Breaking the chain: PTSD, substance abuse and domestic violence

Last week, the Military Compensation and Retirement Modernization Commission (MCRMC) outlined its plans for a 21st century military system. And so they should because we now have an eye-popping 23,816,000 veterans alongside current personnel and all of their families. Few families are left untouched by our military in one way or the other.

According to the Department of Veteran Affairs, two in ten veterans have turned to substance abuse of some kind or another. One in three of these veterans suffer from PTSD and the department estimates that 31% of all veterans are suffering from Post-Traumatic Stress Disorder. This means 7-8 million veterans require treatment. According to veteran mental health specialist Monica Mathieu back in 2008, this care is not integrated properly.

Dov Zakheim, writing in Foreign Policy Magazine, outlined the bipartisan agreement on the Capitol, which given the divided state of government at the moment was quite a surprise, which covers current and former members of the military. Four decades on from the creation of the All-Volunteer Force, the modern military now encompasses families as a fixed part of the landscape but also takes into account that women make up a far larger proportion than any time in our history.

The benefits offered, including great government contributions to retired personnel, are welcome, but with such a large number of veterans with problems, something more integrated is required that goes beyond personal finances. With large numbers of veterans turning to substance abuse – 6 in 10 PTSD sufferers are smokers, many have alcohol and drug addiction problems, a total care package is required.

It is important to look at PTSD and substance abuse because people with a Substance Use Disorder (SUD) are more likely to commit domestic violence. For example, 25-50% of men who committed battery against a spouse had a substance abuse problem. It goes beyond the veterans too because it forms part of a vicious circle. Various studies seem to suggest that 31% to 84% of women who suffer domestic violence show symptoms of PTSD. Many of them then turn to substance abuse themselves.

Back in 2008, Matthieu said that “the increasing number of veterans with post-traumatic stress disorder (PTSD) raises the risk of domestic violence.” In talks with Peter Hovmand, a domestic violence expert at Washington University in St. Louis, Matthieu outlined a solution: “Veterans need to have multiple providers coordinating the care that is available to them, with each provider working on one treatment goal. Coordinated community response efforts such as this bring together law enforcement, the courts, social service agencies, community activists and advocates for women to address the problem of domestic violence. These efforts increase victim safety and offender accountability by encouraging interorganizational exchanges and communication.”

Given the agreed updates to retired veterans in the modern world and the taking into account their spouses and families, it’s time to make sure there is a truly inter-organizational and integrated approach to veteran mental health to help prevent them from turning to substance abuse and domestic violence.

This story written by Mark Wollacott originally published on Military Medical News.