Substance Use Treatment for Veterans

You served, and the drinking or the pills are past what you can manage alone. VA publishes a direct offer: if you are struggling with alcohol, tobacco, street drugs, or prescription medicines, you are not alone, and VA provides substance use services. What you can use depends on eligibility, on a clinical assessment, and on whether the care is inside VA or in the community. What follows stays with what VA and TRICARE publish. Copays live on the plan documents.

If this is an emergency, use the paths VA prints on its substance use page. Call 988 and select 1 to reach the Veterans Crisis Line. You can text 838255. VA describes that line as private, free, and available 24 hours a day, and says many responders are Veterans. You can also call 911, go to the nearest emergency room, or go directly to the nearest VA medical center. VA says that last option does not depend on your discharge status or on whether you are enrolled in VA health care. The FAQ above has the TTY path.

What VA says it provides

VA says the services depend on your needs and range from unhealthy alcohol use to life-threatening addiction. The list it publishes includes:

• Medically managed detoxification, and services to get stable
• Medicines to reduce cravings, including methadone and buprenorphine for opioid addiction
• Nicotine replacement or other medicines to stop tobacco
• Short-term outpatient counseling
• Intensive outpatient treatment
• Marriage and family counseling
• Self-help groups
• Residential care
• Continuing care and relapse prevention
• Programs for women Veterans, returning combat Veterans, and Veterans who are homeless

Care tied to military sexual trauma follows different rules, including free treatment without a disability rating. That door is the military sexual trauma guide. VA also says it treats related conditions, including post-traumatic stress disorder and depression. A program that has no way to talk about those conditions is a weak match if they are part of the history. Whether a particular clinic offers each item on the list is something to ask that clinic. The national page is not an inventory of open beds.

If the history is heavy drinking or a benzodiazepine taken every day, ask specifically about medically managed withdrawal before anyone suggests quitting at home. The placement question is the detox guide. If opioids are the concern, ask about methadone or buprenorphine, and keep naloxone available. How to recognize an opioid overdose is the overdose guide.

Eligibility is a form, not a guess

VA's eligibility page says you may be eligible for VA health care if you served in the active military, naval, or air service and did not receive a dishonorable discharge. If you enlisted after September 7, 1980, or entered active duty after October 16, 1981, the page says you must have served 24 continuous months or the full period for which you were called to active duty, unless an exception applies. Exceptions named on the page include a discharge for a disability caused or made worse by active duty, and a discharge for a hardship or an early out. The page lists further detail. Use it, or ask VA, instead of stopping here.

The same page says VA has expanded care to Veterans who meet basic service and discharge requirements and who were exposed to toxins and other hazards at home or abroad. It says this includes Veterans who served in the Vietnam War, the Gulf War, Iraq, Afghanistan, or any other combat zone after September 11, 2001. That expansion is one route in. It is not a statement that every other Veteran is excluded.

VA says the health care program covers services to treat substance use problems, and that the first step for those services is to apply for VA health care. After you apply, a VA primary care provider can screen for substance use and for related issues such as PTSD or depression. If you do not yet have a VA primary care provider, the substance use page says you can find a VA substance use disorder program, call 800-827-1000, or contact a local VA medical center.

If you do not have VA health care benefits, VA says you may still be able to get some care. Veterans who served in a combat zone can get free private counseling, an alcohol and drug assessment, and other support at one of VA's 300 community Vet Centers. Veterans who are homeless, or at risk of homelessness, can call the National Call Center for Homeless Veterans at 877-424-3838, which VA describes as free and confidential, 24 hours a day.

Community care is a second door, with a lock on it

VA's community-care page says you may be eligible for care outside VA, meaning VA pays a provider in its community-care network. You can still choose a VA facility.

Two basic requirements both have to be met. You must be enrolled in or eligible for VA health care. You must have approval from your VA health care team before you get care from a community provider, except for certain urgent or emergency cases.

At least one more condition must also be true. The conditions VA lists include: VA does not provide the service at any VA facility; you live in a state or territory without a full-service VA facility; you and your VA provider agree that an in-network community provider is in your best medical interest; VA cannot meet its quality standards for the service; you still qualify under an older 40-mile rule in specific states; or VA cannot provide the care within its drive-time and wait-time standards.

For primary care, mental health, and extended outpatient care, VA states the access standard as a 30-minute average drive time or a 20-day wait. Specialty care is a 60-minute average drive or a 28-day wait. Those standards are how VA decides one path to community care. They are not a promise that a residential substance use bed will be authorized.

Do not travel to a non-VA program and assume VA will pay. Ask your VA team first, unless you are in the urgent or emergency situation the page excepts. A private rehab's offer to "bill VA" is not VA's approval.

TRICARE is a different benefit

TRICARE's covered-services page says TRICARE may cover inpatient substance use services, emergency and nonemergency; intensive outpatient programs; withdrawal management; medication assisted treatment; mental health therapeutic services; office-based opioid treatment; opioid treatment programs; and partial hospitalization.

The same page says TRICARE does not cover aversion therapy or unproven treatments. It says the list is not all-inclusive, that services must be medically necessary and considered proven, and that some services have special rules, limits, or exclusions. Cost shares depend on the plan. TRICARE tells beneficiaries to check DEERS so eligibility and enrollment are correct, and to call the regional contractor with questions.

A spouse or child who is not eligible for TRICARE may be asking about CHAMPVA instead. That benefit is the CHAMPVA guide.

TRICARE coverage and VA community care are not interchangeable. A retiree, an active-duty family member, and a Veteran using VA can be in different systems. Bring the card you actually have.

If a private plan that is neither VA nor TRICARE denies a stay, use the process on that plan's letter. HealthCare.gov's internal appeal and external review for many private plans, and Medicare's own appeal rules, are summarized on the appeals guide.

Records, and the next call

VA describes the Veterans Crisis Line as confidential. Treatment records in civilian programs can fall under federal confidentiality rules. Consent, emergencies, and why a subpoena alone does not open that kind of record are explained on the privacy guide. VA's own record system is not identical to a private program. Ask the facility that is treating you.

SmarterRecovery is not VA, not TRICARE, and not a treatment provider. For VA enrollment, use VA's eligibility page or 800-827-1000. FindTreatment.gov lists treatment facilities you can compare with what VA offers. SAMHSA's helpline, 1-800-662-HELP (4357), is another federal referral line, separate from the Veterans Crisis Line.

Block grants and other public paths, if VA and TRICARE are not available to you, are on the guide about paying without private insurance.

Call or text (800) 653-9376 if you want a conversation about non-VA options and what a private plan says it will cover.

Additional Resources

Sources cited on this page:

• VA: Substance use treatment for Veterans
• VA: Eligibility for VA health care
• VA: Eligibility for community care outside VA
• TRICARE: Substance Use Disorder Treatment
• SAMHSA FindTreatment.gov
• SAMHSA National Helpline
• 988 Suicide & Crisis Lifeline

Common Questions