Our country has been in a state of heightened military alert since the tragic terrorist attacks of September 11, and now the threat of war in the Middle East has further increased the number of U.S. troops being called to active duty.

We see poignant photos in the news of soldiers--someone's son or daughter, mother or father, husband or wife--saying goodbye as they head off to foreign lands and experiences. Some are frightened, others are lonely, many are angry, and most are stressed and anxious. That fear, loneliness, rage and anxiety make them more vulnerable to alcohol and drug abuse.

The times have changed and the drugs have changed, but throughout our military history, the reasons that soldiers seek escape through drugs and alcohol remain constant. "There's deep homesickness and there's so much fear," said Don Elverd, a psychologist at Hazelden and a combat veteran who was wounded in his tour of duty in Vietnam. "Soldiers are afraid that they'll let their comrades down, that they won't do the job that's expected of them. They have a new set of rules and behaviors. It's like being on a different planet with no familiar connections or compasses."

Feeling disconnected, many young people who never smoked or drank or experimented with drugs before the service, turn to alcohol and drugs as an escape or as a way to fit in when they enter the military. Alcohol and cigarettes are readily available. In the Vietnam War, opium-laced marijuana and heroin were a problem. Today, the military is also concerned about the growing popularity of club drugs like ecstasy.

Thankfully, Elverd says that better education about drugs and alcohol, stiffer penalties and consequences for abuse, and better access to treatment for military personnel have improved things considerably. Not long ago, the Department of Defense established an Alcohol and Tobacco Use Reduction Committee that focuses on preventing alcohol abuse.

Psychologists like Elverd are occasionally called upon to speak to military and veterans' groups about how to identify, prevent, and treat combat stress and substance abuse. Elverd said that chaplains and older soldiers play an incredibly important role in helping young soldiers cope.

"When I was wounded, I spent two years in Army hospitals, and I was drinking way too much," said Elverd. "An old first sergeant from World War II took me aside and said, 'I've seen alcohol ruin a lot of good men, son.' That's all he needed to say, and I've never forgotten it. Mentoring works."

To lessen the risks of substance abuse, Elverd encourages soldiers to keep mentally and physically active, seek guidance from mentors and chaplains, and watch out for each other. "If you see a comrade in trouble, express loving and respectful concern. You don't have to use 'let me nurture you' language. Just talk to each other soldier-to-soldier." It is especially important that soldiers who are abusing drugs or alcohol in combat situations get help because the risks of hurting themselves or others are so magnified.

Elverd said that it is very important for loved ones to give emotional support to our troops. "Without a doubt the most important thing a young soldier can get is mail," he said. "Research shows that individuals can undergo high levels of stress and are more resilient if they think someone cares. Soldiers often stick a letter in their helmet and keep it there until it rots. It's their connection to their own humanity, to their sanity."

Elverd advises that loved ones communicate about normal things. "Tell soldiers what the neighbor is doing, what the dog looks like, who's growing, who's lost a tooth," he said. Schools may want to start letter-writing campaigns to cheer on soldiers who are far away from home.

And when soldiers come home, Elverd said it is important for loved ones to recognize that they need to debrief. "Just like alcoholics, they have a story to tell, and someone needs to hear it. You need to listen with patience, and be non- judgmental as he or she talks about their journey."

--Published February 24, 2003