Addicted Troops Get Silent Treatment

By Katie Drummond 09/16/12

They risked their lives for their country. Now, even as conflicts in the Middle East heat up, drug-struggling vets and active-duty soldiers find they can ask little in return.

Sean and Sharlene Knapp via author

For former Army Infantry Sergeant Sean Knapp, finding help for his addictions was a grueling, eight-year-long process. Even worse, it was one that nearly cost him, and his family, their lives.

After serving in the Army from 1994 to 2000, Knapp was honorably discharged and moved to Wisconsin, where he met and married his wife, Sharlene. It wasn’t long before the transition to civilian life, which he describes as “absolutely awful,” took a toll: Knapp sank into depression, started abusing narcotic pain pills and later turned to alcohol.

In 2007, he hit what everyone hoped was rock bottom: Knapp, brandishing a loaded gun, contained his wife and their two young children in their home while staging a four-hour standoff with police. “He was telling the police to shoot him,” Sharlene recalls. “He said he just wanted to die, but it was an obvious sign for help.”

Unfortunately, it wasn’t a sign that anyone at Veterans Affairs was paying much attention to: Despite being sent to a VA hospital, Knapp was offered little more than a once-a-week appointment with a psychologist. “It was almost like they were saying, ‘See how far you get alive, then we’ll help you,’” Sharlene says. “That they would do so little was truly incredible to us.”

Finally, when a nearly identical incident happened a year later, VA officials enrolled Knapp in an inpatient addiction treatment program. Two years and three stints in the program later, Knapp eventually kicked his habits.

Among the thousands of soldiers and veterans who’ve coped with addiction, Knapp’s story is arguably on the extreme end of the spectrum. But it highlights a vital shortcoming concerning the military’s treatment for addiction: Care, among those willing to seek it out, has long been difficult to access and only middling successful.

And with heightened tensions across the Middle East, the situation of today's troops and veterans threatens to grow even more dire. With the increasingly less dim prospect of these latest conflicts, precipitated again last week by a deadly assault on the US embassy in Libya, escalating into yet another war, the military is poised to continue its cycle of injury, PTSD, addiction and suicides. Accompanying that, of course, will be a federal budget even more frayed, potentially unable to help the rising tide of suffering soldiers.

On paper, the military looks to have its bases covered on the treatment front. Every service branch offers both inpatient and outpatient substance abuse programs for men and women on active duty. Early this year, for example, the Pentagon reported 215 different outpatient programs across the country.

For veterans, the VA offers several types of “substance use disorder” treatment programs, from once-a-week outpatient counseling to intensive, 28-day, 24-hour residential initiatives like the one that Knapp relied on for his recovery.

But despite the seeming breadth of services to help soldiers and veterans, myriad complications and defects keep many from getting often desperately needed help: Both the military and the VA are plagued by shortages of counselors and space; access to treatment remains a challenge, whether due to stigma, bureaucracy or geography; and because soldiers and veterans often suffer from a unique complexity of mental health problems (like PTSD) and addiction, the bar for successful treatment is unusually high.

This situation is increasingly dire as the veterans from the two Gulf wars come home and attempt, against unprecedented odds, including a stalled economy, to return to civilian life. (One bright spot: In August the unemployment rate for veterans hit a three-year low, 6.9%, thanks to recently implemented Obama administration initiatives.)

“It was like they were saying, ‘See how far you get alive, then we’ll help you,’” Sharlene says.

“In many ways, addiction is a universal phenomenon,” Amy Singer, senior vice-president at New York’s Phoenix House, a rehab center that offers special programs for addicted personnel and veterans. “The challenges we’re seeing in treating military populations, though, really puts them into a category of their own.”

It’s a category that, as the military and the VA admits, continues to grow. Where alcohol abuse is concerned, for example, the military saw a 56% increase among those seeking treatment between 2003 and 2010. Data on other types of addiction is outdated, but in 2009 the VA noted that 19% of current conflict veterans who sought mental health counseling were abusing at least one substance.

“The bottom line is, we don’t have accurate numbers,” Dan Abrahamson, a director at the Drug Policy Alliance who co-authored a 2009 report on military addiction, told the Navy Times. “Veterans are just getting lost as they come back home.”

Even for soldiers and veterans who don’t get lost, the military acknowledged a lack of adequate facilities for treatment seekers. Last year, former Army Vice Chief of Staff Peter Chiarelli warned that the service urgently needed another 130 qualified counselors merely to handle the current load of substance abuse cases, which is expected to grow as more soldiers endure repeat deployments or troubled transitions to civilian life. The problem “needs to be rectified as soon as possible,” he urged.

Among veterans, the crisis may be even more severe. The VA earlier this year announced plans to hire an additional 1,900 mental health counselors to tackle health problems including PTSD, depression and substance abuse among veterans.

But as a memo from leaders at the American Psychiatric Association noted earlier this year, the move will come too late for many: Most veterans, the APA noted, suffer long wait times to access initial help, and then only see their VA psychiatrist two to three times a year “due to access demands.” A 2012 report by the Government Accountability Office found that the average wait time for evaluations and benefit for active-duty troops was close to 400 days. 

In some parts of the country, such as Fort Harrison near Helena, Montana, VA clinician shortages are so severe that newly built clinics can’t even open. Officials at Fort Harrison said they can’t recruit enough staff to open a year-old, $7 million inpatient facility for veterans with mental health or substance abuse problems—forcing vets to seek help from VA clinics in other states.

“I’m very comfortable in the knowledge that even though we don’t have those programs up and running, the veterans are getting a high standard of care where we are sending them,” Robin Korogi, director of Montana’s VA healthcare system, told the Billings Gazette in March. “My number-one goal is that they get the treatment they need.”

The quality of that treatment, however, remains an open question.

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Katie Drummond is a is the deputy editor of Medium. She has been a reporter for Forbes magazine, a contributing editor at The Daily, and a freelance writer for outlets including, New York magazine and Prevention. You can find her on Linkedin and Twitter.