals, the medical community, and people in recovery do not completely agree on this topic yet, but the idea that decreased alcohol or substance use that quantitatively reduces harm is a valid recovery path is gaining traction – and may be a large part of the future of recovery.
That debate – does recovery require abstinence or not? – will continue, and we’ll update you on any new developments here on our blog. In the meantime, we can look at the data above and learn that although veterans use alcohol at relatively high rates, they also recover – and stay in recovery – at relatively high rates compared to the civilian population, where experts estimate relapse rates of around 67 percent.
We’ll end this article on a completely different note, with a message from veterans about Veterans Day.
What Veterans Want You to Know About Veterans Day
The Department of Defense published a helpful explainer article in 2018 called “Five Facts to Know About Veterans Day.” These are common misconceptions that veterans would like cleared up for the benefit of the non-veteran population, and facts they’d like us all to know:
1. The Official Name
- It’s neither Veteran’s Day or Veterans’ Day. Veterans Day does not belong to one veteran or group of veterans. It’s for all veterans. No one owns it: therefore, no apostrophe needed.
2. It’s Different Than the Other Military Holiday
- Memorial Day is when we honor fallen soldiers, meaning those who lost their lives in combat or from wounds or injuries sustained in combat. Veterans Day is when we honor anyone – living or no longer with us – who served in the U.S. Armed Forces. The primary purpose of Veterans Day, however, is to honor our living veterans.
3. The Date
- For reasons unbeknownst to anyone, really, the first official – as in sanctioned by an act of Congress – Veterans Day was scheduled to occur on October 25th, 1971. However, most states ignored this, and observed the day in November. November 1th became the official date in 1975.
4. More on the Name
- Veterans Day was originally called Armistice Day, which was founded to mark the end of World War I, also known as “The War to End All Wars.” In 1954, after the conclusion of World War II and the Korean War, it became clear that WWI, unfortunately, did not end all wars. Therefore, Congress changed the name to Veterans Day, to reconcile the original name with real-world circumstances.
5. Veterans Day in Other Countries
- Canada, Australia, and Great Britain also celebrate variations of Veterans Day, but with a different name: Remembrance Day. Remembrance Day is more akin to our Memorial Day, and it’s celebrated in November each year.
That’s where we’ll end this article: with a reminder that Friday, November 11th is a day to honor all the people who have served in the U.S. Armed Forces. If you know a veteran who needs help with problem alcohol or drug use, please share the treatment resources from the VA above. If you know a veteran having a mental health crisis or addiction crisis, please tell them to dial the new national mental health emergency number 988 – and select “1” to access a specialist in veteran’s issues.