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OEF/OIF Veterans and Substance Use Disorders (SUD)

Dr. Anna Pickering

Medically reviewed by

Dr. Anna Pickering

April 3, 2019

Veterans often face traumatic events that have a lasting impact on their lives. In many cases, individuals may turn to harmful substances as a way to deal with these traumas. Seeking relief through drugs or alcohol can be very dangerous and habit-forming. If you are a veteran or know a veteran who is suffering from addiction, it is important to seek professional help.

There has been much concern in the public and the press about the fate of our veterans returning from active duty overseas. With nearly 1.9 million service personnel—combined active duty, National Guard, and Reserve forces having been deployed to Iraq or Afghanistan alone—it is not hard to see why, based on the number of those impacted by war (NCVAS, 2010). Over the whole history of armed U.S. conflicts, there are approximately 22 million veterans alive right now (NCVAS, 2010), and as the wars overseas continue, those numbers are only going to increase.

All of these lives have been affected by the conflicts, the transition of going to an active war zone, and then returning to a home life very different from the life threatening situations they left overseas. Sometimes extra care is needed for those who have incurred damage during active duty. This damage can be physical, mental, or even both. Sometimes the service member copes with the damage done by reaching out for help, while other times, coping is done with the use of dangerous substances.

The Statistics About Veteran Substance Abuse

One thing we know is that returning service persons have experiences and needs that differ greatly at times from civilians. While it goes without saying, traumatic injuries, brain damage, and post-traumatic stress disorder are much higher for our returning veterans; but looking at the statistics, other sad realities come through as well.

Suicide is a tragedy that most often can be avoided, however, looking at the numbers for Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the scope of this tragedy becomes clear. In 2008, the number of OEF/OIF veterans in the VA system who took their own lives was 38 per 100,000 veterans; looking at the U.S. as a whole in 2008, civilians and veterans combined, the number of those whole killed themselves was 12 per 100,000 (CRS, 2011).

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For veterans who meet criteria for being diagnosed with PTSD, the numbers are equally depressing. This includes vets who are actively seeking help or have seen someone at the VA for PTSD, as well as who had an initial screening at some point in their transition back to civilian life to identify potential instances of PTSD, but never followed up with a healthcare provider to affirm the diagnosis and seek ongoing help. Approximately 27 percent of all service members returning from OEF/OIF meet criteria for a PTSD diagnosis (CRS, 2011).

When it comes to Substance Use Disorders (SUD), a way to think of SUD is like a scale, the more symptoms or the stronger the addiction is, the higher up the scale a person is assessed, so drug abuse would mean a lower end of the spectrum with drugs being used more and more and having some impact on quality of life; drug dependence, however, would be higher on the spectrum and drugs would be seen as a necessary thing for day-to-day living.

The rate for drug abuse for OEF/OIF veterans in the VA system is 4 percent of the population. The rate for drug dependence is 3 percent of vets in the VA system (CRS, 2011). There may be some validity to SUD being hidden in veterans more, but in the VA system that does not seem to be the case. One study shows only 8 percent of individuals who receive treatment for PTSD and having regular urine screens and who do not have a known SUD diagnosis will have a positive urine screen, so the rates listed are close to as accurate as they can be (Calhoun et al., 2000).

In another study done that same time Seal et al. (2010) found rates of alcohol use significantly higher than in the civilian population, and higher rates of first-time drug use overall. While they call for more study on this, they are very clear that there needs to be an improved system of care, with more ways to access treatment, more treatment options, and less stigmatization for seeking help. This was a clear call across all the systems of care for OEF/OIF veterans.

Getting Help As A Veteran With A Substance Use Disorder

The VA has done much work and needs to continue towards improving access to treatment for all kinds of injuries and complications. They are leaders in the field of treatment for traumatic injuries of all kinds, particularly traumatic brain injury and post-traumatic stress disorder. This should always be the first stop for treatment of any kind for returning veterans.

Emergencies arise all the time. Sometimes it is hard to know who to reach out to during dire moments, be they thoughts of suicide, struggles with addiction, or just the difficulties of coming home from a war zone. Let’s make this simple: The National Suicide Prevention Lifeline operates a 24-hour line specifically for veterans. Any veteran is welcome to call about anything and talk with a person immediately about their situation; often it’s another veteran on the other end of the phone. The National Suicide Prevention Lifeline can be reached at: 1-800-273-8255 (Press 1). Also, every VA hospital has a suicide prevention coordinator on site, and while they may not always be there, they will reach back out to you as soon as possible.

There is still much to be learned from the experiences of those returning home from Iraq and Afghanistan, and much more that will be learned in the following months and years ahead. Learning and supporting one another is a vital part of the process of coming home from any battlefield, as well as hearing the message clearly. It takes strength to ask for help, so contact us without hesitation today at

National Institute on Drug Abuse - Drug Facts: Treatment Statistics

National Center for Veterans Analysis and Statistics - National Survey of Veterans, Active Duty Service Members, Demobilized National Guard and Reserve Members, Family Members, and Surviving Spouses

Congressional Research Service - Suicide, PTSD, and Substance Use Among OEF/OIF Veterans Using VA Health Care: Facts and Figures

US National Library of Medicine: National Institutes of Health - Drug use and validity of substance use self-reports in veterans seeking help for posttraumatic stress disorder.

US National Library of Medicine: National Institutes of Health - Substance use disorders in Iraq and Afghanistan veterans in VA healthcare, 2001-2010: Implications for screening, diagnosis and treatment

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