Recovery for veterans grappling with the intertwined challenges of trauma and self-medication is akin to navigating a winding trail through a dense forest. As the U.S. Department of Veterans Affairs reports, roughly 7% of military veterans encounter post-traumatic stress disorder (PTSD) during their lifetime. Exposure to combat, traumatic incidents and life-threatening situations casts a long shadow, rendering veterans more susceptible to trauma-induced behavioral and mental health issues than the general populace.

Regrettably, a profound connection exists between trauma and self-medication. Research studies indicate that nearly 50% of individuals diagnosed with PTSD concurrently experience substance use disorders. This intricate relationship often stems from the compulsion to self-medicate — an attempt to momentarily escape the haunting memories and emotions entwined with traumatic experiences.

However, as the effectiveness of substances wanes, self-medication evolves into a full-blown substance use disorder. When left unaddressed, the co-occurring conditions of trauma and substance use worsen both the mental and behavioral health of the individual.

To pave the way for comprehensive healing, clinicians embark on a two-pronged approach, targeting both trauma and substance use. Treatment programs often integrate veteran support groups to tailor the treatment strategy to each individual. Encouragingly, evidence-based treatments spanning various modalities offer invaluable support to veterans navigating the path to recovery.

The Complex Intersection of Trauma and Self-Medication

Veterans living with trauma frequently present with an array of symptoms. According to the American Psychiatric Association, PTSD manifests through symptoms such as:

• Intrusive thoughts, including distressing dreams and vivid flashbacks
• Avoidance of people, places or situations that may trigger distressing memories, events or emotions
• Distorted thoughts concerning the traumatic event or an inability to recall it accurately
• Mood fluctuations

To cope with these symptoms, veterans may resort to drugs and alcohol. Initially, substances may seem to offer temporary relief, aiding in sleep, providing solace in specific situations or serving as a distraction from issues stemming from PTSD, such as strained relationships or professional setbacks. However, self-medication perpetuates the cycle of avoidance.

While self-medication may appear to provide temporary relief, PTSD symptoms generally exacerbate over time. This deterioration disrupts sleep, alters mood and diminishes the effectiveness of prescribed psychiatric medications. Evidence underscores the most effective approach, involving the concurrent treatment of both PTSD and substance use disorder.

The Path of Healing for Veterans Confronting Trauma and Co-Occurring Substance Use Disorders

Veterans embarking on the journey to recovery often partake in a comprehensive continuum of care customized to their specific needs. Assessments for substance use and psychiatric concerns help determine the most suitable level of care. When veterans require structured and supervised recovery, clinicians may recommend residential or inpatient facilities.

If medically necessary, individuals may undergo supervised detox to safely withdraw from substances. Many detox facilities incorporate medication-assisted treatment (MAT) to ensure a safe and comfortable experience. These acute care levels aim to stabilize individuals and prepare them for transitions into less intensive care.

While the specifics of each care plan depend on the veteran’s needs, residential treatment may be followed by a partial hospitalization program (PHP), an intensive outpatient program (IOP), regular outpatient programs and aftercare services. For veterans, these aftercare services may encompass vocational training, ongoing medication management to address psychiatric symptoms and participation in veteran support groups.

Evidence-Inspired Strategies for Self-Medicating Veterans on the Path to Triumph Over Trauma

Throughout different phases of care, clinicians use a variety of treatments to address both substance use and trauma-induced challenges.

The Power of Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) has emerged as a potent weapon for tackling co-occurring trauma-related disorders. During CBT sessions, clinicians delve deep into maladaptive thinking patterns that may fuel veterans’ self-medication. These trauma-focused psychotherapy sessions also empower veterans to process traumatic events and their associated emotions.

Navigating the Maze of Exposure Therapy

Prolonged exposure therapy endeavors to diminish the emotional “triggers” linked to trauma. These sessions may involve veterans repeatedly confronting detailed images or immersive virtual reality programs designed to evoke fear, distress and other negative emotions. The goal is to create a controlled, secure environment for veterans to systematically confront their emotional reactions.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR, a trauma-focused psychotherapy, introduces a unique approach by inducing eye movement while discussing traumatic events. Thought to mimic REM sleep, EMDR often proves effective in rewiring veterans’ memories of traumatic events, reducing the emotional grip of these memories.

Involving Families in the Counseling Process

Family-centered counseling sessions involve the active participation of loved ones in the treatment journey. This approach helps family members gain insight into the symptoms of trauma and substance use disorders while actively contributing to aftercare planning. Research indicates that involving families in treatment can significantly improve outcomes for veterans.

Managing Medication and Providing Post-Treatment Support

Alongside counseling and psychoeducation, veterans may receive ongoing medication to address symptoms associated with PTSD and substance use. Post-treatment plans typically involve continuous medication management and follow-up appointments with prescribing clinicians.

Other Therapeutic Approaches

Veterans’ treatment may encompass individual counseling and group therapy sessions with fellow veterans or individuals who have undergone similar traumatic experiences. One tailored intervention designed for those with PTSD and co-occurring substance use disorders is Seeking Safety therapy. This evidence-based approach aims to alleviate trauma and substance abuse symptoms while enhancing coping skills related to behavior, thinking and emotions.