For many veterans, the journey home brings invisible wars: trauma, pain, and often, substance use. In systems of care, too often these struggles are treated separately – when in fact they are actually deeply intertwined. National estimates suggest that about 8.0% of U.S. veterans live with PTSD at some point, with 4.8% experiencing current PTSD in representative samples. And among veterans with PTSD, more than one in five are also coping with a substance use disorder (SUD).
In West Virginia, where access to care is already limited and overdose rates are high, these intersecting challenges are especially dangerous. At Hope for Tomorrow, we’ve tailored our Veterans Program to accept those with dual diagnoses and medical complexities, offering coordinated, continuing care that extends beyond discharge.
Trauma rewires the brain, the body, and the way a person copes.
For many veterans, those changes don’t fade after deployment.
Alcohol, painkillers, benzodiazepines, or stimulants can become ways to quiet intrusive memories, calm hyperarousal, or force a few hours of sleep. What begins as survival can slowly turn into dependence – and that dependence deepens the very symptoms it was meant to relieve. Research shows that PTSD often travels alongside other conditions – and that depression, anxiety, and substance use disorders are among the most common. In emergency settings, co-occurring substance use is even found in the majority of PTSD cases, revealing just how tightly the two are linked.
Because these conditions amplify each other, separating their treatment rarely works. When one is ignored, the other resurfaces. Effective referrals focus on the whole person – trauma, substance use, and mental health together – so recovery can take root in every part of life.
Veterans carry exposures and burdens that are unique to military life and amplify risk for co-occurring PTSD and substance use. As a result, referral partners must remain alert to this intersection, not just as an “add-on,” but as a frequent baseline in veteran populations.
Risk Factors for Dual-Diagnosis in Veterans Include:
These factors are not guarantees. Rather, they raise the probability that PTSD and substance use may co-occur. Early identification and integrated treatment planning are crucial to prevent life-threatening situations like overdose..
Every veteran’s story is unique, but the patterns often echo one another. PTSD and substance use rarely appear alone, and their overlap can mask what’s really going on.
Recognizing the signs early helps referral partners guide veterans toward care before a crisis.
When you see multiple patterns appearing together – emotional strain, risky coping, and physical distress – it’s time to think beyond symptom management. These are often signals of dual diagnosis, where PTSD and substance use feed each other and require integrated treatment.
When PTSD and substance use are treated separately, fragmented care often fails. Veterans may improve in one area, but the untreated condition can undermine their progress. A trauma-informed, dual-diagnosis model aligns both disciplines in a unified recovery plan.
A few key elements of integrated and trauma-informed care include:
But these aren’t just guidelines. They are critical steps that execution partners, case managers, and liaisons need to confirm in any program they refer to. Programs that skip or compartmentalize any of these steps risk leaving gaps in their coverage.
Integrated, trauma-informed care isn’t optional – it’s essential for meaningful and sustained recovery in veteran populations.
Veterans and their advocates need more than just a phone number.
They need a smooth pathway.
Strong referrals significantly increase the likelihood that a veteran will not only enroll, but also that they will stick with the treatment. In conversations with veterans, start by leading with empathy: acknowledge their service, express confidence in recovery, and normalize the idea that many fellow veterans are managing similar challenges.
Language matters.
Use phrases like: You deserve care that honors your sacrifice.
Instead of: You are broken and need fixing.
When preparing referrals, include details that facilitate the transition:
However, your referral doesn’t end with them being accepted. As case manager or liaison, maintain oversight: monitor progress, follow up with the treatment provider, and remain a continuity bridge for re-entry into the system.
Not all treatment programs are built with veterans in mind. When making a referral, it’s critical to look beyond basic addiction care and assess whether a facility understands the unique layers of trauma, identity, and medical need that veterans bring.
The following components help determine whether a program is truly equipped to support long-term, sustainable recovery.
| Program Component | Why It Matters for Veterans |
|---|---|
| Trauma-focused therapies | PTSD and substance use require integrated therapeutic models |
| Medical oversight / MAT | Many veterans have co-occurring health conditions needing oversight |
| Veteran peer groups | Shared experience improves trust, retention, and outcomes |
| Family education | Helps family support recovery and reduces enabling behaviors |
| Full continuum care | Smooth transitions reduce dropout and relapse risk |
| Accepts complex cases | Some veterans are turned away from rigid protocols – this should not be a barrier |
| Aftercare & relapse prevention | Long-term support reduces return to use |
Choosing the right program can mean the difference between relapse and lasting recovery.
Facilities that integrate medical, psychological, and peer-based support not only treat symptoms – they help veterans rebuild trust, purpose, and stability. For professionals, the goal isn’t just finding a bed. It’s finding a place that understands where the veteran has been, and how to help them move forward.
At Hope for Tomorrow, “veteran-friendly” is more than a label. Our program is built around the real, often-complicated paths veterans bring. Those with trauma, chronic conditions, past relapses, or dual diagnoses. Our staff coordinate care across disciplines, invite families in, and walk the post-discharge journey with patients through continuing care.
If you serve veterans – whether as a case manager, VA liaison, or provider network partner – and you’re seeking a program built for complexity, Hope for Tomorrow is here.
Our Veterans Program accepts those many programs won’t: including veterans with co-occurring PTSD and substance use disorders, medical challenges, past treatment setbacks, and even pregnant patients. We offer trauma-informed dual-diagnosis care, full continuum services, family inclusion, peer support, and continuing care.
To refer a veteran or learn more, contact us at 877-679-8162 or visit our Veterans Program page.
Treatment today for a brighter tomorrow.
