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Opioid Abuse in Veterans: Risk Factors, Signs & Treatment

Last Updated: December 26, 2023

Editorial Policy | Research Policy

For veterans, opioid misuse can pose serious risks, but there are numerous avenues for opioid addiction treatment and support.

Opioid Misuse in Veterans: An Overview

The opioid epidemic among veterans is a significant concern. Studies have revealed the extent of opioid misuse within this group:

  • In the year prior to a survey, 2.5% of veterans misused opioids, encompassing heroin and prescription painkillers.
  • Out of all veterans, 490,000 misuse prescription painkillers, 57,000 are heroin users, and 53,000 misuse both heroin and prescription painkillers.
  • Oxycodone is the most commonly abused substance among veteran opioid misusers, with 9.4% choosing it.
  • Opioid use disorder (OUD), a clinical term for opioid addiction, affects 0.5% of veterans aged 18 and older.

Research also indicates that veterans are twice as likely as the general population to die from accidental opioid overdoses.

Unique Risk Factors for Opioid Addiction & Overdose in Veterans

While anyone can fall victim to opioid addiction and overdose, veterans face unique risk factors that increase their vulnerability to these negative outcomes. Factors such as military service, the challenges of transitioning to civilian life, and the presence of mental health conditions can elevate the risk of opioid misuse.

PTSD & Other Co-Occurring Mental Health Disorders

Veterans with co-occurring mental health conditions, such as PTSD and depression, may turn to opioid misuse as a way to cope with emotional pain. Nearly one-third of veterans seeking treatment for substance use disorders (SUD) also have PTSD. Additionally, opioids can temporarily alleviate symptoms of depression, which can be appealing to veterans experiencing suicidal ideation alongside depression.

Chronic Pain & Opioid Misuse

Injuries sustained during military service can lead to chronic pain, potentially resulting in opioid misuse when veterans become dependent on prescribed pain medications. Combat-wounded veterans are at a higher risk of opioid misuse compared to the civilian population, highlighting the connection between pain and opioid addiction.

Coping with Military Sexual Trauma

Military sexual trauma (MST), experienced by both men and women, can increase the risk of opioid addiction. Veterans may use substances like opioids to numb the emotional pain stemming from MST. Studies have shown that veterans with a history of MST are 50% more likely to develop opioid addiction.

Battling Social Isolation

Veterans, often dealing with mental health challenges, chronic pain, and limited mobility, are susceptible to social isolation. This isolation can lead to chronic loneliness, elevating the risk of opioid misuse. Additionally, isolated veterans may lack immediate assistance during an overdose, increasing the potential for fatal outcomes.

The Link Between Homelessness & Opioid Misuse

Veterans face a higher risk of homelessness compared to civilians, which can exacerbate opioid addiction. Homeless veterans are more likely to misuse substances, lack social support, and remain vulnerable to fatal overdoses due to reduced access to emergency assistance.

Barriers to Healthcare Access

Limited access to healthcare for veterans increases the risk of opioid addiction and overdose. Veterans underutilize healthcare services, resulting in reduced medical oversight. The lack of regular contact with healthcare providers can lead to insufficient education and information about opioid medications, their side effects, and proper usage.

Recognizing Signs of Opioid Addiction in Veterans

Identifying signs of opioid addiction in veterans is crucial for early intervention and support. Some common signs include:

  • Mood swings
  • Secretive behavior
  • Deviation from prescribed medication instructions (such as using larger doses, crushing, or snorting pills)
  • Neglecting relationships and hobbies due to opioid preoccupation
  • Inability to reduce opioid use
  • Developing tolerance, requiring larger quantities for the same effect
  • Experiencing withdrawal symptoms when not using

Treatment & Support Options for Veterans With Opioid Use Disorder

A variety of treatment modalities and support resources are available for veterans seeking recovery from opioid use disorder (OUD). Treatment typically involves a combination of these approaches:

Therapy & Psychiatric Medication

Given the frequent co-occurrence of OUD and mental health conditions like PTSD and depression, veterans often engage in therapy and may use psychiatric medications to address these issues. Cognitive-behavioral therapy (CBT), including cognitive processing therapy (CPT) and prolonged exposure (PE), has proven effective for veterans with co-occurring PTSD and OUD.

VA Naloxone Access

Veterans at risk of opioid overdose can access naloxone, a life-saving medication that can reverse opioid overdoses. Veterans can obtain naloxone for free by consulting their VA provider.

Peer Support Groups

Peer support plays a vital role in veterans’ addiction treatment. Support groups provide a safe space for discussing the challenges of recovery and connecting with peers facing similar difficulties.

Involving Friends & Family

Including friends and family in the treatment plan provides veterans with social support, reducing the risks associated with social isolation. Family members can participate in family counseling to learn how best to support the veteran in their life.

Comprehensive Drug Rehabilitation

Veterans with OUD often benefit from comprehensive drug rehabilitation programs. These programs can be either inpatient or outpatient, with medical detox typically being the first step due to severe opioid withdrawal symptoms. Rehab programs may include individual therapy, group counseling, medication management, and support groups.

Support for Veterans Struggling With Opioid Addiction

For veterans seeking addiction treatment, The Recovery Village Atlanta inpatient facility offers specialized care for addiction and co-occurring mental health disorders like PTSD. As a member of the VA Community Care Network, our staff is specially trained to assist veterans in their recovery journey.


Substance Abuse and Mental Health Services Administration. “2020 National Survey on Drug Use and Health: Veteran Adults“>2020 Nat[…]eteran Adults.” July 2022. Accessed November 10, 2023.

Bennett, Alex; Watford, J. Alexander; Elliott, Luther; Wolfson-Stofko, Brett; & Guarino, Honoria. “Military Veterans’ Overdose Risk Behavior: Demographic and Biopsychosocial Influences“>Military[…]al Influences.”Addictive Behaviors, December 2019. Accessed November 10, 2023.

U.S. Department of Veterans Affairs. “PTSD and Substance Abuse in Veterans“>PTSD and[…]e in Veterans.” Accessed November 10, 2023.

Riblet, Natalie; Kenneally, Lauren; Shiner, Brian; Watts, Bradley. “Healthcare processes contributing to suicide risk in veterans during and after residential substance abuse treatment“>Healthca[…]use treatment.” Journal of Dual Diagnosis, 2019. Accessed November 10, 2023.

Dembek, Zygmunt; Chekol, Tesema. “The Opioid Epidemic: Challenge to Military Medicine and National Security“>The Opio[…]onal Security.” Military Medicine, 2020. Accessed November 10, 2023.

National Center for PTSD. “Effective Treatments for PTSD:“>Effectiv[…]nts for PTSD:

Consider Cognitive Behavioral Therapy (CBT) as First Line Treatment“>Consider[…]ine Treatment.” January 2015. Accessed November 10, 2023.

U.S. Department of Veterans Affairs. “Academic Detailing Services – Opioid Overdose Education & Naloxone Distribution (OEND)“>Academic[…]bution (OEND).” Accessed November 10, 2023.