It’s an uncomfortable fact: Veterans are at higher risk than the general population for substance use disorders (SUDs). Those substances include drugs and alcohol. And among those with an alcohol use disorder (AUD), liver disease is prevalent.
Here’s a look at why liver disease and military service often go hand-in-hand, and how to address AUDs in veterans.
Alcohol, Liver Disease, and Veterans
AUDs (sometimes known as alcohol abuse or alcoholism) are the most common form of SUDs among military personnel. That includes active members and veterans of the armed forces.
A study in a 2021 issue of Gastroenterology and Endoscopy News looked at people who received care at Veterans Health Administration hospitals. Nearly half had risk factors for liver disease.
One of the main risk factors for liver disease is having an AUD.
A healthy liver filters the blood coming from the digestive tract before it goes to the rest of the body. With heavy drinkers, liver disease often leads to cirrhosis, a dangerous scarring of the liver. The buildup of scar tissue from cirrhosis prevents the liver from working well.
Cirrhosis eventually leads to liver failure and life-threatening complications. You may need a liver transplant.
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Rates of Alcohol Use Among Veterans
Both active military and veterans drink more alcohol more than the general population, according to the National Institute on Drug Abuse. Sixty-five percent of veterans who enter a treatment program identify alcohol as the substance they misuse the most. That’s nearly double the rate of the general population.
Binge drinking is also significantly higher among members of the military. According to a recent Department of Defense survey, one in three active service members reported binge drinking in the past 30 days. That compares to one in six U.S. adults in the general population.
Binge drinking means consuming four to five alcoholic drinks in one to two hours.
High rates of alcohol consumption lead to higher risk for liver disease. Drinking too much alcohol can also raise your risk for cancer, immune system problems, and relationship issues.
Risk Factors for Alcohol Use Disorders Among Veterans
Because veterans are more likely to have an AUD, it’s important to be on the lookout for signs of a problem. Risk factors include:
- Suffering from post-traumatic stress syndrome (PTSD). More than two out of every 10 veterans with PTSD also have substance abuse problems, including alcohol.
- Long absences from home. Frequent moves and long deployments can put a strain on family relationships and lead to reliance on alcohol.
- Having another SUD. Heavy drinkers often have problems with drugs and nicotine.
- Having been in an active combat zone. Exposure to trauma and violence increases the risk of problematic drinking. The U.S. Department of Veterans Affairs says that about one in 10 Afghanistan and Iraqi war veterans have drug or alcohol problems.
Signs and Symptoms of an Alcohol Use Disorder
If you are a veteran, or a family member of a veteran, you may wonder how much alcohol is healthy. An AUD may include:
- An increased urge to drink.
- Inability to stop drinking.
- Drinking alcohol in a dangerous or inappropriate way (like drinking and driving).
- A change in personal relationships because of your drinking.
- Loss of interest in hobbies, work, or personal goals.
- Feeling depressed or anxious about your drinking.
- Showing aggression, irritability, and anger to loved ones.
- Hiding your drinking or drinking in private.
- Having withdrawal symptoms (nausea, insomnia, shakiness) if you stop drinking.
- Needing more and more alcohol to have the same effect as time goes on.
Alcohol Use Disorder Treatment for Veterans
Fortunately, there are treatment options available for veterans who have problems with alcohol. The most important step is admitting you need treatment. The second is reaching out, with the help of family members, to find that help.
The Veterans Administration and other medical facilities provide treatment for AUD.
Some ways to treat AUD include:
- Detoxification programs. A medically managed detox program can help wean you off alcohol. You may need to stay in a hospital or other residential facility while you’re going through detox.
- Medicine. Some medications can help reduce the desire to drink.
- Behavioral therapy. Therapy can include individual, group, and family counseling. Therapy can get to the root cause of why you drink and provide other behaviors when you have the urge to drink.
- Support group meetings. It’s helpful for veterans to talk to others who’ve had similar experiences. Groups like Alcoholics Anonymous can provide ongoing support on a regular basis.
If You’re a Family Member
Family members of veterans with alcohol problems face special challenges. You may need counseling as well. You shouldn’t feel ashamed of needing help, and you should encourage the veteran in your life to seek help as well.
Here are some things family members should know:
- AUD can affect veterans of any age, gender, or military rank. If your loved one has a drinking problem, it doesn’t make them a bad person. It’s important to seek help as soon as possible.
- It’s important to encourage your loved one to talk honestly with their doctor about their drinking. Their doctor can check for early signs of liver disease and other alcohol-related health issues.
- You’re not alone. Men and women in the armed forces often experience traumatic and stressful events. Many turn to drugs or alcohol as a means of coping.
- Drinking can make PTSD symptoms worse and vice versa, so it’s important to seek treatment for both. For instance, if PTSD makes sleep difficult, people may self-medicate with alcohol. But alcohol disrupts your sleep, leaving you less refreshed in the morning.
- If your loved one agrees to treatment, do everything you can to make it happen immediately. People with alcohol use disorders often change their minds about treatment.
- Remember that treatment doesn’t end with a stint in a rehab facility. It’s important to have a support system in place. Groups like Alcoholics Anonymous and Al-Anon can provide support and motivation for veterans and their families.
The following organizations can provide help to veterans with AUDs and their families.
Veterans Alcohol and Drug Dependence Rehabilitation Program.
Substance Abuse and Mental Health Services Administration Helpline.
988 Suicide and Crisis Lifeline.
Benefits.gov, Veterans Alcohol and Drug Dependence Rehabilitation Program, Link
U.S. Department of Veterans Affairs, Substance Use, Link
U.S. Department of Veterans Affairs, Substance use treatment for Veterans, Link
Alcohol Rehab Guide, Alcoholism in Veterans, Link
National Institute on Drug Abuse, Substance Use and Military Life Drug Facts, Link
U.S. Department of Veterans Affairs, PTSD and Substance Abuse in Veterans, Link
CDC, Chronic Diseases and Military Readiness, Link
National Institute on Alcohol Abuse and Alcoholism, Medical Complications: Common Alcohol-Related Concerns, Link
Gastroenterology and Endoscopy News, VA Study Finds Alarming Gaps in Cirrhosis Diagnosis, Link
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