Post Traumatic Stress Disorder and Substance Use in Veterans

Veterans Returning Home From War

How much do we really understand about post-traumatic stress disorder (PTSD)? The term is thrown around often enough these days not just for combat veterans but for victims of all types of traumas and catastrophes, like the Virginia Tech and Sandy Hook Elementary School shootings, suicide bombings, Katrina, tornadoes and hurricanes, car accidents and even child abuse. But what is PTSD exactly?

PTSD over the years….

The term PTSD is fairly new, only about 30+ years old. “Soldier’s Heart” was the first term used to describe the aftershocks of war trauma that soldiers suffered after the Civil War. Later it was called “shell shock” for World War I and World War II. It became “gross stress reaction” in the 1950’s and “post-Vietnam syndrome” after the Vietnam War. By the 1980’s, the term PTSD finally became a formal diagnosis courtesy of the American Psychiatric Association as a result of their work with Vietnam Veterans.

PTSD Symptoms in Combat Veterans

The most common symptoms of PTSD include sleeplessness, recurring nightmares, loss of interest in things that used to be interesting, anxiety, depression, paranoia, anger, irritability and feeling numb.

Sometimes these symptoms do not manifest for months or years after returning from deployment. The symptoms may also come and go. If the symptoms are persistent and/or getting worse to the point that they are interfering with normal daily routines, it is very likely that it is indeed PTSD.

PTSD and SUD

Returning veterans try to cope with PTSD in different ways. Some start to drink heavily. Others become chain smokers. Yet others may start using drugs. While civilians use illicit drugs more heavily than US Military personnel, prescription drug abuse is more prevalent for soldiers and is on the rise. The most misused prescription drugs by service members are opioid painkillers for combat-related injuries and the strain of carrying heavy equipment during multiple deployments.

Over time these combat veterans suffering from PTSD may develop a Substance Abuse Disorder. This condition is called Co-occurring PTSD and SUD. Statistics show that more than 2 out of every 10 veterans with PTSD also suffer from SUD, and of those seeking help for SUD, 1 in every 3 also have PTSD.

The symptoms of PTSD are often made worse by alcohol or drug use, and co-occurring PTSD and SUD often also results in health problems, relationship problems (with family and friends) and/or social problems (being unable to keep a job or stay in school).

PTSD Treatment for Veterans

The Department of Veterans Affairs has made it easier for combat veterans to get help. Evidence shows that PTSD and SUD symptoms improve when treatments address both conditions instead of just PTSD or SUD on their own. Treatment can involve any of the following:

    • Cognitive Behavioral Therapy CBT (individual or group)
    • Behavioral couples therapy with spouse or partner
    • Medications that help manage PTSD and SUD symptoms
    • Specific psychological treatments for PTSD like CPT or PE (Cognitive Processing Therapy or Prolonged Exposure respectively)

    VA suggests talking to a health professional for information about treatment options. Each VA Medical Center has a PTSD-SUD Specialist, duly trained to treat both conditions.

    Other government agencies like the NIDA are currently funding research to better understand the causes of mental health problems and substance abuse among war veterans and other military personnel and their families. The research also seeks to find out how to best prevent and treat these problems.

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