We know how to train soldiers for war. We do it well. We teach them to embrace new rules of conduct in order to survive in combat. We are much better at preparing them for a life at war than we are at preparing them for life after they return. The plane ride from warzone to home takes less than a day, but the mental transformation can take much longer.
The norms of civilized society are ignored in war, and the norms of war are often a transgression in civilized society. The returning soldier is tasked with rewiring the very instincts that kept him or her alive in the combat zone. When left to do this alone, many will not be able to make the transformation successfully.
A while back, an Army veteran in our program told me that while serving as an infantryman in Afghanistan, he and his company would comb the mountains looking for Taliban and Al Qaeda fighters for up to ten days at a stretch. When they returned to their firebase from these long range reconnaissance patrols, they would smoke hash and/or marijuana to decompress. The hyper vigilance of being on point for such an extended amount of time affected their bio-rhythms, which affected their sleep. Their company commanders would turn a blind eye to the drug use -- as long as they could come down after a patrol, as long as they were ready when it came time to go outside the wire again, it didn't matter how they did it.
When this veteran came home he was so scared of his nightmares he turned more to drugs to stay awake and hyper-vigilant. When he eventually had to sleep, he would turn to alcohol and sedatives -- the more sedated he was, the easier it was to forget the bad dreams. This veteran, who had risked his life on intense patrols as a soldier, ended up being arrested for drunk and disorderly conduct after returning home.
Unfortunately, this veteran's story isn't unique. Studies have shown that service members exposed to combat are at greater risk for drinking or drug use. Alcohol abuse is the most prevalent problem and one which poses a significant health risk. A study of Army soldiers screened veterans 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk for related harmful behaviors (e.g., drinking and driving, using illicit drugs). Without adequate training to cope with the transformation back to normal life, this behavior should not be a surprise. But using drugs to numb the residual terrors of war only masks the problem momentarily, and often leads to depression and interpersonal problems. This contributes to the epidemic level of suicide among service men and women - more soldiers are dying from suicide than combat.
It's clear that we have to aggressively address this problem in order to save lives. We have to be more vigilant to identify substance abuse early, and to engage these young men and women in a way that will prompt them to accept treatment. We all have to become more aware of the price our service members pay to protect our freedom, and be ready to help them when they return.
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