Substance Abuse in Military: When to Get Help & Treatment Options
Bottom Line Up Front: 11-20% of service members struggle with substance abuse (vs. 8% general population). Most common: Alcohol (binge drinking culture), prescription painkillers (over-prescribed for injuries), stimulants (to stay awake on duty). Signs: Drinking alone, needing alcohol daily, job performance decline, DUI, relationship problems. Free confidential help: SUDCC (Substance Use Disorder Clinical Care) on every base, Military OneSource (24/7), TRICARE covers rehab. Consequences: Article 15, discharge, loss of security clearance, VA benefits at risk. Early treatment = career saved. Waiting until crisis = career destroyed.
Substance Abuse in Military (The Reality)
Why Military Rates Are Higher
Unique stressors:
- Combat trauma (PTSD, anxiety → self-medication)
- Physical pain (injuries → painkiller dependence)
- Deployment stress (alcohol = coping mechanism)
- Frequent moves (uprooting → instability → drinking)
- High-pressure ops (stimulants to stay alert)
Cultural factors:
- Drinking culture (barracks parties, unit events)
- "Suck it up" mentality (don't seek help, drink instead)
- Easy access (cheap alcohol on base, prescription pills from clinic)
Statistics:
- 20% of service members binge drink monthly (vs. 12% civilians)
- 1 in 10 military prescribed opioid painkillers (injury rates)
- 11% meet criteria for substance use disorder
Types of Substance Abuse in Military
Alcohol (Most Common)
Warning signs:
- Binge drinking (5+ drinks in sitting, multiple times/week)
- Drinking alone (not just social)
- Needing alcohol to relax/sleep
- Blackouts (can't remember night)
- DUI/DWI
- Relationship problems (spouse complains about drinking)
- Job impact (hung over at work, missing duty)
Progression:
- Social drinking (barracks parties, unit events)
- Stress drinking (after rough day, deployment stress)
- Daily drinking (need it to function)
- Dependence (withdrawal symptoms without alcohol)
Physical signs:
- Shaking hands (morning tremors)
- Bloodshot eyes
- Weight gain (beer belly)
- Hangovers multiple times/week
Prescription Painkillers (Opioids)
How it starts:
- Injury (back pain, combat injury, training accident)
- Doc prescribes Percocet, Vicodin, OxyContin
- Take as prescribed initially
- Pain persists, increase dose
- Dependence develops
Warning signs:
- Taking more than prescribed
- "Doctor shopping" (multiple prescriptions from different docs)
- Running out early ("lost pills" excuse)
- Stealing pills (from roommates, family)
- Withdrawal symptoms (sweating, nausea, shaking when dose wears off)
Danger: Overdose risk (especially if mixing with alcohol)
Stimulants (Adderall, Ritalin, Caffeine Pills)
Why military members use:
- Stay awake on duty (guard duty, night ops)
- Study for promotion exams
- Performance enhancement (PT test)
How abuse starts:
- Buddy shares Adderall for studying
- Works great, seek more
- Develop tolerance, need higher doses
- Dependence
Warning signs:
- Taking without prescription
- Using daily
- Can't function without it
- Anxiety, paranoia, insomnia
Marijuana (Illegal for Military)
Reality:
- Automatic drug test failure
- Article 15 or discharge
- Loss of security clearance
- No "medical marijuana" exception for military
Despite being illegal, some use:
- Self-medicating PTSD
- Pain relief
- Sleep aid
Consequences: Immediate career destruction (don't risk it)
When to Get Help (Red Flags)
Personal Red Flags
You need help if:
- ⚠️ Drinking alone regularly
- ⚠️ Needing substance to function (sleep, work, socialize)
- ⚠️ Tolerance increase (need more to get same effect)
- ⚠️ Withdrawal symptoms (shaking, sweating, nausea when you don't use)
- ⚠️ Failed attempts to quit (tried to stop, couldn't)
- ⚠️ Hiding use (lying about amount, sneaking drinks/pills)
- ⚠️ Blackouts or memory gaps
Life Impact Red Flags
Substance abuse affecting:
- ⚠️ Job: Performance decline, absences, showing up drunk/high
- ⚠️ Relationships: Spouse threatening divorce, kids afraid of you
- ⚠️ Legal: DUI, public intoxication, fights
- ⚠️ Health: Liver problems, weight changes, chronic hangovers
- ⚠️ Finances: Spending rent money on alcohol/drugs
"I'm Just a Social Drinker" Test
Answer honestly:
- Do you drink alone? (YES = red flag)
- Do you need alcohol to relax/sleep? (YES = dependence)
- Has anyone (spouse, friend, commander) expressed concern? (YES = listen to them)
- Have you had legal issues (DUI, disorderly conduct)? (YES = problem)
- Do you drink/use to cope with stress/PTSD? (YES = unhealthy coping)
If YES to 2+ questions: You have a substance abuse problem, seek help.
Treatment Options (All Free/Confidential)
SUDCC (Substance Use Disorder Clinical Care)
What it is:
- Military substance abuse treatment program
- On every base
- Outpatient (live at home, attend sessions)
- OR residential (live at treatment facility)
Services:
- Individual counseling
- Group therapy
- Family therapy
- Medication-assisted treatment (if needed)
- Aftercare planning
How to access:
- Self-refer (call SUDCC directly, NO commander approval needed for initial consult)
- OR commander refers (if they know about issue)
- Initial assessment (confidential)
- Treatment plan created
Confidential?
- Initial consult: YES (commander not notified)
- Ongoing treatment: Depends (voluntary = confidential, command-directed = commander informed)
Cost: FREE (TRICARE covers)
Military OneSource (24/7 Counseling)
Phone: 800-342-9647
Services:
- 24/7 crisis support
- Short-term counseling (12 sessions/year, free)
- Referrals to long-term treatment
- Family support
Completely confidential: Commander NOT notified
Best for: Early intervention (before it becomes official issue)
TRICARE Mental Health/Substance Abuse Coverage
Covered:
- Outpatient therapy (unlimited sessions)
- Inpatient rehab (if medically necessary)
- Medication-assisted treatment (Suboxone, naltrexone)
- Family therapy
How to access:
- Referral from primary care doctor
- OR direct access (call TRICARE mental health line)
Cost:
- Active duty: $0
- Family members: Copay ($0-$30 per session depending on plan)
AA/NA (Alcoholics Anonymous / Narcotics Anonymous)
What it is:
- Peer support groups
- 12-step program
- Free, anonymous
- Meetings on most bases + civilian community
How to find meetings:
- AA.org
- NA.org
- Base chapel (often hosts meetings)
Does it work?
- 40-60% success rate (with consistent attendance)
- Best when combined with professional treatment
Command-Directed vs. Voluntary Treatment
Voluntary Treatment (You Self-Refer)
Pros:
- ✅ Mostly confidential (commander may not be told)
- ✅ No automatic punishment (seeking help ≠ automatic Article 15)
- ✅ Shows initiative (commanders appreciate self-awareness)
How to do it:
- Call SUDCC directly
- Schedule assessment
- Attend treatment
- Commander MAY be notified eventually (if treatment is intensive), but you get credit for self-referring
Consequences:
- Usually minimal if you self-refer BEFORE getting caught (DUI, failed drug test)
Command-Directed Treatment
When it happens:
- After DUI
- After failed drug test (alcohol incident, not marijuana)
- After alcohol-related incident (fight, misconduct)
- Commander suspects problem
Process:
- Commander orders you to SUDCC
- You attend assessment (not optional)
- Treatment plan created
- You MUST complete treatment
Consequences:
- Commander fully informed
- May receive Article 15 (for incident that triggered referral)
- Treatment completion = condition of keeping job
- Failure to complete = discharge possible
Difference from voluntary:
- Voluntary = you chose to get help → less punishment
- Command-directed = you got caught → punishment likely
Consequences of NOT Getting Help
Military Consequences
Minor first offense (DUI, alcohol incident):
- Article 15 (non-judicial punishment)
- Reduced rank (E-5 → E-4)
- Loss of pay ($500-$2,000)
- Extra duty
- Command-directed treatment
Repeat offenses:
- Court-martial (possible)
- Discharge (General or Other Than Honorable)
- Loss of security clearance
- Loss of promotion eligibility
Failed drug test (marijuana, cocaine, etc.):
- Automatic discharge (usually)
- Loss of benefits
- Other Than Honorable discharge (bad for VA benefits)
VA Benefits at Risk
If discharged for substance abuse:
- May lose GI Bill (depends on discharge characterization)
- May lose VA disability (if determined misconduct, not service-related)
- May lose VA home loan eligibility
Fix: Get treatment BEFORE discharge (shows you addressed problem)
Personal Consequences
Health:
- Liver disease (alcoholism)
- Overdose (opioids)
- Heart problems (stimulants)
- Brain damage (long-term alcohol abuse)
Relationships:
- Divorce (substance abuse = #1 cause of military divorce)
- Kids removed (CPS involvement if abuse endangers children)
- Lost friendships
Financial:
- DUI costs: $5,000-$15,000 (lawyer, fines, insurance increase)
- Job loss (income gone)
- Debt (spending on substances)
Action Steps
If You Think You Have a Problem:
- ✅ Call Military OneSource: 800-342-9647 (24/7, confidential)
- ✅ Self-refer to SUDCC (before getting caught)
- ✅ Attend AA/NA meeting (find one on base or AA.org)
If You've Had an Incident (DUI, alcohol-related misconduct):
- ✅ Lawyer up (consult JAG or private attorney)
- ✅ Immediately enroll in SUDCC (shows commander you're taking it seriously)
- ✅ Stop drinking/using NOW (even before treatment starts)
If Family/Friends Are Concerned:
- ✅ Listen to them (denial = common, they see what you can't)
- ✅ Seek assessment (SUDCC, Military OneSource)
- ✅ Be honest with counselor (they can't help if you lie)
Related Guides
Remember: Substance abuse is treatable, not a character flaw. Military rates are higher due to stress, culture, easy access. Early treatment saves careers - waiting until DUI/discharge destroys careers. Free confidential help available (SUDCC, Military OneSource, TRICARE). Voluntary treatment = minimal consequences. Command-directed (after getting caught) = career at risk. Don't wait. Get help today.