You may have heard stories about detox for veterans and active-duty military, but do you know what actually happens? Painful? Possibly, but manageable, if done under medically-supervised care with therapeutic support. Read on to learn more about this important first step on the road to recovery.
Why Detox Matters for Veterans with PTSD and Addiction
Detoxification (detox) is the foundation for veterans ready to recover from both addiction and Post-Traumatic Stress Disorder (PTSD). It sets the stage for safe, effective, and lasting recovery. Due to their military experiences, veterans face unique challenges such as higher rates of trauma, stress, and co-occurring mental health conditions. These significantly increase the risk of substance use disorders [1].
The Link Between Trauma and Substance Use
About 8% of people who have experienced trauma go on to develop PTSD in the course of their lifetime. Military life is linked with substance use problems, and military personnel are at greater risk of developing an addiction if they have had:
- Multiple deployments
- Combat exposure
- Combat-related injuries
- Post-deployment civilian/reintegration challenges
According to NIDA, reported rates of illicit drug use increase when active duty personnel leave military service. Although cannabis misuse is the highest among substances, 10.7% of veteran admissions to substance use treatment centers were for heroin, followed by cocaine at just over 6%.
Of veterans presenting for first-time care within the VHA system, close to 11% meet criteria for an SUD diagnosis. Veterans with SUDS commonly meet the criteria for co-occurring mental health disorders such as PTSD, depression, and anxiety [2].
Veterans can develop PTSD following exposure to traumatic events during service. Common symptoms such as flashbacks, nightmares, hypervigilance, and emotional numbness often lead veterans to self-medicate with alcohol or drugs as they try to manage distress [3].
A destructive cycle of self-medication ensues for many seeking temporary relief. Ultimately, however, this worsens PTSD symptoms and heightens vulnerability to addiction.
Severe or chronic stress affects brain circuits that are involved in reward, motivation, and learning. Stress can also increase someone’s craving and decrease their ability to control how they respond to impulses. Addiction affects these same brain processes [1].
Veterans or active-duty military with both PTSD and addictions (known as dual diagnosis or co-occurring disorders) need integrated treatment. This treats both conditions simultaneously, since treating only one can leave the other unaddressed and increase the risk of relapse.
Risks of Detoxing Without Medical Support
Detox can cause uncomfortable physical symptoms and this is one of the number one causes of relapse when military personnel try to detox on their own (”cold-turkey”) or with others (“social detox)”. While this can be done for mild addiction, it is dangerous for those with deeper addictions.
Here are some of the main risks in detox [4]:
- Severe Withdrawal Symptoms: Abruptly stopping substance use can trigger intense and sometimes life-threatening withdrawal symptoms, including seizures, hallucinations, delirium tremens, heart problems, and severe psychological distress.
- Increased Risk of Relapse: The discomfort and danger of withdrawal often drive individuals to resume substance use to alleviate symptoms, undermining recovery efforts. Without medical supervision, the likelihood of relapse is significantly higher.
- Medical Complications: Some substances, like alcohol, benzodiazepines, and opioids, can cause fatal complications if detox is not medically managed. Symptoms such as dehydration, respiratory problems, and cardiac events require immediate medical attention.
- Lack of Psychological Support: Detoxing without professional support leaves veterans without the coping strategies, peer support, and trauma-informed care necessary to manage both PTSD and addiction. This isolation can worsen mental health symptoms and hinder long-term recovery.
Detox is a vital, potentially life-saving step for veterans with PTSD and addiction. Attempting detox without medical support is dangerous and can worsen both physical and psychological symptoms. Professional, veteran-specific treatment ensures safety, addresses the root causes of addiction, and provides the best chance for lasting recovery.
What to Expect At a Veterans Detox Center
Once you are assessed and admitted for detox, medical staff will greet you, make you as comfortable as possible in your private room, explain the process, and answer any questions you may have. This is done while respecting your confidentiality.
The best detox programs are tailored to the client’s individual needs, health, severity of addiction, and where they are in recovery. During your withdrawal the medical team will provide around-the-clock care, monitoring vital signs and helping you manage withdrawal pain or cravings.
After you complete withdrawal (typically 7 to 10 days), transitional services help you receive effective treatment either in a residential rehab or intensive outpatient program (IOP). These provide you with evidence-based therapies, medication management, and social support to increase long-term recovery success.
Why Professional, Veteran-Specific Detox and Treatment Matters
There are three main reasons why professional veteran-specific detox is important:
1. Medical Supervision and Withdrawal Management
In a professional setting, withdrawal symptoms are managed safely, and medications can be used to ease discomfort and prevent complications.
2. Supportive Environments Tailored for Veterans
Veteran-focused programs provide a sense of community and understanding, with a shared background of military experiences. This reduces isolation and increases motivation for recovery.
3. Emotional Support During Early Recovery
Withdrawal in detox is an emotional experience as veterans cope with the pain and discomfort of withdrawal itself and trauma-related feelings which may have been suppressed by substance abuse. Professional therapeutic and counselling offer support during the final stages of withdrawal and transition to the next level of care.
Trauma-Informed Care and Dual Diagnosis Treatment
Following detox and working from a trauma-informed framework, therapists provide a range of therapy approaches and support during recovery.
- Trauma-Informed Therapies: Veteran-specific programs offer therapies designed to address both PTSD and addiction, such as Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy, Dialectical Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT) [5].
- Dual Diagnosis Treatment: By treating the physical, medical, and psychological dimensions of both substance abuse and trauma, the therapeutic team seeks to help you uncover the root causes of these behaviors. With the knowledge and insight gained as you process this information and your emotions, you will be helped to safely and securely advance on your recovery journey.
- Comprehensive Recovery: The best programs also address reintegration challenges, offering life skills training, vocational support, and ongoing aftercare to support long-term sobriety.
From Detox to Long-Term Recovery
Detox is the first important step, and may be tough, but the real work begins in residential or outpatient care.
After detox, moving into residential or outpatient care is a pivotal step for veterans with PTSD and addiction. It supports sustained recovery and addresses the complex interplay of trauma and substance use. In both models staff will create a personalized recovery plan together with you.
Transitioning to Residential Rehabilitation (Inpatient) Care
Residential programs, such as those offered by the VA, provide 24/7 structured support in a safe environment for veterans with PTSD, substance use disorder, and other mental health conditions.
These programs are veteran-centered and individualized, integrating evidence-based therapies, medication management, and support for co-occurring medical or social challenges like housing and employment.
Group therapy and peer support foster a sense of community and help veterans feel less isolated as they work through trauma and addiction.
Where available, transitional housing and Compensated Work Therapy-Transitional Residence (CWT-TR) programs help veterans develop independence, job skills, and community reintegration while continuing treatment.
Transitioning to Outpatient Care
Outpatient programs allow veterans to receive therapy, counseling, and medication management while living at home or in transitional housing.
These services are flexible and can be tailored to the veteran’s schedule, making them ideal for those with work or family obligations.
Outpatient care is often a step-down from residential treatment, providing ongoing support as veterans build skills for independent living and relapse prevention.
Community-based outpatient programs may include trauma-informed counseling, substance abuse treatment, and family support sessions to address both immediate and long-term needs.
Questions to Ask When Choosing the Right Detox Center
Selecting the right detox center is essential for veterans with PTSD and addiction. Choosing a detox center that can respond thoroughly and transparently to these questions can significantly improve the chances of a safe, effective recovery for veterans with PTSD and addiction:
- Does the center specialize in treating veterans and co-occurring disorders?
- What types of therapies and treatments are offered?
- Is medical detox available and supervised by qualified professionals?
- What level of care is provided (inpatient, outpatient, or both)?
- Are family and peer support services included?
- How does the center coordinate with the VA or other veteran services?
- What amenities and accommodations are available?
- What is the staff-to-patient ratio and staff qualifications?
- What is the aftercare or relapse prevention plan?
- What insurance coverage is there and what other costs are there?
- When can I tour the facility or speak with alumni?
Confidential Help Is One Call Away at Miramar Health
Miramar Health is a veteran-owned and operated recovery program exclusively serving veterans. Our mission is to free veterans from America’s mental health and addiction crisis and to empower them to create a better future for themselves and their families.
We understand the complex nature of trauma and offer individualized treatment options that are specific to veterans. Take the first step to your recovery. You’re not alone. Reach out to our Admissions team today.
Sources
[1] National Institute on Drug Abuse. 2024. Trauma and Stress.
[2] US Department of Veterans Affairs. National Center for PTSD. Substance Use and PTSD.
[3] National Institute on Drug abuse. Substance Use and Military Life DrugFacts.
[4] Detoxification and Substance Abuse Treatment [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 45.) 4 Physical Detoxification Services for Withdrawal From Specific Substances.
[5] Norman, S. et al. Overview of Psychotherapy for PTSD. US Department of Veterans Affairs. National Center for PTSD.
