Substance Abuse Common Among PTSD Sufferers

Soldiers returning home from war have been known to experience symptoms of trauma and stress—everything from hallucinations to sleeping disturbances, fear and social withdrawal. Today, these symptoms are diagnosed as post-traumatic stress disorder, or PTSD. A new report published in the National Center for Post-Traumatic Stress Disorder´s PTSD Research Quarterly shows that alcohol and other drug abuse is common among people with PTSD.

According to the report, “PTSD and Health Risk Behavior,” 52 percent of people with post-traumatic stress disorder (PTSD) have been diagnosed with alcohol abuse or dependence, and 35 percent have been diagnosed with drug abuse or dependence. The smoking rate among people with PTSD is about double that of the general population, as is the rate of alcohol abuse and dependence. PTSD increased the odds of having an alcohol use disorder two-fold and the odds of a drug use disorder nearly three-fold.

In a recent broadcast/webcast hosted by CADCA entitled “Stress Induced Substance Abuse,” experts in the field of drug use and mental health treatment said stress—particularly acute and repeated over time—causes changes in the brain that can make a person vulnerable to substance abuse.

Bert Bauer, a licensed clinical social worker with the Pathways New Learning Center in Atlanta, Ga., said when he first began working with soilders returning from combat, he didn’t understand why some were having hallucinations or kept reliving the disturbing events and situations they had experienced. “I started realizing that PTSD was very, very complex and probably a lot more common than we’d given it credit for,” he explained.

Bauer said people with PTSD who have experienced stress or trauma early in their lives and have certain genetic predispositions are particularly vulnerable to developing an addiction.

Kay Doughty, Vice President of Operation PAR in Pinellas Park, Fla., noted that PTSD is not limited to people who are exposed to combat. “Another way that PTSD can form is in young people or adults who are living in inner city neighborhoods with a lot of crime and gun shots going off,” she said during CADCA’s broadcast. “People who are victims of child abuse can also develop PTSD.”

In the PTSD and Health Risk Behavior study, authors Miles McFall, Ph.D., and Jessica Cook, Ph.D., of the Mental Illness Research, Education and Clinical Center at the VA Puget Sound Health Care System, note that there are several reasons why people with PTSD have a higher likelihood of alcohol or drug abuse. One reason is that people returning from traumatic situations like war self medicate their symptoms and emotions with drugs and alcohol. In addition, studies have suggested that substance abuse and withdrawal intensify PTSD symptoms and promote further substance use.

They recommend routine screening of health-risk behaviors for individuals seeking help for PTSD so that those behaviors are incorporated into their treatment plans. In addition, people seeking help for substance use disorders should be assessed for PTSD early on and should receive sustained interventions for the disorder. “Care of both conditions should be integrated into the clinical activities of a single provider team in order to minimize barriers associated with referral to outside consultants that undermine treatment adherence,” the authors note.

For community coalitions and other grassroots organizations, Doughty stressed the importance for communities to determine whether PTSD is a risk factor for substance abuse in their area. “It should be part of the assessment that a community coalition undertakes and prevention strategies should be developed for that,” Doughty said during CADCA’s Broadcast.

The “PTSD and Health Risk Behavior” study appears in the Fall 2006 issue of the National PTSD Quarterly; click here for a PDF version of the publication. Click here to view CADCA’s “Stress Induced Substance Abuse” broadcast.