Substance Use Disorders, Stigma, and the Military: Breaking the Silence

Substance use disorders (SUDs) affect individuals across all walks of life, but those serving in the military often face unique challenges when dealing with these conditions. The pressures of military service, combined with the pervasive stigma surrounding SUDs, create significant barriers to seeking treatment. Addressing the challenges surrounding stigma and SUDs is critical for ensuring the well-being of service members and veterans while promoting a culture of wellness and support.

The Prevalence of Substance Use in the Military

Substance use is a complex issue within military contexts. Research has shown that service members are at increased risk of misusing substances such as alcohol, prescription medications, and, in some cases, illicit drugs. Contributing factors for active service members often include the high-stress environment of military life, exposure to trauma, and the physical demands of the job. 

After leaving the military, veterans may face additional challenges. This may include behavioral health disorders such as post-traumatic stress disorder (PTSD), depression, and adjustment disorder, which are often intertwined with SUDs. These struggles can escalate without proper intervention, leading to severe personal and professional consequences.

The Role of Stigma

Stigma plays a profound role in substance use disorders (SUDs), shaping how individuals experience their condition, whether they seek help, and how society responds to their struggles. It can create barriers to recovery by perpetuating shame, misinformation, and discrimination. Understanding the role of stigma in SUDs is crucial to building a more compassionate and effective approach to treatment and support.

What is Stigma?

Stigma refers to negative stereotypes, judgments, and prejudices directed toward individuals with a particular condition or characteristic. In the context of SUDs, stigma is seen in personal attitudes, societal norms, and institutional practices, often painting those struggling with addiction as morally weak, irresponsible, or unworthy of support.

Types of Stigma: Substance Use Disorders (SUDs) are accompanied by several types of stigma, each affecting individuals in unique and harmful ways. Understanding these forms of stigma is crucial to dismantling them and creating a more supportive environment for recovery. 

1. Self-Stigma: People with SUDs often internalize societal judgments, believing they are flawed or beyond help. This self-stigma can lead to feelings of shame, isolation, and low self-worth, which may discourage them from seeking treatment.
2. Social Stigma: Society frequently views substance use as a choice rather than a medical condition. This misconception fosters stereotypes that those with SUDs lack discipline or character, reinforcing exclusion and discrimination in social and professional settings.
3. Structural Stigma: Institutional policies and practices often reflect and perpetuate stigma. Within the Military, structural stigma can present as:
   • Perceived Weakness: Many service members fear that seeking help for a SUD will be seen as a sign of weakness or a lack of discipline, which can harm their careers and reputations.
   • Career Implications: The potential for career repercussions, such as being deemed unfit for duty or losing security clearances, deters many from seeking the treatment they need.
   • Cultural Barriers: The “tough it out” mentality often ingrained in military culture can discourage open discussions about struggles with substance use and mental health.

Breaking the Cycle

Combating stigma and supporting those with SUDs requires a multifaceted approach. Efforts should focus on education, policy changes, and the promotion of a supportive culture within the military:

• Education and Awareness: Increased education about SUDs should be integrated into military training. Normalizing these conversations can reduce stigma and encourage service members to seek help early.
• Accessible Treatment: Expanding access to confidential, evidence-based treatment options ensures that individuals can seek help without fear of repercussions. 
• Language Matters: Using person-first language, such as “a person with a substance use disorder” instead of “addict,” emphasizes the individual rather than the condition, reducing stigmatization.  Other examples of the impact of language and stigma include “Clean” vs. “In Recovery” or “Substance-Free; “Drug Abuse” vs. “Substance Misuse”; “Enabling” vs. “Supporting Recovery”.  For more information on the impact of language and stigma, please see the resources listed below.
• Leadership Involvement: Military leaders have a responsibility to model openness and support for mental health initiatives. When leaders demonstrate compassion and understanding, it sets a powerful example for everyone.
• Community Support: Building inclusive support networks and encouraging open conversations about addiction can create environments where individuals feel safe seeking help.

Conclusion

Addressing substance use disorders (SUDs) within the military is crucial for the well-being of our service members and veterans. Unfortunately, the stigma surrounding these issues often silences those in need of help. By fostering open dialogue and understanding, we can dismantle barriers to treatment, create a supportive environment, and ultimately enhance the mental health and readiness of our military forces. It’s time to break the silence and encourage those affected to seek the assistance they deserve.

References and Resources:

• OneOp webinar – Drug Trends in Military Adults: Essential Insights for Mental Health Professionals
• Addiction Language Guide. (n.d.). https://www.in.gov/recovery/files/Stigma-AddictionLanguageGuide-v3.pdf
• SAMHSA’s Center for the Application of Prevention Technologies – Words Matter: How Language Choice Can Reduce Stigma. (n.d.). https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/Words-Matter-How-Language-Choice-Can-Reduce-Stigma.pdf
• ‌Words Matter – Terms to Use and Avoid When Talking About Addiction. (n.d.). https://doi.org/10.1080/10826084.2019.1581221?journalCode=isum20
• ‌The Real Stigma of Substance Use Disorders – Recovery Research Institute. (2010). Recovery Research Institute. https://www.recoveryanswers.org/research-post/the-real-stigma-of-substance-use-disorders/

Photo by Josue Verdejo from Pexels

John Haenes holds a master’s of science in social work and is an internationally certified prevention specialist with 32 years of experience in the field of substance use disorders, juvenile delinquency, trauma, and child welfare. Mr. Haenes is a recognized expert in addiction and adolescent brain development. He currently serves as the Chief Operations Officer of Challenge of Tarrant County, a non-profit agency in Fort Worth, TX, whose mission is to confront substance abuse by identifying needs, educating the community, mobilizing resources, promoting collaborations, and advocating for sound public policy.

Mr. Haenes presented a OneOp webinar on, Drug Trends in Military Adults: Essential Insights for Mental Health Professionals (https://oneop.org/learn/160056/).