Substance Abuse in the Army

The U.S. Army is the largest branch of the American military, and substance use disorders affect soldiers and Army Veterans at significant rates. Addiction is a chronic medical condition characterized by the compulsive use of substances despite harmful consequences. 

While addiction can affect anyone, military service members and Veterans face unique risk factors that increase vulnerability, including combat exposure, traumatic brain injuries, chronic pain from service-related injuries, and the stress of transitioning back to civilian life.

Alcohol and prescription medications are the most commonly misused substances among active-duty soldiers. Marijuana is the second most commonly misused substance among Veterans. If you or someone you care about served in the Army and is struggling with substance use, treatment is available, and recovery is possible.

Alcohol Abuse in the U.S. Army

Alcohol is the most widely used and abused substance among both active-duty soldiers and Army Veterans. Military culture has a long history of normalizing drinking, and the stresses of Army life can reinforce problematic patterns.

According to the RAND Corporation’s Health Related Behaviors Survey (HRBS), 1 in 3 service members reported binge drinking in the past month, compared to 1 in 4 civilians.

Key statistics on alcohol use in the Army:

• Among Veterans entering VA inpatient rehab, 50% cite alcohol as the reason for admission. That is twice the rate of the civilian population
• 34% of active-component service members reported binge drinking in the past 30 days (vs. 26.5% of U.S. adults)
• 65% of all Veterans report alcohol as the primary substance that led them to seek addiction treatment
• Binge drinking is more common among enlisted personnel and lower-ranking officers
• Drinking culture in the Army persists after separation, with many Veterans continuing or escalating patterns developed during active duty

Signs and symptoms of alcohol abuse include strong cravings, blackouts, memory loss, neglecting responsibilities, increased tolerance, withdrawal symptoms when stopping (tremors, racing pulse, agitation), and continued drinking despite harm.

Drug Abuse Among Army Service Members and Veterans

The Army has the highest rates of prescription pain reliever misuse among all military branches, according to the RAND HRBS. This is closely connected to the high rates of combat injuries, chronic pain, and traumatic brain injuries experienced by Army soldiers.

Drug use among active-duty soldiers is low due to strict zero-tolerance policies under the UCMJ and regular random testing:

• Less than 1% of active-duty service members across all branches used illicit drugs in the past year
• 4.1% of active-duty service members misused at least one prescription drug, most commonly opioid painkillers
• The Army leads all branches in prescription pain reliever misuse

After separation from the Army, the picture changes significantly:

• Heroin accounts for 10.7% of Veteran admissions to VA substance use treatment programs
• 598,000 Veterans misused prescription pain relievers in the past year, compared to 66,000 who used heroin
• Marijuana is the most commonly used illicit substance among Veterans after separation

According to the National Institute on Drug Abuse (NIDA), the loss of protective factors like random testing and zero-tolerance enforcement after separation contributes to increased substance misuse among Veterans.

Warning Signs of Substance Abuse

• A sudden drop in work or school performance
• Abrupt changes in social groups or withdrawal from family
• Acting suspicious or secretive
• Changes in personality without explanation
• Engaging in risky behaviors without considering consequences
• Legal charges related to drug use
• Inability to fulfill responsibilities at home or work
• Paranoid behaviors without cause
• Sudden mood changes, irritability, or emotional outbursts

Addiction with Co-Occurring Mental Health Issues in the Army

The Army, along with the Marine Corps, has the highest rates of combat exposure among all military branches. This exposure directly correlates with higher rates of PTSD, depression, anxiety, and substance use disorders.

• PTSD: Around 30% of Vietnam Army Veterans have met the criteria for PTSD at some point. Among OIF/OEF Veterans, 11% to 20% have PTSD in any given year. 2 out of 10 Veterans with PTSD also have a substance use disorder, and 1 in 3 Veterans seeking SUD treatment also have PTSD.
• Depression: 1 in 3 Veterans report symptoms of depression. 1 in 8 have major depression. Vietnam Army Veterans are twice as likely to have depression as Korean War or WWII Veterans.
• Anxiety: 9.9% of Veterans report symptoms of anxiety, often co-occurring with both PTSD and substance use disorders.
• Traumatic Brain Injury (TBI): More than 185,000 VA-enrolled Veterans have been diagnosed with TBI, the majority mild. Service members with TBI have higher rates of PTSD and are at elevated risk for substance misuse.

Among Veterans dealing with a severe mental illness:

• 34% also struggled with binge drinking
• 23% concurrently used marijuana.
• Nearly 9% misused opioid drugs.

Co-occurring disorders require integrated dual diagnosis treatment that addresses both the substance use and the mental health condition simultaneously. Treating one without the other leads to poorer outcomes and higher relapse rates.

Asking for Help

It is not easy for Veterans to reach out and ask for help with mental health issues or substance abuse. Some of the reasons Veterans do not ask for help, especially for PTSD, include:⁸

• Difficulty accessing services, including distance from providers and delays in care.
• Lack of awareness, such as not realizing certain feelings are stemming from PTSD.
• Lack of social support and encouragement to seek help.
• Not believing that treatment will work.

The VA operates numerous helplines and sites to search for information. The U.S. Army offers a series of videos that discuss numerous mental health topics. The Veteran’s crisis line is open 24/7 online or by phone, 1-800-273-8255, then press 1.

VA Substance Abuse Assessment

If you are concerned about substance abuse, the VA also provides a screening tool that can help determine if you could benefit from treatment for alcohol abuse or drug abuse at a VA rehab center or other treatment provider.

Health Insurance and VA Benefits

If you or your loved one is a former service member, numerous treatment options are available, including VA inpatient rehab, as well as private providers. Veterans can also seek community-based services through the MISSION Act Community Care program. These benefits can be used for mental health treatment, substance abuse treatment, or treatment for co-occurring disorders. The VA Community Care Network can help you find treatment near home. Learn more about VA benefits for rehab.

Rehab for Veterans

The VA offers numerous treatment options at various centers throughout the United States. VA drug rehab and VA rehab centers treat mental health issues and co-occurring disorders.

If the VA doesn’t offer a program in your area, or the VA rehabilitation program in your area has no openings for treatment, the VA may also approve a private provider for treatment through the MISSION Act. The VA must approve these types of requests.

Information regarding TRICARE and its crisis services may be accessed for more information.

In addition, while seeking help, you can reach out to the Veterans’ crisis line.

What is the Veteran Program?

AAC offers a Veteran program that is geared towards Veterans with a substance abuse and mental illness. Many of the staff members are Veterans themselves, which gives them a perspective to help Veterans in a more focused and passionate way.

Remember that PSTD, depression, drug use and misuse, and co-occurring illnesses are frequent issues for Veterans. You can reach out through the numerous services offered through the VA, either directly, or by the VA approving outside providers who can offer addiction treatment or treatment for mental illness. AAC offers services geared to Veterans, which can help you or your loved one recover for substance abuse or co-occurring illnesses.

Stigma and Barriers to Seeking Help in the Army

One of the most significant barriers to treatment for Army Veterans is stigma. Some of the reasons Veterans do not seek help, especially for PTSD and substance use, include:

• Lack of awareness that symptoms like insomnia, irritability, and heavy drinking are signs of a treatable condition
• Fear of being seen as weak or unable to handle what other soldiers endure
• Lack of social support or encouragement to seek help
• Distrust of the VA system or military healthcare
• Not believing that treatment will work
• Not knowing where to go or how to navigate the VA system

Research shows that seeking treatment does not harm military careers for 97% of service members. For Veterans who have separated from the Army, HIPAA protections govern the confidentiality of treatment records. Seeking addiction treatment does not affect VA benefits eligibility.

If you or someone you know is in crisis, the Veterans Crisis Line is available 24/7. Call 988 (then press 1), text 838255, or chat online. The VA also offers free, private online screening tools for PTSD, depression, and substance abuse.

Addiction Treatment Options for Army Veterans

VA Treatment Services

The VA provides addiction treatment at all levels of care for enrolled Veterans:

• Medical detoxification
• Inpatient and residential rehabilitation
• Intensive outpatient programs (IOP)
• Standard outpatient counseling
• Individual, group, and family therapy
• Medication-assisted treatment (MAT) for opioid and alcohol use disorders
• Telehealth for Veterans in rural areas
• Specialized programs for women Veterans, homeless Veterans, and combat Veterans

Through the MISSION Act, Veterans who cannot access timely VA care can receive treatment at community care providers like AAC. TRICARE also covers addiction treatment for eligible active-duty members, retirees, and their families.

AAC’s Salute to Recovery Veterans Program

American Addiction Centers offers the Salute to Recovery Veterans program at most facilities:

• Veteran-only group therapy with fellow service members who understand military culture
• Therapists who are Veterans themselves or deeply experienced with Army populations
• Trauma-informed care and PTSD-specific therapy (PE, CPT, EMDR)
• Dual diagnosis treatment for substance use and co-occurring mental health conditions
• Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT)
• Pain management and emotional regulation training
• Family therapy and reintegration support
• Aftercare planning and relapse prevention from day one