Konnections with Dr. K focus on the mental health of veterans and their families. The trauma that is suffered by these veterans after suffering from horrible events can mentally cripple them. In times when they can no longer bear the horrid memories, they may turn to different medications and drugs which can easily turn into an addiction. In cases concerning substance abuse, the underlying cause is almost always a psychological problem. These cases are very common among the patients; which is heartbreaking. During the internship, the final project included organizing a counseling event that allowed for a closer observation of the patients. The stories about their time in the service allowed a deeper understanding of their traumas and the reasons that they turned to substance abuse. This paper will take an extensive look into the mental health problems that lead to substance and alcohol abuse, to understand the suffering of the patients.
Mental health and Veterans
The concerns about the mental health of veterans have increased over the past few decades. PTSD along with depression is the most common mental health concern among them. This is more common among the veterans that were deployed to Iraq and Afghanistan with the percentage of the veterans developing a mental disorder being 14 to 16 percent. Other concerns include anxiety, suicidal tendencies, substance abuse, traumatic brain injury (TBI), and violence against others. The effects of these mental health problems can spread to families as well and cause them to suffer mentally. Proximity to combat is the most common reason but it has been observed that general military service can also lead to mental health issues (Inoue et al., 2022).
Substance Abuse as Coping Mechanism
Substance abuse is the activity that involves the consumption of illicit or legal drugs to reach a state of euphoria. This is usually done due to high stress and anxiety levels that become out of the control of the patient. It has been observed that the cases of substance abuse are highly common among veterans and their families. Many patients have stated that their substance intake is to cope with the trauma or the stress of dealing with certain situations. These situations may include separation from the family and normal life, living near warring zones, witnessing deaths of fellow soldiers, etc. However; their need to suppress these memories and disassociation with reality can get out pretty quickly leading to substance abuse.
The clinical term for substance abuse is Substance Use Disorder (SUD) and it co-occurs with other mental disorders. SUD affects the functions of the brain and can lead to behavioral issues. A substance can be any medication, alcohol, legal or illegal drugs that may put the patient in a euphoric state. Depression and anxiety can increase in intensity due to this disorder which can lead to suicidal thoughts (NIMH, 2019). 30 percent of the suicide rate and 20 percent of deaths due to high-risk behavior in veterans have been attributed to have been attributed substance abuse (Inoue et al., 2022).
Substance abuse is the fourth cause of death in the United States of America that could have been prevented. Drunk driving has led to 31 percent of the driving-related fatalities. SUD can be a cause of clusters of behaviors that can be dangerous for the patients and the people around them.
Substance Abuse and Gender Behavior
It has already been established that substance and alcohol abuse starts as a coping mechanism but it was observed that women and men had different reasons that led them to rely on these substances. Women reported that they started to rely on drugs in response to growing demands of the family, psychophysiological distress, physical changes in beauty, or the absence of the spouse. They stated that it was difficult to cope when their spouse was deployed to another country and they had to deal with the stress of their absence as well as take care of the family.
They play the part of both parents and have to make sure that none of the children feel neglected or feel the absence of their father. This can be very stressful for the women and sooner or later they turn to the bottle to feel some degree of relief. Men, on the other hand, reported that they used substances due to various reasons like problems related to community, work-related stress, financial stress, and family-related stress and if the person was a veteran then service-related trauma was also one of the reasons.
The studies found that the women were better at managing the stress and turned to substances as a last resort but the number of substance abuse cases in men was higher than in women. This meant that men did not know how to cope with their problems in a healthy way. This was attributed to the men’s lack of interest in communicating their problems and bottling them up until they could no longer manage the stress.
Women are more willing to talk about their problems with others which allows them to develop a support system that helps them in getting through difficult times. Unfortunately, men have been taught to be manly in every society and not show their emotions as it is seen as a sign of weakness. This behavior can be destructive and lead to many toxic behaviors such as substance and alcohol abuse (O’Hare, 1995).
Substance Abuse in Teens
The children of a dysfunctional family have a hard time adjusting to society, mainly because they may face neglect early on in their lives. Their lives may be tumultuous due to different reasons, the prime reason being child abuse. If the child abuse is reported then the children may be removed from the custody of the parents but then maybe placed under foster care. There is no guarantee that these foster parents would provide quality lives to the children which may add to childhood trauma. These children may start to withdraw from society and during their teenage years may turn to drugs as a form of escape from reality.
They slowly turn into a social pariah and pull away from the people they know. It has been observed that the teenagers that suffered from substance abuse may grow up to be highly depressed individuals that suffer from anxiety and addiction. They suffer from abandonment issues and may be highly dependent on the people around them. In most cases, the patients even as adults have a severe drug addiction that can cripple their lives (Herrenkohl et al., 2013).
Domestic Violence and Substance Abuse
In most domestic violence cases, drug addiction is the biggest culprit. It is mostly the perpetrator that is highly intoxicated and carries out acts of violence. The mental health of the whole family is unstable in such an environment with everyone showing signs of high stress and anxiety. It has been reported that every 1 in 4 women experiences domestic violence and can develop strong drug dependence to ease the pain. It is common for the victims of abuse to develop Substance Use Disorder (SUD) which can lead to other mental and physical health problems. Domestic violence cases not only affect the mental health of the victims but also their families that have to witness the abuse (TOLMAN & ROSEN, 2001).
Treatment for Substance and Alcohol Abuse
Addiction of any kind can be hard to cure especially drug addiction but it is not impossible. There are different types of treatments for substance and alcohol addiction as different patients respond to different treatments. The treatment is selected according to the substance being abused and the level of addiction the patient has. The financial constraints are considered when suggesting the treatment plan and patients’ will to recover can play a huge part in their recovery. Some treatment methods have been explained below.
Detoxification: This treatment is used to detox the body of the patient to get rid of substances that have caused addiction. This process is medically assisted so that any problem that may arise can be prevented immediately. This option is beneficial to reduce the symptoms of withdrawal and helps make the process of treatment easier for the patient. Withdrawal is a nightmarish process and if not treated correctly can cause the patient to reject treatment and in the worst-case scenario; it can be life-threatening. The behavioral issues are treated through detoxification so this treatment is used with other types of therapies.
Cognitive Behavioral Therapy (CBT): This therapy is very useful as it can be utilized for different types of addictions which include drugs and alcohol addictions as well. This therapy focuses on recognizing and treating the unhealthy and negative behaviors that have been caused by addiction. It also observes different elements and situations that can trigger these behaviors and develops a plan that would help the patient in recognizing as well as coping with these triggers. The detoxification therapy is usually combined with CBT for optimal results.
Rational Emotive Behavior Therapy (REBT): This therapy also focuses on treating the unhealthy behaviors that are caused by addiction by helping the patient recognize these behaviors and helping them in dealing with them in a healthy way. During this therapy, the therapist helps the patient in avoiding negative thoughts that leads them to feel dejected. The self-pity is turned into positive emotions that can help the patient feel more confident about their existence. It helps the patient realize external situations are not the reflection of the patient’s thoughts. Changing the mindset of the patient towards themselves and life can help them recover faster from any drug addiction.
Contingency Management: In this therapy, positive reinforcement is used to develop positive behavior in the place of negative behavior. The therapist rewards the patient for different positive behaviors, for example maintaining sobriety is a positive behavior that can be reinforced by giving tangible rewards. This type of therapy can be used for different types of addictions and is usually used for those cases that have a history of relapsing. This therapy has proven to combat the relapse and effectively treat the patient.
12-Step Facilitation: This therapy was specifically designed to treat substance and alcohol abuse. This therapy is carried out in a group setting in which the participants are taught to accept that their addiction has impacted their lives negatively and will have adverse consequences that can be emotional, social, physical, or spiritual. In this therapy, the participants are allowed to accept their addictions and then move on from them slowly with the help of other patients. In this type of therapy, group meetings are essential and facilitators may be involved to help in maintaining sobriety. Groups like Alcoholics Anonymous use this therapy in helping the patients recover from addiction.
Treatment with Medication: Using medication in combination with other therapies can make the process of becoming sober a bit easier. These therapies are used to elevate the mood of the patient as well as to suppress the desire to use the addictive substance. Lofexidine is a medicine that has been approved by the FDA which helps in reducing the withdrawal symptoms and carving in the patients that may be addicted to opioids. Drinking addiction can be reduced by using a prescription called Acamprosate.
These treatment methods are among the most successful treatments for substance and alcohol abuse. In any treatment, the will of the patient to recover and the support of their loved ones can play a huge part in the success of the treatment. Substance and alcohol abuse may be the result of trauma related to other mental disorders but treating it can help in treating related mental disorders as well. Addiction of any kind can create a toxic dependency and cripple the life of the patient. They are unable to live a normal life and can slowly descend into depression which can be life-threatening as depression can invoke suicidal thoughts. Addiction and its underlying causes must be treated immediately to prevent any unfortunate event (Underwood, 2020).
Substance Use disorder is usually a part of dual diagnosis as other mental health disorders co-occur with it. At Konnections with Dr. K, it was observed that in veterans or their families SUD occurred as a coping mechanism that got out of hand. It is not only the veterans that suffer from this but all over the world, people fall into the trap of drug addiction as a result of circumstances that they can no longer bear. These individuals must receive timely treatment as it can become fatal if intervention is not carried out on time. Different treatment plans and medications exist that can help these individuals fully recover and return to society as functional human beings.
Herrenkohl, T. I., Hong, S., Klika, J. B., Herrenkohl, R. C., & Russo, M. J. (2013). Developmental Impacts of Child Abuse and Neglect Related to Adult Mental Health, Substance Use, and Physical Health. Journal of Family Violence, 28(2), 191–199. https://doi.org/10.1007/s10896-012-9474-9
Inoue, C., Shawler, E., Jordan, C. H., & Jackson, C. A. (2022). Veteran and Military Mental Health Issues. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK572092/
NIMH. (2019). Substance Use and Co-Occurring Mental Disorders. National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
O’Hare, T. (1995). Mental Health Problems and Alcohol Abuse: Co-occurrence and Gender Differences. Health & Social Work, 20(3), 207–214. https://doi.org/10.1093/hsw/20.3.207
TOLMAN, R. M., & ROSEN, D. (2001). Domestic Violence in the Lives of Women Receiving Welfare: Mental Health, Substance Dependence, and Economic Well-Being. Violence Against Women, 7(2), 141–158. https://doi.org/10.1177/1077801201007002003
Underwood, C. (2020, December 12). 6 Treatments For Addiction That Are Proven Successful. WebMD. https://www.webmd.com/connect-to-care/addiction-treatment-recovery/successful-treatments-for-addiction