Opioid Abuse in Veterans: Risk Factors, Signs & Treatment

Some veterans may be vulnerable to opioid misuse, but many options are available for opioid addiction treatment for veterans.

When veterans return home, they face many challenges, including adjusting to civilian life and overcoming the lasting effects of the stress experienced during deployment. Some veterans may be vulnerable to opioid abuse and addiction, but support and treatment are available. 

Opioid Misuse in Veterans: Overview

We are in the midst of what some have called an opioid epidemic in veterans. Research has shown just how common opioid misuse has become in this population. An annual survey from the Substance Abuse and Mental Health Services Administration (SAMHSA) revealed the following veteran opioid abuse stats: 

• Within the year before the survey, 2.5% of veterans misused opioids, including heroin and prescription painkillers.
• Among all veterans in the population, 490,000 misuse prescription painkillers, 57,000 are heroin users and 53,000 misuse heroin and prescription painkillers. 
• Among those who misused opioids, oxycodone was the most abused substance, with 9.4% of veteran opioid misusers choosing oxycodone. 
• Opioid use disorder (OUD), the clinical term for opioid addiction, is relatively uncommon in veterans, with just 0.5% of veterans aged 18 and older having an OUD. 

Other research has shown that opioid misuse presents a great risk to veterans, who are twice as likely as members of the general population to die from an accidental opioid overdose.

Risk Factors for Opioid Addiction & Overdose in Veterans

Anyone can fall victim to opioid addiction and overdose, but based on their unique risk factors, veterans can be particularly vulnerable to the negative effects of opioid addiction. Their time in the service, coupled with the challenges that veterans face upon their return to civilian life, can increase their risk of opioid misuse. 

PTSD & Other Co-Occurring Mental Health Disorders

Opioid addiction and overdose in veterans can result from co-occurring mental health conditions, such as PTSD and depression. Opioid misuse may become a way of coping with painful emotions related to mental illness, which are common in veteran populations, especially among those with addictions. 

For example, nearly ⅓ of veterans who seek treatment for a substance use disorder (SUD) also have PTSD. Furthermore, opioids can temporarily relieve depression, and for some veterans who experience suicidal ideation alongside depression, opioid overdoses may be intentional. 

Chronic Pain

Injuries related to time in the service can lead to chronic pain. In this case, opioid misuse can arise when a veteran becomes dependent on prescribed pain medications. Research shows that combat-wounded veterans are more likely to misuse opioids when compared to the civilian population, suggesting that injured veterans who suffer from pain are at higher risk of opioid addiction.

Military Sexual Trauma

Military sexual trauma (MST), which is common in both men and women, can increase the risk of opioid addiction because veterans may use substances to numb the pain and distress arising from MST. Studies show that opioid addiction is 50% more likely in veterans with a history of MST. 

Lack of Support

Due to factors like mental health challenges, chronic pain and lack of mobility, veterans are at risk of social isolation. Consequently, veterans may lack social support and develop chronic loneliness, which increases the risk of opioid misuse. When veterans are isolated, they also lack help in the case of an emergency overdose, which increases the risk of death.

Homelessness

Veterans are at increased risk of homelessness compared to civilians, and being homeless makes opioid addiction more likely. Homeless veterans lack social support, which increases their risk of substance misuse and makes them vulnerable to a fatal overdose, as they are less likely to have help available during an emergency. 

Barriers to Health Care

Finally, veterans’ poor access to healthcare places them at risk for opioid addiction and overdose. Veterans underuse healthcare services, which means they lack consistent medical oversight. Without regular contact with healthcare providers, veterans may not receive proper education and information about the side effects, potential risks and appropriate uses of opioid medications. 

Signs of Opioid Addiction in Veterans

If you or someone you love is struggling with opioid misuse, the following signs may be indicative of an addiction:

• Mood swings
• Secretive behavior 
• Not taking medications as prescribed (using larger doses than prescribed, crushing and snorting pills)
• Letting relationships and hobbies fall by the wayside because of preoccupation with opioids 
• Being unable to cut back on opioid use
• Developing a high tolerance so that larger quantities of opioids are needed to achieve the same desired effects 
• Showing withdrawal symptoms when not using 

Treatment & Support Options for Veterans With Opioid Use Disorder

Many treatment options are available for veterans seeking to recover from opioid use disorder (OUD). Opioid addiction treatment for veterans typically involves some combination of the following modalities: 

Therapy & Psychiatric Medication

Given that OUD commonly co-occurs with mental health conditions like PTSD and depression, it is common for veterans in recovery to participate in therapy and take medications to address mental health conditions, as needed. Cognitive behavioral therapy (CBT) can be especially effective for veterans with co-occurring PTSD and OUD. 

Two specific forms of CBT have been proven effective for treating veterans and include:

• Cognitive processing therapy (CPT) 
• Prolonged exposure (PE) 

VA Naloxone Access

Veterans who are at risk of opioid overdose can access naloxone for free. This medication reverses an opioid overdose and is life-saving in the event of an overdose. Veterans can ask their VA provider for a naloxone prescription. 

Support Groups

Peers are known to play an important role in the addiction treatment process for veterans. For this reason, support groups are often a part of OUD treatment. These groups provide a safe setting for discussing the challenges linked with addiction recovery and connecting to peers experiencing the same difficulties. 

Friends & Family

Friends and family can also make a positive difference for veterans in addiction treatment. Veterans who include friends and family in their treatment plan will have access to social support, which helps them avoid some of the risks that come with social isolation. Family members can also take part in family counseling to help them learn how to best support and communicate with their loved ones. 

Drug Rehab

Veterans with an OUD often benefit from a drug rehab program. Such programs can occur at the inpatient level, meaning that veterans must live on-site at a treatment center while in rehab. Other programs are offered at the outpatient level, allowing patients to continue to live at home while going to appointments at a clinic. Given the fact that opioid withdrawal can be severe, OUD treatment often begins with medical detox. 

Drug rehab programs typically include:

• Individual therapy 
• Group counseling
• Medication management
• Support groups

Help for Veterans Struggling With Opioid Addiction

For veterans seeking Colorado addiction treatment, The Recovery Village at Palmer Lake offers a full continuum of services, with a state-of-the-art inpatient facility featuring scenic mountain views. We are a member of the VA Community Care Network, with staff trained specifically in helping veterans. Visit our webpage today to verify your insurance.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Jenni Jacobsen, LSW

Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has seven years of experience working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more