If you are reading this for yourself, or for a service member you love, the things that brought you to this page are things our clinical team has heard before. Roanoke Refuge provides outpatient addiction treatment for veterans and active-duty service members across the Roanoke Valley and the surrounding Southwest Virginia region. Our PHP and IOP programs are built to address the specific clinical needs veterans bring into outpatient care, including the high co-occurrence of post-traumatic stress disorder, traumatic brain injury, moral injury, and military sexual trauma alongside substance use. The Salem VA Medical Center on Roanoke Boulevard serves veterans across a 26-county area of Southwest Virginia, and Roanoke Refuge provides a community-based outpatient option for veterans who want civilian care, who are waiting for VA services, or who prefer the privacy and accessibility of a local outpatient program outside the VA system.
Veteran admissions follow the same clinical-based clinical pathway used across our outpatient programs, anchored by our treatment approach with veteran-specific coordination woven through every step.
Substance Use Among Veterans: Understanding the Scope
Most veterans walking into our admissions calls already know the patterns below. They just have not had anyone say them out loud in clinical language yet. Substance use disorders are significantly more prevalent among veterans than in the general population. U.S. Department of Veterans Affairs National Survey data consistently documents elevated rates of alcohol use disorder, opioid use disorder, and tobacco use disorder among veterans compared to age-matched civilian peers. The contributing factors below show up in nearly every clinical picture we see.
Combat-related PTSD
Post-traumatic stress disorder is the single strongest predictor of substance use disorder among veterans. VA data indicates that approximately 20 percent of veterans with PTSD also have a substance use disorder. Many veterans use alcohol, opioids, cannabis, or stimulants as the primary mechanism for managing PTSD symptoms, particularly hyperarousal, intrusive memories, and sleep disruption. Learn more
Chronic pain and opioid prescribing
Military service involves significant physical demands and injury exposure. The VA’s historical overprescribing of opioid analgesics for service-related pain conditions has created opioid dependence in a substantial number of veterans across the country and across this region.
Traumatic Brain Injury (TBI)
TBI is among the most common injuries of the post-9/11 conflicts. TBI is associated with impulsivity, emotional dysregulation, and reward-seeking behavior that increases vulnerability to substance use disorders.
Moral injury
Distinct from PTSD, moral injury refers to the psychological damage caused by actions, inactions, or witnessed events during military service that violate deeply held moral beliefs. Moral injury is associated with profound shame, guilt, and spiritual distress that is frequently self-medicated with substances.
Military sexual trauma (MST)
MST is reported by approximately 23 percent of women veterans and one percent of male veterans accessing VA care, and is strongly associated with both PTSD and substance use disorders.
Transition challenges
The transition from military to civilian life is one of the highest-risk periods for veteran substance use. The loss of structure, identity, community, and purpose that military service provided creates significant vulnerability in the post-separation period.
How We Serve Veterans at Roanoke Refuge
Here is what to expect when you walk through the door. Veterans who enter our PHP or IOP programs receive the same evidence-based clinical care as all our clients, with specific attentiveness to the veteran-specific factors that shape the clinical presentation. The pieces of a typical plan look like this.
Trauma-informed care
Recognizing combat trauma, military sexual trauma, and moral injury alongside civilian trauma types, and shaping the treatment environment to hold all of them. Learn more
PTSD treatment
Using approaches with strong evidence in veteran populations, including Cognitive Processing Therapy, a first-line treatment in the VA and Department of Defense Clinical Practice Guidelines for PTSD. Learn more
MAT prescribed on-site
For veterans with opioid or alcohol use disorder, our medical team prescribes FDA-approved MAT (buprenorphine, naltrexone, acamprosate, disulfiram) and coordinates with the Salem VA Medical Center when the veteran is an established VA patient.
Peer support
Clinicians and peer recovery specialists who understand military culture and can speak the language of service.
Veteran-specific psychoeducation
Content that acknowledges the specific stressors of military service and the transition to civilian life rather than treating veterans as a generic clinical population.
Case management for VA benefits
Support navigating VA mental health services, disability claims processes, and veteran community resources across the Roanoke region.
VA Benefits and Non-VA Treatment
This is the part most families want to understand before the clinical conversation even begins. Veterans enrolled in VA healthcare can use VA benefits to access treatment at VA-affiliated providers. Roanoke Refuge is pursuing enrollment as a VA Community Care provider through the VA Community Care Network, which would allow eligible veterans to receive care at our facility with VA benefits. Until that enrollment is complete, veterans may use private insurance or self-pay for treatment at Roanoke Refuge while we complete and VA Community Care Network enrollment. plans typically cover outpatient mental health and substance use disorder treatment, including PHP and IOP. credentialing for Roanoke Refuge is in process; once finalized, eligible veterans will be able to use benefits directly at our facility. Our admissions team will help confirm whether benefits can be applied as part of the standard insurance verification process.
Local Veteran Resources in the Roanoke Area
You are not navigating this alone, and Roanoke has more veteran-specific support than most cities its size. The community-based supports that often work alongside our outpatient program are below.
Salem VA Medical Center
1970 Roanoke Boulevard, Salem, VA 24153. Substance use disorder treatment, mental health services, and primary care for eligible veterans across the 26-county Southwest Virginia service area.
VA Carilion Clinic Community-Based Outpatient Clinic
VA outpatient services in Roanoke for veterans who do not need the full hospital setting at the Salem VAMC.
Roanoke Valley Veterans Council
Community organization connecting veterans to local resources and support across the region.
Virginia Department of Veterans Services
Statewide benefits assistance, transition services, and veteran-focused resources.
Vet Center Roanoke
350 Albemarle Avenue SW, Roanoke. Confidential, community-based readjustment counseling for combat veterans and military sexual trauma survivors. Not affiliated with the VA hospital and operates with separate confidentiality protections.
Veterans Crisis Line
Call or text 988, then press 1. Chat at veteranscrisisline.net. Confidential support for veterans in crisis.
Dual Diagnosis and Veterans
The drinking, or the pills, or whatever it became, is rarely the whole story for a veteran. PTSD, depression, anxiety, traumatic brain injury, and moral injury appear in nearly every veteran clinical picture in our admissions. Treating the substance use without treating the underlying mental health condition is like treating the smoke while leaving the fire burning. Our integrated dual diagnosis program addresses both at the same time, in the same setting, and by the same clinical team, with psychiatric medication management coordinated through outside prescribers or VA providers as appropriate.
Local, regional, and accessible.
Treatment for this substance is delivered from our Salem facility at 1630 Braeburn Drive — just off I-81 exit 137. The Roanoke Valley service area covers Roanoke City, Salem, Vinton, and the surrounding counties of Roanoke, Botetourt, and Bedford. The Salem VA Medical Center sits roughly two miles away and serves as a referral partner for veterans transitioning to civilian outpatient care.
The path in is a single phone call. The admissions team walks through fit, level of care, insurance, and what the first week of treatment will actually look like — at no cost and with no clinical commitment until you are ready. Insurance benefits get verified during the same call. Call (540) 900-0353 to start the conversation.