Behavioral Health Issues Among Afghanistan and Iraq U.S. War Veterans

Behavioral Health Issues Among
Afghanistan and Iraq U.S. War Veterans

Behavioral Health Issues Among Afghanistan and Iraq U.S. War Veterans – Since 2001, more than 2.2 million U.S. veterans have served in Afghanistan (Operation Enduring Freedom, or OEF) and Iraq (Operation Iraqi Freedom, or OIF).

Although more than two-fifths of these veterans receive healthcare and social services through the U.S. Department of Veterans Affairs (VA),2 the remainder may seek services elsewhere—from community clinics, primary care providers, and other community centers.

This In Brief introduces some of the problems facing OEF and OIF veterans and can help healthcare and social service professionals understand these veterans’ needs.

Returning Veterans and Possible
Behavioral Health Issues

Although the majority of veterans who return from Iraq and Afghanistan do not have a behavioral health condition and have not experienced a traumatic brain injury, all veterans experience a period of readjustment as they reintegrate into life with family, friends, and community.

The veterans’ juggling of military and family responsibilities, reintegration into civilian life in the United States after living in unfamiliar settings, and processing exposure to combat may contribute to problems for veterans themselves, as well as their spouses and family members.

Behaviors needed to survive in a war zone, such as maintaining a constant state of alertness, may initially translate into troublesome behaviors in civilian life, such as feeling edgy or jumpy and being easily startled.

Healthcare and social service providers and clergy—from the community, military, or VA—may be the first contacts sought for help by veterans and their families, making it important for these providers to know about problems faced by veterans.

Those returning from a combat zone may experience a variety of common stress reactions, including sleeplessness, nightmares, and feelings of sadness, rejection, abandonment, or hopelessness.

Veterans may also struggle to concentrate; engage in aggressive behavior, such as aggressive driving; and use alcohol, tobacco, and drugs excessively. However, the intensity and duration of these and other worrisome behaviors can indicate a more serious problem and the need for professional treatment.

The VA offers screening, diagnostic assessment, and treatment to help veterans overcome discrimination or barriers that prevent them from seeking treatment.

Substance Abuse Among OEF and
OIF Veterans

Few data have been reported on illicit drug use among OEF and OIF veterans, but one study of VA healthcare users reports that more than 11 percent of OEF and OIF veterans have been diagnosed with a substance use disorder (SUD)—an alcohol use disorder, a drug use disorder, or both. In addition, the data available for alcohol use show that some veterans use alcohol to self-medicate.

VA data show that almost 22 percent of OEF and OIF veterans with post-traumatic stress disorder (PTSD) also have an SUD.

Alcohol Consumption Guidelines

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), at-risk alcohol consumption is having 5 or more drinks in 1 day for men and 4 or more drinks in 1 day for women—or more than 14 drinks per week for men and 7 drinks per week for women—1 or more times in the past year.

Individuals are considered at risk for alcohol abuse or dependence if they need to drink a lot more to achieve the same desired effect as when they drank previously, have problems with work or family caused by drinking, or have been unable to cut down or quit.

In Brief

In addition, a recent national study of OEF and OIF veterans receiving VA health care was the first to show that those diagnosed with mental disorders, particularly PTSD, were notably more likely to receive prescription opioid medication for conditions related to pain than those with no mental health diagnoses.

They were more likely to have co-occurring SUDs, to receive higher-dose opioid regimens and early refills, and to take the opioids for longer periods of time. These veterans were also at higher risk for adverse clinical outcomes.

Studies show that alcohol misuse and abuse, hazardous drinking, and binge drinking are common among OEF and OIF veterans. Veterans sometimes drink alcohol as a way to numb the difficult feelings and erase the memories related to their war experiences.

For example, increased combat exposure involving violence or human trauma among OIF veterans was linked to more frequent and greater quantities of alcohol use than was less exposure to such combat.

  Post-Traumatic Stress Disorder

PTSD may develop after an individual has been exposed to an event that involved the deaths of others, or an event that threatened death or serious injury to oneself or others, and the person’s response to the event involved fear, helplessness, or horror.

Traumatic experiences that lead to PTSD among OEF and OIF veterans involve exposure to combat—including knowing someone who was injured or killed, killing an enemy combatant, or being shot at.24 Signs and symptoms of PTSD include re-Experiencing the traumatic event by way of flashbacks, nightmares, and intrusive thoughts about the event; efforts to avoid thoughts, feelings, or conversations associated with the trauma; efforts to avoid activities, places, or people that arouse recollections of the trauma; and diminished interest or participation in significant activities.

Other indicators of PTSD include sleep difficulties, feelings of detachment from others, angry outbursts, and startling easily. The DSM-IV-TR provides a fuller description of PTSD.



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Warmest Regards, Coyalita

Behavioral Health Rehabilitative Specialist & Addiction Counselor

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