According to a specialist from Nevada, combat trauma and addiction to drugs and/or alcohol go hand and hand and must be treated together.
"Self-medicating or numbing the stress that follows a traumatic event is especially prevalent in combat veterans who don't reach out for mental health help because of the stigma or out of fear that admitting a problem will hurt their career, said Larry Ashley, a veteran of the Vietnam War."Most civilian counselors aren't trained in combat trauma," Ashley said. "And there are some unique challenges in working with military veterans who have faced combat."
War veterans, he said, "give out the trauma, by the very nature of what they do, and receive the trauma. Let's get real. In combat, your job is to kill. Knowing you've inflicted trauma, or killed someone, can be just as damaging as facing a life-threatening event."

John Haywood, administrator of the Newport News Drug Court and a 15-year Hampton-Newport News Community Services Board employee, said he's already started a veterans support group to address needs on the Peninsula. Typically, Haywood said, two years go by between the time veterans experience combat trauma and when they are either forced to seek assistance or reach out for the help on their own. Given that the war in Iraq is 5 years old, Haywood said, Virginia counselors should be prepared now.

The national association of abuse counselors agrees. Patricia Greer, president of the National Association of Alcoholism and Drug Abuse Counselors, told Congress this month, "Some experts estimate that about 40 percent of veterans who have served in Iraq or Afghanistan will experience a mental health problem and that of those … 60 percent will have a substance use disorder. In the case of mental health conditions," she said, "substance use disorders frequently result from attempts to self-medicate with alcohol or other drugs rather than receiving mental health care."

Ashley warned that combat veterans could also seek out other ways to cope. "There's lots of ways we can sell our bodies and souls," he said. "Gambling. Eating disorders. Sex. A combat veteran sitting at a slot machine for hours gets the same high as a veteran sitting at a bar, Ashley said, and counselors should be looking for signs of those addictions, too.War is hell," Ashley said. "But that is not the half of it."