SUD Program Implementation Considerations for Service Members, Veterans, and Their Families

Approximately 4.7 million veterans live in rural areas where access to healthcare and support services is often limited. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 12% of veterans (2.4 million) experience substance use disorders (SUD), with 91.7% not receiving treatment in the past year.

The U.S. Department of Veterans Affairs (VA) has implemented telehealth programs and intensive case management resources that bring treatment options closer to rural communities. Rural treatment programs that work with veterans should consider becoming VA-authorized community care providers or partnering with existing providers. These partnerships enable rural providers to offer expanded services while leveraging VA funding and resources to meet the needs of veterans.

Stigma remains a significant barrier for service members and veterans seeking help for SUD or mental health concerns. Fear of career repercussions, judgement from peers, or concerns about confidentiality can discourage individuals from pursuing treatment. Families may also hesitate to seek support due to fears of social stigma or a lack of awareness about available resources. Education campaigns, peer-led initiatives, and community-based programs can normalize help-seeking behaviors and reduce stigma.

Substance Use During Military Service
Substance use among active-duty service members carries serious consequences, including disciplinary action, dishonorable discharge, and loss of health insurance benefits. The high demands of military life, such as deployments and combat exposure, contribute to stress and may increase the likelihood of substance use. These behaviors can jeopardize not only a service member's career, but also their relationships with family, who may face emotional and financial strain as a result.

Challenges of Transitioning to Civilian Life
Transitioning from military to civilian life presents numerous challenges, such as finding employment, adjusting to new routines, and redefining one's identity outside of the military. These stressors can contribute to mental health conditions like depression, anxiety, and post-traumatic stress disorder (PTSD), which are linked to SUD. Addressing these challenges requires comprehensive support systems that integrate mental healthcare with substance use treatment.

Substance Use, PTSD, and Suicide Risk
Substance use often co-occurs with PTSD among veterans. Combat exposure, deployments, and the challenges of transitioning out of military service can contribute to the development of these conditions. Many veterans attempt to self-medicate PTSD symptoms with alcohol or drugs, which can worsen their struggles and complicate treatment. For rural veterans, the lack of access to integrated care — programs that address both SUD and mental health conditions — can make recovery challenging. The VA Health System and Department of Defense offer evidence-based clinical guidelines for managing PTSD and SUD.

Impact on Families
Substance use in military families can lead to increased domestic conflict, divorce, and behavioral issues in children. Supporting families is essential to addressing these challenges. Resources such as counseling, educational materials, and support groups can help families build resilience and cope with the difficulties they face. Family-centered approaches that actively involve loved ones in the recovery process have been shown to improve outcomes for both individuals and their families.

Resources to Learn More

Make the Connection
Website
Provides online resources designed specifically for veterans and their families to help identify the signs of drug problems and seek treatment options. Resources include videos, information and resource locator, treatment and recovery locator, self-help materials, and self-assessments.
Organization(s): U.S. Department of Veterans Affairs

Services for Substance Use Disorders, and Efforts to Address Access Issues in Rural Areas
Document
Discusses the results from a study outlining rural-urban disparities in substance use disorder service utilization among veterans.
Organization(s): U.S. Government Accountability Office
Date: 12/2019

Substance Use Disorder (SUD) Program Locator
Directory
Allows users to search for VA Medical Centers with substance use disorder programs by program type or by location.
Organization(s): U.S. Department of Veterans Affairs

Substance Use Treatment for Veterans
Website
Explains available services and resources for veterans with substance use problems.
Organization(s): U.S. Department of Veterans Affairs

Technical Assistance Tools for Action
Website
Collection of toolkits and resources from SAMHSA, the Department of Defense, and the Department of Veterans Affairs that address the behavioral health needs of service members, veterans, and their family members.
Organization(s): SAMHSA Service Members, Veterans, and their Families Technical Assistance Center

Veterans Crisis Line
Website
Provides confidential crisis support for veterans and their loved ones through phone, chat, and text.
Organization(s): Veterans Crisis Line