Active duty and retired members of the armed forces are not immune to the substance use problems that affect the rest of society.The stresses of deployment during wartime and the unique culture of the military account for some differences in substance use between military members and civilians. Those with multiple deployments, combat exposure, and related injuries are at greatest risk of developing substance use problems. NIDA continues to examine the trends in substance use in specific populations, including military personnel, and to search for better methods for preventing and treating substance use disorders that are specific to these populations. Learn more in the DrugFacts: Substance Use and Military Life.
NIH Multi-Institute Research Initiatives
Zero-tolerance policies and stigma pose difficulties in identifying and treating substance use problems in military personnel, as does lack of confidentiality that deters many who need treatment from seeking it.
Those with multiple deployments are more apt to engage in new-onset heavy weekly drinking and binge drinking, to suffer alcohol- and drug-related problems, and start smoking or relapse to smoking. Like civilians, they risk addiction to opioid pain medicines prescribed after an injury.
NIDA is currently funding studies in this area. The links below will take you to the project descriptions in the NIH RePORT database. You can also find recent publications of NIDA-funded research in the PubMed database. In addition, there are many clinical trials currently open to military personnel and veterans. For more information, see our Clinical Trials page.
NIH multi-Institute research initiatives:
- NIH and VA address pain and related conditions in U.S. military personnel, veterans, and their families
- Studies on Combat-Related Substance Use and Abuse to be Funded by NIH and VA
- Federal agencies partner for military and veteran pain management research
- Management of Opioid Therapy (OT) for Chronic Pain (2017) - VA/DoD Clinical Practice Guidelines (U.S. Department of Veterans Affairs)
- Annual Evaluation of the TRICARE Program (Health.mil)
- Alcohol and Substance Abuse Disorders (Congressionally Directed Medical Research Programs (CDMRP)
- Pain: U.S. Military and Veterans (National Center for Complementary and Integrative Health, December 2016)
- Prevalence of Past Year Substance Use and Mental Illness by Veteran Status in a Nationally Representative Sample (PDF, 2MB) (SAMHSA, The CBHSQ Data Review, November 2016)
- Military Drug Take-Back Program offers safe drug disposal (Health.mil, September 2016)
- Veterans' Primary Substance of Abuse is Alcohol in Treatment Admissions (SAMHSA, The CBHSQ Report, November 10, 2015)
- 1 In 15 Veterans Had A Substance Use Disorder In The Past Year (SAMHSA, The CBHSQ Report, May 7, 2015)
- FDA and the Department of Defense: A Joint Force to Reduce Tobacco Use in the Military (FDA blog, September 2015)
Service members, veterans, and their families who need help dealing with substance use issues may find the following resources helpful:
- Become a Smokefree Veteran
- U.S. Department of Veterans Affairs (VA), Treatment Programs for Substance Use Problems
- VA National Center for PTSD
- SAMHSA, Veterans and Military Families
- SAMHSA Treatment Locator or 1-800-662-HELP
- Military Officers Association of America, Veterans and Opioid Addiction
VHA's Opioid Safety Initiative Toolkit
The VHA recognizes the clinical challenges to successfully managing pain and prescribing safely for our veterans while implementing the Opioid Safety Initiative (OSI) Directive and the Informed Consent Directive. The National Pain Management Program office convened a national task force comprising multidisciplinary pain exerts to create an OSI Toolkit (evidence-based to the extent possible) to help guide the field.
The resulting toolkit contains documents and presentations that can aid in your clinical decisions about starting, continuing, or tapering opioid therapy, and other challenges related to safe opioid prescribing. You may find these tools useful for your clinical teams caring for veterans with chronic pain.
Opioid Safety Initiative Toolkit Materials
- Acute Pain Provider Guide - Acute Pain Management Opioid Safety VA Educational Guide (2017) (PDF, 4MB)
- Chronic Pain Provider Guide - Transforming the Treatment of Chronic Pain Moving Beyond OpioidsA VA Clinician’s Guide (2017) (PDF, 10MB)
- Pain Quick Reference Guide - Transforming the Treatment of Pain A Quick Reference Guide (2017) (PDF, 3MB)
- Effective Treatments for PTSD: Consider Cognitive Behavioral Therapy (CBT) as First Line Treatment - for Clinicians (PDF, 302KB)
- PTSD Overview – for Patients (PDF, 181KB)
- Effective Treatments for PTSD: Helping Patients Taper from Benzodiazepines – for Clinicians (PDF, 275KB)
- Benzodiazepines Overview - for Patients (PDF, 175KB)
- Cognitive Behavioral Therapy for Chronic Pain - Therapist Manual (PDF, 4MB)
- Consent Form for Long-Term Opioid Therapy for Pain (PDF, 1MB)
- TAKING OPIOIDS RESPONSIBLY - Patient Information Guide on Long-Term Opioid Therapy for Chronic Pain (PDF, 189KB)
If you have any questions or suggestions, please contact: Your VISN or facility Pain Point-of-Contact (POC) through, email Pamela Cremo.
- MEDLINEplus Health Information on Drug Abuse (National Library of Medicine, NIH)
- Healthfinder.gov (U.S. Department of Health and Human Services)
Clinical trials are research studies in human volunteers conducted to answer specific health questions. Learn about the NIH-sponsored clinical trials available to you.