Practical Considerations for Addressing Substance Use Disorders in Veterans and Service Members

Abstract

Support and treatment for military veterans and active duty service members is a national priority. Furthermore, there is increased need for professionals with experience and interest in working with these brave individuals. Veterans and service members face significant challenges both during their service and after transitioning back to civilian settings. One such challenge for some veterans is substance use and its multidimensional effects on mental and physical health. The current article presents a brief but comprehensive overview of the prevalence and comorbidity of substance use disorders in veterans and service members. It also reviews practical information about assessment, treatment, and general clinical issues from the authors' clinical experience that is relevant to providers working with veterans and service members with substance use disorders. This information may be of particular interest to professionals with an interest in helping veterans, those who have limited experience working with veterans, or those who may work outside of standard military or Department of Veterans Affairs settings. Finally, future directions in this important area are discussed.

Military Combat Deployments and Substance Use: Review and Future Directions

“…Social workers can be instrumental in community outreach and the implementation of stigma-reduction programming. Skidmore and Roy (2011) highlight the importance of distinguishing between barriers to care specific to substance use and those specific to veterans, and advise practitioners to explore with veterans the meaning of help-seeking, trust in the therapeutic relationship, and the risks and benefits of treatment. This dialogue will help social workers distinguish between behaviors traditionally labeled as non-compliance, denial, or manipulation, and the complexities of help-seeking inherent to military organizations.…”

Comparing Treatment Outcomes Among Canadian Military and Civilian Substance Users Attending the Same Residential Treatment Program

“…For example, group therapy has been found to be effective for Veterans due to the ability to share common military experiences (Skidmore & Roy, 2011). Group therapy aims to acknowledge and address underlying emotions; however, some military service members may have learned to suppress their reactions.…”

An Ecosystemic Perspective in the Treatment of Posttraumatic Stress and Substance Use Disorders in Veterans

“…However, coping skills and a resilient personality can also be utilized to help the veteran overcome the challenges associated with comorbid disorders. According to Skidmore and Roy (2011), resilience and positive coping mechanisms also need to be assessed, highlighted, and reinforced in working with veterans; how these factors have helped the veteran to adjust to the demands of military service need to be recognized. The strengths acquired during military service can be utilized in assessment and treatment.…”

“…Heredity has been implicated in the risk of SUD and the high-stress environment of the military might pose an environmental risk factor for those who have a genetic predisposition (Skidmore & Roy, 2011). Developmental factors also need to be considered.…”

“…Skidmore and Roy (2011) asserted that veteran experiences vary widely depending on "branch of service, era of service, military occupational specialty (MOS) and rank" (p. 86). However:…”