Summer is the season we honor our veterans. There’s Memorial Day and the 4th of July, but even beyond these holidays, a summer filled with barbecues and Slip n’ Slides is a time to appreciate the life our country offers and remember the veterans who make it possible. This summer as we are remembering our veterans’ contributions, we are forced to confront our own failures. See, there’s an implicit deal we make as a society with these people who fight for our freedom—you risk your lives so that we don’t have to, and in return we as a society will take care of you. With scandals at V.A. hospitals, we’ve reneged on our end of the deal.
It’s time to recommit to the health of our veterans who willingly sacrifice so much. Part of this commitment must be on the part of health systems to work toward making our veterans whole in body and in mind. But another part must come from you and from me and from everyone who makes a community of support for returning veterans. It is our responsibility to work toward understanding the difficult experiences that dot our veterans’ paths to recovery.
There are two pieces in particular that have become part of too many vets’ experiences: PTSD and addiction. Too often, these challenges are seen together. Now we know that vets who struggle with PTSD are also likely to struggle with addiction. But why? And why do these two come as a pair?
One hypothesis has always been that veterans experiencing symptoms of PTSD self-medicate with drugs or alcohol to mask or escape from these symptoms. Interestingly, one of the most comprehensive studies of vets, PTSD and substance abuse disorders found support for drugs but not alcohol used as a coping mechanism. Specifically, the study found that PTSD symptoms predicted a bump in drug use but didn’t predict a bump in alcohol use.
Another hypothesis is that vets experience more stress than most people and so have to put more energy into coping with this stress. If vets have many coping outlets, for example exercise or family or career or therapy, they may stay healthy. But if vets are without these other coping outlets, substance abuse may provide the only relief.
But now, more often, PTSD and addiction are being seen not necessarily in relation to each other but as two consequences of the same cause. Not only in PTSD but also in addiction, trauma may be to blame. It’s not only veterans, but anyone who has experienced trauma, including police officers and sexually abused individuals and even car crash survivors, who are prone to PTSD and addiction.
For returning veterans, it is the power of these overwhelming experiences that create PTSD and it may be the same power that drives addiction, with or without the two occurring together. From combat or car crash or abuse, trauma creates addiction.
The disastrous outcome of trauma that leads to PTSD and addiction can be suicide. For if substance abuse is used as a temporary relief from symptoms of trauma, then it can seem like suicide is the ultimate escape. In January 2014, the Department of Veterans Affairs released suicide data showing that about 22 vets per day take their own lives. While rates for older vets remain stable, inside these numbers is a 44 percent jump in the suicide rate for veterans under age 30. In active duty military, deaths by suicide now outpace the number of deaths in war zones.
In an article for the magazine Stars and Stripes describing the data, Jan Kemp, the VA’s National Mental Health Director for Suicide Prevention, describes the suicide rate in young vets as, “astronomically high and climbing.” She attributes growing suicides, in part, to young veterans surviving injuries that might have killed earlier generations of veterans, leaving today’s returning veterans more traumatized and more injured than previous returning vets. Pointing out that only 5 of the 22 suicides per day are by veterans being treated in the V.A. health system, she says, “What we’re seeing is that getting help does matter. Treatment does work.”
When the mind is overwhelmed by an experience it can’t process, it becomes ripe for addiction, PTSD, and eventually suicide. And in turn, addiction and PTSD can hint at the terrible experiences our vets have endured so that we can enjoy barbecues and Slip ‘n Slides. This 4th of July and beyond, it is our responsibility as a society to respect the impact of this trauma and to provide the community of support than can help our veterans release it in a way that does not lead to addiction, PTSD, or suicide.
Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.