Alcohol & substance use after service

Veterans who served in a combat zone are more likely to binge drink, drink heavily and have an alcohol use disorder than veterans who did not. A survey can’t prove combat caused this, but it shows where support is most needed.

Drinking close to bedtime gets in the way of restful sleep. DoD’s brain injury experts advise avoiding alcohol within two hours of bed.

Heavy drinking raises the risk of a traumatic brain injury, and a TBI can raise the risk of drinking problems. The risk is highest for people who drank heavily before the injury, people with milder TBIs, and people with other mental health conditions.

Bars and drinking can feel like the easiest place to find people who get it. Finding other ways to connect, like veteran groups, sports or volunteering, can meet the same need with less harm.

Each VA medical center has a PTSD-substance use specialist trained to help veterans with both. They, your primary care provider or your mental health provider can help you weigh treatment options.

Trauma-focused therapies, like Cognitive Processing Therapy, Prolonged Exposure and EMDR, are the most effective PTSD treatments, with or without a substance use problem. One therapy, called COPE, blends PTSD and substance use treatment.

Substance use therapies include

• Cognitive behavioral therapy
• Contingency management: rewards for staying substance-free
• Motivational enhancement: building your own reasons to change
• Relapse prevention

VA’s National Center for PTSD offers a confidential PTSD self-screen and a brief alcohol and drug use questionnaire online. They are not a diagnosis, but they can help you decide whether to talk with someone.

• Veterans will not be denied VA benefits because of marijuana use.
• Veterans are encouraged to talk about marijuana use with their VA providers.
• VA clinicians may not recommend medical marijuana.
• Using or having marijuana is not allowed at any VA medical center, location or grounds.

• Quit VET quitline: 1-855-QUIT-VET (1-855-784-8838), Monday to Friday, in English and Spanish
• SmokefreeVET: text VET to 47848 for 24/7 text support

VA’s free Stay Quit Coach app is designed to help veterans with PTSD quit smoking. Your VA provider can also talk with you about other ways to quit.

VA shares information on alcohol, opioid, stimulant and cannabis use disorders, and offers care for all of them. It also offers harm-reduction support to lower the risk of overdose and other health harms.

• Continuing care and relapse prevention
• Intensive outpatient treatment
• Marriage and family counseling
• Self-help groups
• Short-term outpatient counseling

VA residential programs offer structured, around-the-clock support, with on-site help for substance use, other mental health conditions, physical health, and needs like work and housing. More than 29,000 veterans used them in fiscal year 2025.

Contingency management is a proven approach where veterans earn chances to win small prizes, like canteen vouchers, for negative drug tests or for attending group sessions. Rewards grow with each week of progress. VA has used it at more than 100 sites.

If you served in a combat zone, you can get free private counseling and an alcohol and drug assessment at one of 300 community Vet Centers, even if you don’t have VA health care.

Groups like Alcoholics Anonymous, Narcotics Anonymous and SMART Recovery can help, alongside treatment. They don’t focus on PTSD, but many veterans find strength in them.

VA offers medically supervised withdrawal care (detox) to help veterans stop substance use safely and get stable. In an emergency, you can go to any VA medical center, whatever your discharge status.

1. Set a clear goal, like “no drinking on weeknights”.
2. Know your triggers: times, places, people and feelings.
3. Plan what you’ll do instead in those moments.
4. Find people who support you in changing.
5. Reward progress, and have a backup plan for slips.

VA offers harm-reduction support to lower the risk of overdose and other health harms during recovery. Ask your VA provider what that looks like for you.

VA says veterans will not be denied VA benefits because of marijuana use, and encourages veterans to talk about it with their providers.

In an emergency, you can go to a VA medical center whatever your discharge status. Combat veterans can get a free alcohol and drug assessment at a Vet Center, even without VA health care.

Help works at every stage. A short conversation or a confidential online check-in is a low-pressure way to start.

Peer specialists, mutual support groups and Vet Centers are full of veterans who have walked this road. Leaning on them is not weakness.

1. Pick a calm time when they are sober.
2. Name what you’ve noticed, without labels: “You’ve been drinking most nights since you got out.”
3. Say why you care: “I miss you, and I’m worried.”
4. Offer one specific step, like finding a Vet Center together.
5. Expect more than one conversation.

Set boundaries that keep you and any children safe. Lean on your own support, such as family counseling, a support group or a trusted friend.

• Alcohol-free veteran events and service projects
• Faith or community groups
• Mutual support groups
• Sports, fitness or outdoor groups

Finding people who support you in changing your drinking or use is one of the most helpful steps.

• Veterans Crisis Line: dial 988 then press 1, text 838255, or chat at VeteransCrisisLine.net
• Anyone in the U.S. can also call or text 988
• If a life is in danger or someone may be overdosing, call 911

• SAMHSA National Helpline: 1-800-662-4357 (1-800-662-HELP), free, confidential, 24/7, English and Spanish
• VA general information: 800-827-1000
• VA health care enrollment: 877-222-8387 (weekdays)
• Vet Center Call Center, 24/7: 877-927-8387

National Call Center for Homeless Veterans: 877-424-3838. Free, confidential, 24/7.

The Veterans Crisis Line chat works from anywhere with internet, and its website lists numbers for calling from overseas. You can also find a free local helpline at findahelpline.com.