Study sheds light on interplay among PTSD, combat experience, alcohol use
Content
Initial and ongoing assessment is critical to understanding the needs and progress of Veterans with PTSD and SUD. Measurement based care (MBC; 29) or the use of patient-reported information collected as part of routine care, can be used to inform clinical care and shared decision making, individualize treatment, and assess progress toward recovery goals. The PTSD Checklist for DSM-5 (PCL-5) and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are evidence-based measures that screen for PTSD. The PCL-5 is offered in past-month and past-week versions and provides PTSD symptom severity. The Brief Addiction Monitor (BAM) is a questionnaire that assesses alcohol and substance use, risk factors, and protective factors with 7- and 30-day versions (30). The Alcohol Use Disorders Identification Test (AUDIT; 31), Drug Abuse Screening Tool (DAST; 32,33), and the Substance Use Inventory (SUI; 34) are brief measures to assess recent use, some of which also assess functional impacts of use.
For Treatment Providers
- Research on personalized treatment could lead to the development of a menu of evidence-based treatments from which practitioners and patients could jointly tailor a treatment plan for the patient.
- However, depending on the nature of the trauma, the endorphin response may remain elevated as a biological coping mechanism.
- Many people who experience a traumatic event may use alcohol as a means to cope with experiencing extreme stress.
- Drinking may provide momentary relief, but ultimately it makes the situation worse.
- However, females were much more likely to have been sexually abused than males and consequently the symptoms of PTSD were more common for female than male alcohol abusers (Clark et al. 1997).
Author NHW conceptualized the current study, conducted literature searches, and provided summaries of previous research studies. Author AAC was an investigator on the larger study and contributed to the writing of the final draft of the manuscript. There must be a clear “nexus,” or link, between the in-service stressor and your PTSD.
Finally, individual preference is a critical consideration when matching people with treatment modalities. Typically, the sessions are 60 to 120 minutes, approximately once a week for 4 to 10 weeks. However, because traumatic experiences that can lead to the development of PTSD include events such as natural disasters, car accidents, and witnessing a loved one experience trauma, men are just as vulnerable as women to unexpected forms of environmental trauma. Much of the data gathered relies on self-reported incidents of trauma inflicted by another person, which may skew researchers’ ability to accurately compare trauma risk based on gender. However, as we learned, not everyone who experiences or witnesses a traumatic event will develop PTSD.
Veterans Health Library
While panic attacks on their own are not dangerous, for someone with PTSD, they can induce intense fear, anxiety, and flashbacks. For people struggling with alcohol and PTSD, it’s clear that consuming alcohol does little to help them cope; instead, it only temporarily numbs traumatic memories. In other words, the combination of PTSD and alcohol abuse is not only a poor coping mechanism, it can also be a harmful one.
- Both conditions affect similar brain regions and neurotransmitter systems, particularly those involved in stress response and reward processing.
- This might include things like witnessing or experiencing physical violence, the death of a parent or caregiver, neglect, or emotional abuse.
PTSD and Alcohol: How Does Alcohol Affect PTSD Symptoms?
A review of PTSD andalcohol abusestatistics indicate that nearly 28 percent of women diagnosed with PTSD report concerns about alcohol abuse and dependence. Nearly 52 percent of men diagnosed with PTSD report similar problems.The National Center for PTSDestimates as many as 75 percent of trauma survivors experience an alcohol use disorder. Post-traumaticstress disorder (PTSD)and alcohol use can frequently co-occur. PTSD andalcohol abusemay occur together due to the tendency of people diagnosed with PTSD to engage in self-destructive behavior and the desire to avoid thinking about the trauma. Exposure must be either directly experienced, witnessed, learned about in the case of a close family or friend, or indirectly experienced in the course of one’s professional duties.
Recovery from co-occurring PTSD and alcohol use disorder is a journey that requires ongoing effort and support. Developing healthy coping mechanisms is a crucial aspect of long-term management. drug addiction treatment This may involve learning and practicing stress reduction techniques, such as mindfulness meditation, deep breathing exercises, or yoga.
These strategies may include identifying triggers, developing coping plans for high-risk situations, and regularly attending therapy or support group meetings. It’s important to recognize that relapse is often a part of the recovery process and should be viewed as an opportunity for learning and growth rather than a failure. Behavioral interventions are a primary component of the treatment of AUD and can be used as freestanding treatments or as part of a more comprehensive treatment plan that includes pharmacotherapies. Behavioral interventions for AUD include providing psychoeducation on addiction, teaching healthy coping skills, improving interpersonal functioning, bolstering social support, increasing motivation and readiness to change, and fostering treatment compliance. When a person is under stress, the body reacts by releasing hormones that produce the “fight or flight” response. However, long-term stress (also called chronic stress) may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms.
- Researchers are working to include studies with female participants with AUD.
- Researched, fact-checked and transparent articles and guides that offer addiction and mental health insight from experts and treatment professionals.
- Look for wellness activity groups that align with your interests, whether it’s walking, meditation, yoga, or even adventurous experiences like wild swimming.
Causes include combat exposure, physical abuse, an accident or other forms of trauma. Alcohol abuse disorder is also common, affecting some 15 million people in the US. Those with stress and anxiety disorders such as PTSD are not only more likely to abuse alcohol, but also have increased alcohol withdrawal symptoms and relapse risk. The field has made major advances in understanding the interplay between PTSD symptoms and substance use/craving (Bountress et al., 2018; Coffey et al., 2010; Possemato et al., 2015).
Implications for Treatment of PTSD and Alcoholism
The indirect effect is significant if the 95% confidence interval does not contain zero (Preacher & Hayes, 2004). Standardized estimates are presented to facilitate comparison of the magnitude of change from the total to the direct effect. Sobel tests examined whether the relation between PTSD symptom severity and alcohol misuse decreased when accounting for alcohol to down-regulate despondency, anger, and positive emotions, separately. In the model testing alcohol use to down-regulate despondency, anger, and positive emotions, simultaneously, percent reduction in effect between the total and direct effect was calculated. PTSD with Alcohol Use Disorder (AUD) involves a scenario where a veteran diagnosed with PTSD also suffers from an alcohol use disorder. The VA recognizes that veterans with PTSD may use alcohol to cope, leading to the development of AUD.
In this way, the patients learn how to better control or avoid such situations. Because research shows that both alcohol use and trauma increase endorphin activity, opioid receptor blockers may be a useful part of treatment for PTSD. We speculate that as trauma-related memories brought up during therapy may cause a release of endorphins and subsequent emotional numbing, this may interfere with the patient’s ability to engage in therapy fully. We also speculate that as endorphin levels decrease after the therapy session ends, endorphin withdrawal may lead to increased alcohol craving. Although alcohol use may temporarily relieve PTSD symptoms, alcohol withdrawal intensifies such symptoms. To avoid the increase in PTSD symptoms following a bout of drinking, the patient is caught in a vicious cycle in which he or she must continue to drink to avoid the unpleasant reaction following an alcoholic binge.
People with PTSD sometimes use alcohol to cope with the intense emotional pain and stress caused by their trauma. This can result in a harmful cycle where alcohol consumption exacerbates PTSD symptoms and contributes to increased addiction. In this blog, we will look at the link between PTSD alcohol abuse, why they often go hand-in-hand, and explore healthier ways to cope. To begin, two systematic reviews discuss the current state of behavioral (Simpson et al., 2017) and pharmacological (Petrakis & Simpson, 2017) treatments for comorbid AUD/PTSD. The evidence suggests that there is no distinct pattern of development for the two disorders. Some evidence shows that veterans who have experienced PTSD tend to develop AUD, perhaps reflecting the self-medication hypothesis.
Two OEF/OIF veterans received VALOR therapy in two separate case studies.49 These veterans greatly reduced their alcohol use at the start of treatment or shortly before beginning the treatment, and their PTSD symptoms substantially decreased over the course of treatment. People with PTSD may turn to alcohol as a way to cope with the distressing symptoms they experience. Alcohol can provide temporary relief from anxiety, sleep disturbances, and intrusive thoughts or memories. However, using alcohol as a coping mechanism can lead to a dangerous cycle of dependence and worsen the symptoms of both disorders.
Early intervention, professional treatment, and strong support systems are critical in breaking this cycle. By seeking healthier coping mechanisms and understanding the dangers of alcohol abuse, individuals with PTSD can begin the journey toward recovery and emotional wellness. Survivors of trauma often deal with intense emotions and constant stress, making alcohol appealing as a way to numb their emotional pain. Trauma may also lead to risky behaviors, like binge drinking or self-medicating, to cope with the anxiety and fear linked to PTSD. People with complex post-traumatic stress disorder (CPTSD) often experience chronic emotional distress. Symptoms include emotional dysregulation, intense shame, and a negative self-concept due to prolonged exposure to trauma.
