Post Traumatic Stress Disorder and Drug or Alcohol Abuse
Not everyone who witnesses or is subjected to a terrifying situation or an imminent threat to life will develop PTSD, but many people do develop this syndrome of symptoms, and people with PTSD are far more likely to turn to the use and abuse of alcohol or illicit drugs as self medication to the negative symptoms of the disorder.
About 70% of Americans have been exposed to a violent trauma severe enough to cause PTSD, and about 11% of these people will develop PTSD. People are considered to have PTSD after symptoms of anxiety and insomnia continue for more than a month. Additional symptoms of PTSD include irrational terrors, fatigue, poor concentration and memory performance, emotional blunting, apathy, tachycardia and gastro intestinal distress. The risks to developing PTSD are increased with increasing trauma severity, and as well with a prior history of anxiety or other psychiatric conditions.
Concurrent alcohol or substance abuse with PTSD will almost invariably entrench and worsen the experienced symptoms of the disorder, and PTSD sufferers need treatment that confronts both their psychological problems as well as their dependency issues, simultaneously.
Clinical experts remain unsure about how exactly PTSD and substance abuse are linked together; and research has linked the two disorders in diverse ways. People may have a genetic vulnerability to the two conditions together, alcohol or drug use may alter the brain to increase the vulnerability to PTSD and people experiencing PTSD may use alcohol or drugs as self medication. Although researchers are not yet certain how the two disorders interact, that they are interrelated is known with certainty.
Some Facts About PTSD and Alcohol or Drug Abuse
Being diagnosed with PTSD greatly increases the likelihood of experiencing an alcohol abuse problem, and 25% - 75% of people exposed to violent trauma will also develop substance abuse problems.
Alcohol and substance abuse worsens the symptoms of PTSD. Substance abuse worsens sleep (greatly linked to PTSD symptoms) increases feelings of hyper vigilance and also makes the treatment for PTSD much more difficult.
Women are twice as likely as men to develop PTSD, and women seeking residential alcohol rehab are 500% more likely to be suffering PTSD symptoms than the general population.
60-80% of Vietnam vets receiving PTSD treatment have a concurrent substance abuse problem
Treatment for Concurrent PTSD and Substance Abuse
The treatment needed for concurrent PTSD and substance abuse will depend on the relative severity of both anxiety symptoms and substance abuse behaviors. As they are interrelated, the two problems cannot be treated separately; and treatment must begin with a comprehensive pre assessment period to gain an accurate understanding of the severity of symptoms.
The initial withdrawal and detox stage of substance abuse treatment can greatly increase anxiety and other PTSD symptoms, and patients undergoing detox need special monitoring and maintenance for safety and comfort during this period.
The substance abuse strategies for treatment do not differ substantially from strategies offered to single diagnosis patient, but corresponding and concurrent therapies should be offered to treat the unique symptoms of PTSD. Cognitive behavioral "exposure" therapy, in which patients learn to confront their fears and memories of trauma are often used to lessen symptom severity. Cognitive skills education also teaches PTSD addicts how to manage and assess symptoms of the disorder.
Medications such as SSRI anti depressants are often used to decrease symptoms severity and decrease the likelihood of alcohol or drug relapse.
Aftercare therapies need to be maintained at a relatively intensive level, as PTSD symptoms often seem worse through the initial months of abstinence and sobriety, and are a significant threat to recovery and relapse.
Dual Diagnosis Patients Need Early Intervention and Treatment
Similar to any dual diagnosis of a psychiatric condition and addiction, PTSD and addiction treatment needs to be more intensive, needs to provide comprehensive and interlinked care for symptoms of all co-occurring disorders, and treatment will likely take longer than for a single diagnosis patient.
Because the risks towards abuse and also the risks of abuse are higher with PTSD patients; people suffering both stress related anxiety disorders and substance abuse problems need early intervention and treatment.
Very rarely will either problem dissipate without treatment, so getting help is always the first step to getting better!
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