Military veterans battling substance abuse helped by addressing addictions together

All in it together. Andrew Matthews/PA Archive

Each year, roughly 15,000 people leave the British armed forces. The vast majority make a successful transition into civilian society, having had their lives enriched by their service experience.

But a small and increasing number of ex-forces personnel face difficulties making that successful transition. They can struggle alone for long periods of time with problems such as alcohol misuse, mental health issues, unemployment, homelessness and prison. It has been estimated that the symptoms of poor transition from military service cost the UK tax payer £98m in 2015.

New research that my colleagues and I have just published highlights of one project that is making a difference. The project we evaluated, Right Turn, was designed for military veterans with alcohol and drug addictions and is run by the charity Addaction in 20 locations across the UK. For those taking part, it involves weekly peer support meetings with fellow veterans, supplemented by social activities and mentor training. The main point of the project was to foster friendships so group members would support each other out side of formal meetings.

We found that compared to a different intervention run by Addaction that wasn’t aimed specifically at veterans, the project had a marked difference in veterans’ transition to civilian life and recovery from addictions.

Tough times on civvy street

The task of becoming a civilian after time in the forces can prove one of the toughest changes that service personnel face. One ex-forces member in recovery from addiction, Gillie (not his real name), explained to me:

Being able to go out in to the world and not ‘tolerate’ civilians, but sort of realise ‘well I am a civilian now’, and have that like change in thinking of being like ‘I’m not going to get very far if I think that every civilian is an alien’, if you like.

Transition to civilian life can be tough. via www.shutterstock.com

Many veterans can struggle with this sense of separation from the civilian population – and some veterans need more help than others. Substance misuse problems may arise from a sense of loss of a veteran’s military identity and confidence. Veterans often find themselves at the end of their military career without having the inclination or the emotional and social resources to adopt a civilian identity.

Some non veteran-specific services may not adequately address veterans’ distinct transitional and ongoing challenges.

The veterans we interviewed in the Right Turn project told us that they had previous experience of support services that were designed for civilians. But they said these services did not acknowledge the unique experience of those who have served in the military and how this is linked to other aspects of their lives.

Help back on the ‘straight and narrow’

The Right Turn model looks at a person’s issues in the context of their whole life, rather than focusing on their substance use in isolation. We found this reduced the likelihood of contact with the criminal justice system and continued substance misuse. It also helped to avoid further deterioration in mental and physical health, as well as helping participants address practical day-to-day issues, such as the social exclusion that many veterans experience on leaving service.

Some of the veterans had come into contact with criminal justice services before joining the project. Since the Right Turn intervention all the 23 veterans we interviewed and surveyed throughout the project had stayed on the “straight and narrow”. They all also gained and maintained recovery status – meaning they had achieved their goal of managing their addiction.

When we compared this with an equivalent group of veterans who accessed a separate service run by Addaction that wasn’t aimed specifically at veterans, the Right Turn participants achieved improved physical and psychological health outcomes. In contrast, the majority of the veterans in the comparison sample experienced a significant deterioration in their physical and psychological health.

Using military camaraderie

Rather than ignoring veterans’ military identity, the Right Turn project builds upon it to create a new military-veteran citizenship in the civilian world. Right Turn redirects the comradeship and mutual resilience that underpinned veterans’ military life to support them in establishing a new identity. This then helps them to sustain their recovery from alcohol and drug addiction.

Our research illustrated that the greatest asset veterans have is their membership of the wider armed forces community – with a shared sense of belonging and purpose. Two ex-forces personnel meeting on the street for the first time instantly know they have more in common with each other than their work colleagues, their neighbours and other civilians living around them. They are still “in it” together.

We found that engaging in this project resulted in significant behaviour change. Veterans reported an greater sense of security and confidence in their capacity to manage practical, day-to-day matters, such as accommodation and finances.

As Gillie told me:

I’ve got to conform, but you’ve got that safety net from the Right Turn that helps you make that transition.

Veterans told us that they had accessed Right Turn because it was only for military veterans. This also meant they were motivated to keep attending because they did not want to let down the group. If military identity is valued these veterans can recognise their individual strengths and play a full and valued part in civilian life – a part enhanced by their proud acceptance of their status as ex-forces.