Source: U.S. Navy photo by Photographer’s Mate 3rd Class Bryan M. Ilyankoff (RELEASED)

It is not unusual for veterans of the conflicts in Iraq and Afghanistan to experience symptoms of combat stress. Additionally, some veterans may also misuse alcohol, tobacco or drugs, which can lead to significant risks to health and well-being. The abuse of alcohol, tobacco or drugs can seriously harm your health, cause mood and behavior problems, damage relationships, cause financial problems and lead to a number of other problems for veterans reintegrating into civilian life.1

Fortunately, problems with substance misuse can be treated or dealt with. A number of helpful resources from the Department of Veterans Affairs (VA) and other organizations are available to help those who have served our nation in the armed forces return to peak functioning.

You Are Not Alone in the Fight Against Alcohol and Drug Misuse

A number of studies of military personnel deployed to Iraq and Afghanistan have found a strong connection between alcohol and drug use and PTSD and other psychological concerns that may occur after traumatic events. In fact, similar findings have been reported among Vietnam and 1991 Gulf War veterans. Another study found a significantly increased risk for alcohol misuse among Reserve and National Guard personnel deployed with reported combat exposure, compared with non-deployed Reserve and National Guard personnel.2

Simply put, misusing drugs, alcohol or other substances can be a common reaction to experiencing uncommonly stressful events.

The use of alcohol or drugs among veterans may be motivated by desires to escape or alleviate uncomfortable or painful memories. That is, alcohol or drugs may be wrongly used to self-medicate distressing thoughts about guilt, anger, isolation or other emotions that arise from having PTSD or depression, or the experience of a traumatic event.3 While drinking and drug use may initially result in a reduction in stress, it can lead to many serious problems.

Finding Treatment for Misuse of Alcohol or Drugs

Talk to Someone Now

Log on to Real Warriors Live Chat or call 866-966-1020 to speak with a trained health resource consultant at the DCoE Outreach Center. This free, confidential resource is available to you 24/7.

Many people find it difficult to reduce their misuse of drugs or alcohol on their own. That’s why a variety of effective treatments are available to veterans through VA. These treatments address all types of problems related to substance use, from unhealthy use of alcohol to life-threatening addictions. Treatment options include therapy (alone or in a group), as well as medications to help veterans reduce their use of alcohol or drugs.

To ensure veterans can attend VA treatment services, programs offer evening and weekend hours. Residential (live-in) options are available for veterans who live far away from a VA clinic or have unstable housing. And special programs for women, Iraq and Afghanistan veterans and homeless patients are also available.

Here are four ways to take the first step towards treatment and recovery:

Speak with your existing VA health care provider

Contact the Operation Enduring Freedom / Operation Iraqi Freedom Coordinator at your local VA Medical Center

Contact your local Vet Center

Call 800-827-1000, VA’s general information hotline

If you’d like to look for treatment options outside of VA, use the Substance Abuse Treatment Facility Locator on the Substance Abuse and Mental Health Services Administration’s website. This searchable directory displays the location of facilities around the country that treat alcohol and drug abuse problems. Here, you will find information for more than 11,000 treatment options, including programs for marijuana, cocaine and heroin addiction.

Quitting Smoking Is Also Important to Health

Veterans have also been found to have high rates of smoking and nicotine use. In fact, one study showed that about one-third of veterans were current smokers, a rate that is higher than that of the civilian population.3 This is a serious issue, as smokers die 13 to 15 years earlier than non-smokers.4 Fortunately though, despite these high rates of smoking, many of those in the study were motivated to quit. In fact, half of the smokers said they intended to quit within six months.

There are a number of resources available to help you quit smoking and improve your health. A great place to start is the Quitting Smoking page on the VA website. The Department of Defense program, Quit Tobacco, Make Everyone Proud, provides information and resources for developing a personalized plan for quitting and a private live help feature. Finally, you can visit for a free, step-by-step quitting guide.

Reaching Out Is a Sign of Courage

If you’re experiencing concerns about drinking, drug use, smoking or a psychological health concern, don’t hesitate to ask for help. Substance misuse can be a common reaction to uncommon stress, but it can be treated and dealt with. Use the resources in this article to find the right resources for regaining your peak functioning.

Additional Resources


1Topics in Brief: Substance Abuse among the Military, Veterans and their Familes,” National Institutes of Health National Institute on Drug Abuse. Last accessed Oct. 18, 2012.
2Jacobson, Isabel G., MPH, et al.“Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment,” The Journal of the American Medical Association 2008;300(6):663-675. Published Aug. 13, 2008.
3Tull, Matthew, Ph.D. “Alcohol Abuse in Veterans: Links to Post-Traumatic Stress Disorder.” Updated Nov. 5, 2008.
4Quitting Smoking,” United States Department of Veterans Affairs Public Health. Last accessed Oct. 18, 2012.



Most nights when Anthony Klecker, a former U.S. marine, finally slept, he found himself back on the battlefields of Iraq.  He would awake in a panic and struggle futilely to return to sleep.  Days were scarcely better.  Car alarms shattered his nerves.  Flashbacks came unexpectedly, at the whiff of cleaning chemicals.  Bar fights seemed unavoidable; he nearly attacked a man for not washing his hands in the bathroom. Desperate for sleep and relief, Klecker, 30, drank heavily.” – From “After the Battle, Fighting the Bottle at Home” by Lizette Alvarez.

Alcohol use among active military and veterans is a major health issue in America

Throughout our military history, holding one’s liquor has been akin to being a “real soldier”…on par with knowing how to handle one’s weapon.  Heavy drinking, glamorized in the culture of those serving in uniform, is common.  After active duty, many veterans who served our country with honor abuse alcohol – for many reasons –  and often because of PTSD (Post Traumatic Stress Disorder) associated with their experience during military conflicts on the battlefield.

To “really drink” wasto be a man.  In more recent times, more women have served in all four branches of military – Army – Navy – Air Force – Marines Corps and many use alcohol like their male counterparts but studies show that women veterans tend to abuse prescription drugs more frequently than alcohol according to the Center for Behavioral Health Statistics and Quality.

FACT:  1 in 8 Troops:  One in eight troops returning from Iraq and Afghanistan from 2006 to 2008 were referred for counseling for alcohol problems after their post-deployment health assessments, according to data from the Armed Forces Health Surveillance Center.

The NHSDA (National Household Survey on Drug Abuse), reported the following alcohol use among the nearly 30 million veterans aged 18 and older living in the United States:

ALCOHOL USE:  Males Veterans 56% vs. Female Veterans 41%

BINGE DRINKING:  Male Veterans 23% vs. Female Veterans 14%

HEAVY DRINKING:  Male Veterans 7% vs. Female Veterans 2%

Male veterans are more likely than female veterans to report alcohol use, binge drinking and heavy alcohol use.  But the percentages are still alarming regardless of gender – both male and female veterans have problems with alcohol.

One telling fact about the seriousness of alcohol abuse in the military is this:  The Army’s substance abuse budget in 2004 = $38 million; in 2008 = $51 million.  When Ms. Alvarez wrote an for The New York Times, she quoted Lt. Col. George Wright…. “Our branch of the military has deployed a three-pronged attack against the misuse of alcohol and other substances…the Army takes alcohol and drug abuse very seriously and has tried for decades to deglamorize its use…with the urgency of this war (Iraq and Afghanistan), we continue to tackle the problem with education, prevention, and treatment.”

Another telling fact is this: In 2007, a Freedom of Information Act request had forced the US government to disclose that more than 33% of troops who were convicted of criminal acts in Afghanistan and Iraq had committed offenses while under the influence of alcohol or other drugs.

As a result more active and veterans are seeking help than ever before: According to the Army, in 2009, the number of soldiers enrolled in treatment after being diagnosed with alcohol problems, increased by 56% since 2003, when the Iraq war started.


Tue Aug 12, 2008 6:00pm EDT

CHICAGO Aug 12 (Reuters) – A significant number of U.S. veterans back from wars in Iraq and Afghanistan begin abusing alcohol after returning, perhaps to cope with traumatic memories of combat, military researchers said on Tuesday.

Younger servicemen and women, those who were previously heavy drinkers, and call-ups from the National Guard and Reserves were the most likely to increase their drinking and to develop alcohol-related problems, according to the study.

“Increased alcohol outcomes among Reserve/Guard personnel deployed with combat exposures is concerning in light of increased reliance (on these) forces” by the Pentagon, the report said.

“Active-duty Marines were also found to be at increased odds of continuing to binge drink after deployment, as well as to experience new-onset alcohol-related problems,” wrote Isabel Jacobs and colleagues at the Naval Health Research Center in San Diego, California.

Men were considered heavy drinkers if they consumed more than 14 alcoholic drinks per week, women seven drinks; binge drinking referred to downing five or more drinks in a day or occasion, four for women; and alcohol problems constituted drunkenness or hangovers that interfered with work or other responsibilities.

Reasons for the increased rates of alcohol abuse among Guard and Reserve members may be that they receive less training and support services than other arms of the military, they must transition from civilian life to a war zone, and their units are less cohesive, the report said.

The researchers surveyed 48,400 service members before (between 2001 and 2003) and after likely deployment (2004 to 2006) to identify heavy drinkers, binge drinkers, or those with alcohol-related problems.

Of those interviewed, 5,500 experienced combat and they were interviewed about a year after their return.

Combat veterans were 31 percent more likely to have begun binge drinking than those not exposed to combat. Six percent of returning combat veterans started a new habit of heavy weekly drinking and 5 percent developed a drinking-related problem.

New cases of alcohol abuse also arose among those who had not been deployed or did not see combat, but the rate of new cases was lower compared with returning combat veterans.

Women also had different drinking habits than men.

“Women were significantly more likely to start drinking heavily but less likely to start binge drinking or have alcohol-related problems compared with men, which may be due to women turning to drinking as a coping mechanism, whereas men may have a higher propensity for risk-taking behaviors,” the researchers wrote in the Journal of the American Medical Association.

The findings were consistent with a recent study of soldiers returning from Iraq that found 12 percent of active-duty personnel had alcohol problems, and 15 percent of Reserve and National Guard members did.

The researchers said they hoped to direct intervention efforts at younger soldiers and other groups prone to alcohol abuse. They also pointed to the need to treat post-traumatic stress suffered by returning veterans who may try to drown their memories in drink.

(Editing by Maggie Fox)



Some people try to cope with their Posttraumatic Stress Disorder (PTSD) symptoms by drinking heavily, using drugs, or smoking too much. People with PTSD have more problems with drugs and alcohol both before and after getting PTSD. Also, even if someone does not have a problem with alcohol before a traumatic event, getting PTSD increases the risk that he or she will develop a drinking or drug problem.Eventually, the overuse of these substances can develop into Substance Use Disorder (SUD), and treatment should be given for both PTSD and SUD to lead to successful recovery. The good news is that treatment of co-occurring (happening at the same time) PTSD and SUD works.How common is co-occurring PTSD and SUD in Veterans?Studies show that there is a strong relationship between PTSD and SUD, in both civilian and military populations, as well as for both men and women.Specific to Veterans:

How can co-occurring PTSD and SUD create problems?

If someone has both PTSD and SUD, it is likely that he or she also has other health problems (such as physical pain), relationship problems (with family and/or friends), or problems in functioning (like keeping a job or staying in school). Using drugs and/or alcohol can make PTSD symptoms worse.

For example:

VA has made it easier to get help. It is important to know that treatment can help and you are not alone.

What treatments are offered for co-occurring PTSD and SUD?

Evidence shows that in general people have improved PTSD and SUD symptoms when they are provided treatment that addresses both conditions. This can involve any of the following (alone or together):

Talk with your provider about treatment for specific symptoms like pain, anger, or sleep problems.

What should I do if I think I have co-occurring PTSD and SUD?

The first step is to talk to a health professional and ask for more information about treatment options. Each VA medical center has an SUD-PTSD Specialist trained in treating both conditions to reach the best health outcomes. If there are signals you are at risk for both disorders, you will be encouraged to talk with a provider about how to best support your recovery. There are treatment resources at every VA medical center. The VA wants you to have the best possible care for co-occurring PTSD and SUD.

If you continue to be troubled or distracted by your experiences for more than three months or have questions about your drinking or drug use, learn more about treatment options. Life can be better! Talk to a VA or other health professional to discuss choices for getting started.

Date Created:12/23/2011 See last Reviewed/Updated Date below.


The National Center for PTSD does not provide direct clinical care or individual referrals.
Please see: Where to Get Help for PTSD

PTSD Information Voice Mail: (802) 296-6300
Contact Us:
Also see: VA Mental Health


*Links take you outside the VA website to a non government site.
VA does not endorse and is not responsible for the content of these linked websites.

Having trouble opening a file? Access free Plug-Ins and File Viewer