The War on Addiction Comes Home
Combat veterans with PTSD and Traumatic Brain Injuries are suffering from skyrocketing rates of addiction, alcoholism and suicide. Thirty-five years after Vietnam, is America creating another lost generation?
Every war has its “signature” wound. In the Civil War, it was gangrene; in World War I, it was lungs shredded by mustard gas attacks; in World War II, shrapnel. In Iraq and Afghanistan, it's Traumatic Brain Injury, or TBI. With armored Humvees and new body protection, soldiers are surviving massive IED blasts that send huge shock waves through their bodies. The concussive force of five artillery shells exploding beneath a vehicle damages a soldier's brain in ways researchers are just starting to understand.
The symptoms of TBI are similar to those of post-traumatic stress disorder (PTSD); one of the main commonalities is, of course, increased alcohol and drug use. Take First Sergeant Hector Matascastillo, a warrior’s warrior. He finished top of his class in Ranger training, and had boots on the ground in 57 countries with a whopping 13 combat deployments in an 18-year career in the military.
“Multiple tours and violent conflict generate PTSD. Add to that the worst economy since the Great Depression, traumatic brain injury, and suicide and divorce rates that are off the charts—there is going to be a tsunami of addiction, alcoholism and homelessness.”
Seven years ago he was on a “house cleaning” operation in Iraq, sweeping room to room, a pistol in each hand, ferreting out enemy combatants. “My training had taught me that when faced with an armed enemy to kill him,” he says.
This house was clear, but as Matascastillo stepped outside, an enemy stood directly in front of him with his gun raised. Matascastillo’s weapons were at his sides. He was wondering why the man hadn't instantly fired when, inexplicably, the enemy began backing away with his gun raised. Then he tripped on a curb. Matascastillo raised his sidearm and just as he was about to open fire, he heard his wife screaming behind him.
Suddenly, he realized he was standing in front of his modest home in Lakeville, Minnesota. Police lights were flashing all around him. He emerged from a nightmare to a life marked by increased drinking, to nights when he had to "Nyquilize" himself to sleep. This time, a late-night fight with his wife had led to this moment, an extreme manifestation of the damage of Post Traumatic Stress Disorder.
Matascastillo is one of thousands of vets who've dealt with the harrowing transition from combat to civilian life and the complications of substance abuse. Unlike Hector, though, most remain silent, and countless go untreated. The consequences are grave: A recent study reported that a veteran commits suicide every 80 minutes; another determined that in 2009, 1,868 veterans from the wars in Iraq and Afghanistan tried to kill themselves. Clearly, not enough is being done to help.
Defense attorney Brock Hunter has made a study of the relationship between soldiering and booze. “PTSD and alcohol have gone together for as long as there has been war,” he says. “There are clear images of combat soldiers using alcohol going back to Homer and The Iliad.” Alcohol works well for soldiers trying to manage the flashbacks, insomnia, anger and anxiety of PTSD and TBI, Hunter says. “Some veterans have told me that their prescriptions for PTSD are not as effective as alcohol at managing nerves and anxiety. Alcohol is by far the most popular and widely abused [drug in the military]—and the most likely to get them in trouble with the police.”
Hunter specializes in representing veterans who get into legal scrapes, mostly due to PTSD and related alcohol and drug use. And he has seen a dramatic spike in caseload in the last six months. “It's scary,” he says. “I am getting three or four calls a day.”
Lisa Jaycox, project co-leader of a 2008 Rand report on veterans, said, "If PTSD and depression go untreated or are under-treated, there's a cascading set of consequences: Drug use, suicide, marital problems and unemployment."
Veteran’s advocates like Hunter expect the percentage of veterans suffering from PTSD to be far higher than during previous wars. “The United States has the smallest military in our history,” says Hunter, “and we are fighting the two longest wars. Two or three combat tours is commonplace, with some serving as many as eight deployments. And the combat is brutal: face-to-face, hand-to-hand in the street in an urban civilian environment.”
Soldiers returning from the Vietnam War with PTSD led to a wholesale reform of how vets are treated. Veteran’s advocates like Hunter and Shad Meshad, founder of National Veterans Foundation, made sure vets kept benefits if they sought help for mental illness, worked to get services like alcohol treatment programs at VA hospitals, and devised ways to fill holes in VA services—resources like the Vets Clinic, or Military OneSource, a VA facility that protects confidentiality of its patients.
Hunter wants to build on that. In response to the cases he has in Minnesota, he has helped establish a “Veteran's Court” in Hennepin County, Minnesota. He and Meshad are writing a book for other attorneys to help them represent veterans better in the legal system. Says Meshad, “These men and women deserve therapy first; the violence is a result of their PTSD, and they are trained killers.”
Meshad has worked with veterans for over 40 years, helping soldiers from World War I on. He has appeared on Dateline and been quoted in the New York Times, and he was also once held hostage by a disgruntled vet for hours (he later made the veteran a partner in one of his organizations; they're close friends today). He has slept on the streets with homeless vets and testified before Congress. Meshad is not easily rattled, but this time around, with these wars, he's afraid.
“Multiple tours and violent conflict generate PTSD," he says. "Add to that the worst economy since the Great Depression, high incidence of traumatic brain injury, and suicide, violence and divorce rates that are off the charts—there is going to be a tsunami of addiction, alcoholism and homelessness.” According to Meshad, “Los Angeles has the largest homeless population in the country and a third are veterans. It took 15 years for the Vietnam vets to start showing up under the 405 bridge. The Iraq and Afghanistan kids are up there now.”