Alcohol in the armed forces
Alcohol abuse is an inescapable reality for many who serve in the armed forces. The prevalence of alcohol in the military, with its associated rituals and camaraderie, is well known. Historically alcohol was seen as a means of ‘man management’ – the rum ration in the Royal Navy was only abolished in 1970. Overall alcohol is used and abused more frequently and in higher doses than in civilian life and this amplifies its negative effects both for men and women. These include drunkenness, fighting and abuse, poisoning, injury, hangovers, dependency and addiction.
A service member who has a drinking problem is a major cause of concern in the military. The armed forces can lose good and well-trained troops to the effects of alcohol abuse. Once a drinking problem has been identified it is incumbent on commanding officers to take action to correct the problem.
Illegal drug abuse in the military
The use of illegal drugs is obviously a very serious offence for anyone serving in the armed forces – as there is often a zero tolerance approach, but illegal drug abuse still accounts for a high number of discharges from the US military (17,000 since 1999). However the growing use of legal highs and the illegal use of prescription drugs should be of increasing concern for military health chiefs.
There have been huge increases in prescription drug use and abuse within the military in recent years. Anti-depressants, sedatives, antipsychotics and anti-anxiety are all routinely prescribed, and in some cases troops have to be trusted to self-regulate their intake for months at a time. As a result, prescription drug abuse was found to have almost tripled between 2005 and 2008 with one in four combat troops in the US admitting to prescription drug abuse. At the same time suicide rates in the military and amongst veterans is a growing concern for both the UK and US militaries.
Post-Traumatic Stress Disorder in the military
The nature of military life – especially combat duty – is closely linked to traumatic episodes. These traumatic episodes need to be processed and dealt with internally by individuals. However, the nature of combat duty, or the routine and duties of a military lifestyle, can often lead to these issues being avoided. This in turn can lead to problems of isolation, depression and severe anxiety, which overwhelm the individual’s ability to cope. These symptoms will often develop over time, and if they persist then a diagnosis of post-traumatic stress disorder (PTSD) is likely. Spontaneous recovery from PTSD is possible, but for a significant proportion, the disorder becomes chronic and needs specialist treatment.
Addiction & PTSD
The link between alcohol or drug abuse and trauma is certainly very close. Trauma patients are often seen to ‘self-medicate’ with alcohol or other depressants or stimulants in order to mask the symptoms of Post Traumatic Stress Disorder (PTSD). Before attempting to treat an individual with PTSD, their drinking habits should be known by their clinician, as trauma cannot be processed by individuals who are under the influence of alcohol or other drugs. It is also true that when assessing a serviceman or woman for addictive disease, their clinician will often need to assess them for trauma too.
Just as a service member with a drinking problem is a major concern in the military – so a veteran soldier with a drinking problem is a major concern for the family, community and society. The statistics are lacking in the UK because of the poor tracking of veterans. However in the USA 60% of 140,000 veterans were found to have a substance abuse problem. The higher proportion of substance abuse among veterans can be understood in terms of the nature of addictive disease and PTSD which can take years to develop. Also the difficulties associated with moving back into civilian life can compound these problems – in particular a sense of isolation.
Alcohol & Drug Treatment for servicemen & veterans
Castle Craig has treated veterans, servicemen and women of UK and international armed forces, and their dependents, for over 20 years. The hospital and treatment is under medical direction, with a full time consultant psychiatrist, and is recognised by the major medical insurers and the NHS for the treatment of addictive disease and the treatment of trauma. It should be noted that military personnel and PTSD patients particularly benefit from inpatient care.