Now that all but four of the hostages have been returned, Israel is breathing a collective sigh of relief, but the battle isn’t over - not even close. As combat veterans return from the front lines, a time of Post Traumatic Growth can begin, and the need to address the long-term results of wartime-related trauma is urgent.
Surge in Substance Use in Israel
Almost everyone who struggles with substance use has faced trauma at some point in their lives, with one study showing a rate as high as 95%. Other studies have shown that Israeli veterans diagnosed with PTSD have a significantly higher rate of substance use and abuse versus the general Israeli male population. Since the October 7th massacre substance use in wartime Israel has also spiked.
According to Professor Shauli Lev-Ran, a leading expert in addiction treatment and research in Israel and co-founder and academic director of the Israel Center on Addiction and Mental Health, Israel is experiencing its second major surge in substance use right now.
“The first occurred during the COVID-19 pandemic,” he said. “We’re seeing a significant rise in prescription drug misuse, as well as increased use of alcohol and other substances among high-risk groups: youth and young adults, soldiers and their partners, evacuees from the Gaza envelope and the North, and others directly affected by war-related trauma.”
How We’re De-Stigmatizing Substance Use
Now is the time to begin unraveling the damage caused by wartime trauma on our hostages, veterans, evacuees, children, families, and communities. And part of this damage is related to that increase in substance use.
What Israelis need now more than ever is support. That’s why the language commonly used to talk about substance use is now changing. It’s a calling for a shift from high-stigma terms like “addiction” or “substance abuse disorder” to this new term: problematic substance use.
People know both anecdotally and from studies like this one that increased social support has beneficial impacts on problematic substance use. Part of perceived social support is the way people talk about this issue.
Why now?
Professionals and mental health organizations are addressing problematic substance use now because of the collective trauma Israel has faced since October 7, 2023 and throughout the Swords of Iron war.
“This has naturally led to a marked increase in problematic substance use,” added Lev-Ran. “Addressing recovery today requires treating both trauma and substance use together.”
Although the vast majority of people with problematic substance use report trauma exposure, Lev-Ran noted that exposure to trauma is generally widespread, even more so among people with mental health conditions, including problematic substance use.
“Still, it’s important to remember that addiction is multifactorial - shaped not only by trauma, but also by biological, psychological, and social factors that together influence vulnerability and recovery,” he added.
Co-morbid substance use and trauma have been linked to poorer treatment outcomes. According to Lev-Ran, there are two key mechanisms at play here.
“First, the therapeutic effect of many medications can be blunted by concurrent substance use,” he explained. “For example, alcohol or sedatives may interfere with antidepressants or anti-anxiety medications. Second, many evidence-based therapies rely on emotional and behavioral exposure to distressing memories or situations; substance use can dampen this process, making it harder for patients to fully engage and benefit from treatment.”
Meeting of the Minds
With all of Israel staggering from the immense collective trauma that’s been happening since the October 7 attack - and the surge in problematic substance use - there’s never been a more important time to talk about this issue than right now.
That’s why American Friends of NATAL, a U.S.-based organization that supports NATAL: Israel’s Trauma and Resiliency Center, and the Israel Center on Addiction and Mental Health are hosting a conference dedicated to the intersection of trauma and substance use. The Resilience Under Pressure conference creates a space for a wide range of voices to share perspectives, trigger dialogue, and suggest solutions via collaboration.
The goal is to share evidence-based sessions that will unite professionals for mutual learning, dialogue, and practical exchange, both from the U.S. and the Israeli professional communities. Lev-Ran and Professor Rivka Tuval-Mashiach, chair of NATAL’s professional steering committee, will be featured in the opening session, offering an overview of the context of trauma and problematic substance use in this new world.