Key Takeaways
- Binge drinking is more common among active duty service members than in the general population
- Alcoholism in veterans often starts as drinking that was normal in service and grows after separation
- PTSD, poor sleep and pain are common reasons veterans drink, and treating them together with the drinking works best
- Stopping heavy drinking suddenly can be dangerous, so detox should be medically supervised
- VA health care covers alcohol treatment, in VA programs or through a community care consult
For a lot of people who served, drinking was part of military life. It was how a unit relaxed, celebrated and came down after a deployment. For many, that drinking stays where it was. For others, it gets heavier after service, quietly, until it is doing a job it was never meant to do.
This guide is for veterans who are starting to wonder about their own drinking, and for the people who love them. It covers how alcohol in the military carries into civilian life, the signs of alcoholism in veterans, why stopping alone can be dangerous, and how to use VA benefits for treatment.
How Alcohol in the Military Carries Into Civilian Life
Military life cuts both ways. Random drug testing and zero tolerance policies keep illegal drug use among active duty service members low. Alcohol is different. Binge drinking is more common among active duty personnel than in the general population, and in the Defense Department's own health survey, one in three service members reported binge drinking[1].
Alcohol use disorder is the most common substance use disorder among military personnel, and combat exposure raises the risk of problem drinking[1]. Alcohol abuse in the military also tends to stay hidden. Half of service members have said they believe asking for mental health help would hurt their career[1], so drinking is often the thing nobody brings up.
Leaving the service removes some of what held drinking in check: the structure, the schedule, the testing, the unit. Compared with people who never served, veterans are more likely to drink and more likely to drink heavily[1]. The usual pattern is gradual. Drinking that was normal in service becomes heavier after separation or retirement, then becomes the way to get to sleep, the way to get through a bad anniversary, the way to stop thinking.
What Are the Signs of Alcoholism in Veterans?
Alcoholism is the everyday word for what clinicians call alcohol use disorder. It is a medical condition, not a character flaw, and it ranges from mild to severe depending on how many signs are present.
The National Institute on Alcohol Abuse and Alcoholism lists the questions a clinician would ask about the past year[2]. Have you:
- Ended up drinking more, or for longer, than you meant to?
- Wanted to cut down or stop more than once, and could not?
- Spent a lot of time drinking, being sick from it, or getting over it?
- Wanted a drink so badly you could not think of anything else?
- Had drinking get in the way of your family, your home or your job?
- Kept drinking even though it was causing trouble with family or friends?
- Given up things you used to care about so you could drink?
- Gotten into situations while drinking that could have gotten you hurt, such as driving?
- Kept drinking even though it made you depressed or anxious, or after a blackout?
- Needed more alcohol than before to feel the effect?
- Had withdrawal symptoms as it wore off, such as shakiness, sweating, trouble sleeping, a racing heart or nausea?
Two or three of these point to a mild alcohol use disorder, four or five to a moderate one, and six or more to a severe one[2]. Any of them is a reason to take a closer look. The more that are true, the more urgent the need for change.
Veterans and Substance Abuse: Why Drinking Becomes a Way to Cope
Very few veterans drink heavily for no reason. The reasons are usually some mix of these:
PTSD. For most people who have both PTSD and a drinking problem, the PTSD came first. Alcohol helps them relax, feel easier around people, or push away thoughts they would rather not have[4]. Veterans who have had PTSD are about twice as likely to have problems with alcohol as veterans who have not[4]. If this sounds familiar, our page on PTSD and trauma treatment explains how both are treated.
Sleep. Many veterans drink to fall asleep. Alcohol makes sleep less restful, not more[4], so the tired, short fuse next day becomes another reason to drink that night.
Pain and the return home. Chronic pain, a traumatic brain injury, losing the structure of service, and the stress of building a civilian life are all tied to substance use in veterans[1].
The fear that keeps people from asking for help is usually about what they could lose: a job, a marriage, a house, a business they built after service. Treating the drinking is how those things are protected, not how they are lost.
Is It Dangerous for a Veteran to Stop Drinking Alone?
It can be. After heavy drinking over a long period, stopping suddenly can set off withdrawal that is painful and can be life threatening, with symptoms such as a racing heart, nausea and seizures. The National Institute on Alcohol Abuse and Alcoholism advises getting medical help to plan a safe stop.[3]
Doctors can prescribe medicines that make withdrawal safer and less miserable[3]. That is what medical detox is for. A detox that did not hold, or a hospital stay that ended with nothing lined up after it, is common. It is a reason to plan the next step before detox ends, not a sign that treatment cannot work.
Does the VA Pay for Alcohol Rehab?
Yes. VA health care covers substance use treatment, including alcohol, either in VA programs or at a community provider when the VA approves a community care consult.
Veterans who served in a combat zone and are not enrolled in VA health care can still get a free alcohol and drug assessment at a VA Vet Center[5]. Our guide Does the VA pay for rehab? walks through how to ask your VA for a community care consult and what happens after it is submitted.
How to Help a Veteran Whose Drinking Worries You
Talk when they are sober, about specific things you have seen, and say plainly that you are worried. Keep it to what you have noticed rather than labels. Then offer one concrete next step, such as a call together.
You can call us before they are ready and ask what treatment would look like. VA health care covers the veteran, so the veteran has to take part in the VA consult, but the first conversation can start with you. Look after yourself too. Caring for someone with a drinking problem is stressful, and support for you matters[3]. Our guide on how to help an alcoholic in denial has more on that conversation.
Alcohol Treatment for Veterans at Virtue Recovery Center
Alcohol use disorder is treatable, and most people who have it recover or markedly improve[3]. Treatment works best when the drinking and what sits underneath it, such as PTSD, are treated at the same time[4].
Veterans are treated at our Killeen, Las Vegas, Astoria and Houston locations, each with medically supervised detox and residential care. Killeen is the home of Warriors Path, our veteran program, designed by Dr. Rajesh Harripersad, a retired U.S. Army combat veteran and the author of this article. Astoria coordinates rides for veterans from up to six hours away, and admissions can help anyone coming from further afield plan the trip.
Read more about drug and alcohol rehab for veterans and our alcohol addiction treatment, or call and talk it through.
Sources
- [1] National Institute on Drug Abuse. (2019, October). Substance Use and Military Life DrugFacts. National Institutes of Health.
- [2] National Institute on Alcohol Abuse and Alcoholism. Understanding Alcohol Use Disorder. National Institutes of Health.
- [3] National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help. National Institutes of Health.
- [4] U.S. Department of Veterans Affairs, National Center for PTSD. Substance Use and PTSD.
- [5] U.S. Department of Veterans Affairs. Substance use treatment for Veterans.
- [6] Veterans Crisis Line. Dial 988 then press 1.
Virtue Recovery Center is a private treatment provider, not a VA facility, and is not operated by the Department of Veterans Affairs.
Written by
Regional Executive Director — U.S. Army Retired
Dr. Rajesh Harripersad is the Regional Executive Director for Virtue Recovery Center Killeen, a retired U.S. Army combat veteran with over 35 years of combined military and civilian leadership experience. He holds a Doctor of Education (EdD) in Organizational Leadership with an emphasis in Behavioral Health from Grand Canyon University, and a Master’s degree in Counseling Psychology from the University of Mary Hardin-Baylor. He is the founder of “Don’t Walk Alone,” a community initiative supporting veterans facing homelessness and addiction. His current role at Virtue is executive leadership, not direct clinical care.
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