Veterans and Cocaine Addiction: Treatment and Rehab Centers

Veterans struggle with substance use, just like any sector of the American populace. While drug use amongst veterans varies, cocaine abuse and addiction remain persistent problems amongst veteran communities. Veterans may use cocaine for a variety of reasons. Some veterans may use cocaine in an attempt to manage symptoms of depression or post-traumatic stress disorder (PTSD) or to try and decrease inhibition that may have developed in connection with a traumatic brain injury (TBI). Others may use cocaine due to its mental and emotional effects, such as feelings of increased confidence and energy.

Cocaine abuse can quickly spiral into an addiction. Past studies have estimated that roughly 11% of veterans who visited the Department of Veterans Affairs (VA) for the first time met criteria for a substance use disorder diagnosis.¹ Other studies have demonstrated that roughly 4% of veterans report having used any type of illegal drug within the prior month, with 1.7% reporting that they had used something other than marijuana.¹ While these particular figures don’t specifically delineate the pervasiveness of cocaine use amongst veterans, it remains an issue that many struggle with. It’s important for veterans to recognize the warning signs of cocaine abuse and addiction, and to know the support options available to them.

What is Cocaine?

Cocaine is a highly addictive stimulant derived from the coca plant.^{2, 3} Pharmaceutical cocaine is a Schedule II substance, meaning there are some legitimate medical uses for the drug, though they are quite limited. Despite these uses, cocaine is also recognized as having a high potential for abuse and severe dependence.² Illicitly manufactured cocaine is commonly encountered in two forms: powdered cocaine that is most often snorted or injected, and crack cocaine, a free base form of the drug processed into crystalline rocks which are then smoked.^2,3

All forms of cocaine, whether it be powdered cocaine or crack, are incredibly addictive because of their pharmacological effects in the brain. After ingestion, those who use cocaine may experience an intense high that fades quickly. During this process, cocaine alters brain chemistry in a manner that results in a surge of dopamine activity, resulting in a rewarding sense of euphoria. ^{2, 3, 4} In stimulating the reward region of the brain, repeated cocaine use is reinforced.² Continued cocaine use can result in tolerance to the drug.³ As a result, some chronic cocaine users may find themselves needing to gradually increase their use to achieve a desirable high.³ 

Cocaine use is fairly common throughout the United States. In 2019, 5.5 million Americans aged 12 or older used some form of cocaine within the last year.⁵ Nearly 780,000 of those people had used crack cocaine in the last year.⁵ While not all these individuals will develop an addiction to cocaine, it is estimated that nearly 1 million people did struggle with cocaine addiction—or, what’s diagnosed as a cocaine use disorder.⁵

Cocaine Use in Veterans

Veterans may be at greater risk for developing addictions to various drugs, including cocaine.⁶ Stressors such as mental illness, grief, pain, exposure to combat or other types of trauma, and difficulties reintegrating back into civilian life may be associated with this increased risk.⁶  Cocaine use amongst veteran populations appears to be prevalent. In 2018, 1.1 percent of the veteran population over the age of 18 (nearly 235,000 individuals) reported having used cocaine within the last year, and roughly 72,000 veterans ages 26 or older had reported past month cocaine use.⁷ Even isolated use can lead to additional problems, as cocaine’s reinforcing properties could potentially put many veterans at risk for addiction.

Causes and Risks

Several factors can increase the risk for veterans developing cocaine addictions. Being deployed in the military can be a highly stressful time, and may involve exposure to combat, trauma, military sexual trauma, or injuries. Furthermore, various issues can arise upon reintegration into civilian life.¹ Causes and risk factors of cocaine addiction in veterans may include:^{1, 6}

• Losing the social support and structure associated with the military upon separation.
• Mental health issues such as depression, anxiety, or PTSD.
• Stressors such as unemployment or homelessness.
• Struggling with readjusting to family life and a role that may have changed during military service.

Side Effects

Cocaine can have undesirable or harmful effects on the body, some of which are potentially fatal. This is especially true when cocaine is taken in large doses or combined with alcohol or other drugs.²  In its various routes of use, cocaine can result in adverse physical, mental, and behavioral effects including:^{2, 3, 4, 8, 9, 10}

• Inability to sleep.
• Irritability.
• Restlessness.
• Anxiety or panic.
• Paranoia.
• Psychosis, involving hallucinations and a loss of touch with reality.
• Increased sensitivity to sensory stimuli.
• Rambling or rapid speech.
• Strange, unpredictable, and violent behavior.
• Impaired memory, attention, decision making, and motor skills after chronic use.
• Chest pain.
• Abnormal heart rhythms.
• Damage to the heart muscle.
• Loss of appetite.
• Shaking or twitching muscles.
• Seizures.
• Coma or sudden death.

Impacts

Cocaine can negatively impact many areas of your life, including your physical and mental health. This may be particularly true for veterans, especially those who have other mental, physical, or social issues. Using cocaine can result in major short-term and long-term problems.^{3 (what happens to your body)}

For veterans with one or more substance use disorders (SUDs), long-term effects of cocaine use can include increased risk of mental health disorders such as depression and PTSD, physical health issues, suicide, and homelessness.^{1, 6} Veterans with co-occurring mental health disorders (mental health issues in addition to SUD) are more likely to experience more severe symptoms and have a much higher risk of homelessness.¹

Use of cocaine or other substances is more likely in veterans with PTSD or other mental illness who may use it to manage distressing symptoms.^{1, 11} People with severe cocaine use disorders may prioritize getting the drug over anything else, which can make it difficult to work and pay bills, contributing to financial distress and homelessness. In fact, a study in 2014 showed that about 70% of veterans who were homeless also struggled with addiction.⁶

Will Cocaine Use or Rehab Affect My Veteran Benefits?

If you are eligible for VA benefits, seeking or attending cocaine treatment will not interfere with your insurance or disability benefits from the VA. However, if you are discharged dishonorably for committing a felony or engaging in willful misconduct, you will not be eligible to receive VA healthcare benefits.^{12, 13} You may also be ineligible for VA benefits if you are hurt while under the influence of cocaine or another substance as a result of willful misconduct.¹⁴

The VA defines willful misconduct as doing something you know is wrong, regardless of the consequences.^{14, 15} Using cocaine would be considered to be willful misconduct if it is used specifically to get high, and directly leads to injury or death.^{14, 16} However, if it is determined that the veteran started to use cocaine in an attempt to manage the symptoms of a service-related condition such as PTSD, disability compensation might cover injuries or illness related to such drug use.¹⁴ Veterans may have other types of health insurance coverage as well, including TRICARE, Medicaid, and/or Medicare. You won’t be denied or lose coverage for having a pre-existing condition.^{17, 18}

Signs of Cocaine Addiction

Since the effects of cocaine fade quickly, it is commonly used in binges.²Any regular pattern of use can lead to the development of cocaine tolerance, where you become relatively desensitized to certain drug effects and require larger amounts and/or more frequent use to elicit the same initial level of pleasure or reward.² If you are concerned that you or a loved one might have an addiction to cocaine, here are some diagnostic criteria that clinicians use to make a stimulant use disorder diagnosis:⁸ 

• Being unable to control how much cocaine you use or how long you take it.
• Desiring to cut back or quit using cocaine, but not being able to.
• Spending a lot of time in cocaine-related activities such as getting the drug, using it, or coming down from it.
• Experiencing cravings or strong urges to use cocaine.
• Your ability to fulfill your responsibilities at home, school, or work is impacted by your recurrent cocaine use.
• Being unable to stop using cocaine even after knowing that it has caused or worsened a problem with your relationships or physical or mental health.
• Stepping back from important activities or hobbies because of cocaine use.
• Using cocaine repeatedly in situations that can be dangerous, such as while driving.
• Developing a tolerance to the effects of cocaine.
• Experiencing withdrawal symptoms, such as sleeping or eating more and depressed mood, when cocaine use is stopped.

Cocaine Rehab and Treatment Options

Effective treatment is available for cocaine addiction at facilities throughout the country, and many offer programs designed to address the unique challenges that veterans face. Veterans can access cocaine treatment programs through the VA or at cocaine rehab centers and private facilities in the community. These programs utilize various behavioral therapies to help veterans increase motivation towards staying sober and attending treatment.

Treatment commonly involves learning how to cope with stressors and effectively manage triggers, improving the ability to communicate with family members and peers, building a sober support network, addressing any co-occurring mental health issues that may be present, managing physical health concerns (if any), encouraging participation in support groups, and learning effective relapse prevention skills.^{2, 10}

The Process

Although the precise cocaine treatment protocol can vary depending on your individual needs, you’re likely to start with a thorough assessment when you first contact a treatment facility. To determine your specific needs and what level of care is right for you, staff will ask about your family history; physical and mental health; your home life; and any social, family, and legal issues.^{20, 21} Then they can develop a treatment plan utilizing one or more of the following settings:^{1, 20, 22} 

• Detox, where you go through withdrawal in a safe, supervised setting at either an inpatient or outpatient facility. For best results, this should be followed with additional treatment.
• Inpatient/residential rehab, where you stay at a staffed facility around the clock while receiving support and treatment.
• Outpatient programs or varying levels of intensity. For example, in relatively intensive outpatient treatment settings, you may expect to receive up to 20 hours of treatment weekly at regularly scheduled appointments. However, outside of treatment hours you may be able to continue working, attending school, and participating in your typical home life.

Prior to the completion of any treatment program, an aftercare plan—which may involve private counseling, sober living arrangements, as well as regular self- or mutual-help meeting attendance—will be devised to provide an extra layer of support for you after completing drug addiction treatment.

Does the VA and Veteran Benefits Cover Cocaine Rehab?

VA healthcare benefits do cover cocaine rehab and other types of treatment services.¹ Any veteran who is linked to VA healthcare services can receive this care, and there are support and treatment services available at every VA health center in the United States.^{1, 6} Each VA medical center also has a specialist who is qualified to treat co-occurring substance use disorders and PTSD in veterans.¹¹