Co-OccuringSubstance Abuse Disorders and PTSD
Co-occurring substance abuseand posttraumatic stress disorder patients present a severe challengeto clinical personnel. Clinicians report that such patients are hardto treat than those diagnosed with one of the two disorders alone.Specifically, the medical staff is unsure of which disorder to treatfirst. Standard practice in the medical field observes that it iseasier to treat substance abuse first due to the high possibility ofpatients relapse from a posttraumatic disorder. Ongoing researchindicates that the most efficient approach entails addressing bothconditions concurrently (McDermott 45).
Epidemiological studies haverevealed high rates of substance abuse disorders among post-traumaticindividuals. Substance misuse occurs at 21-43% of people withpost-traumatic disorders compared to9-26% among people without traumarelated sickness. Besides, higher occurrence of posttraumaticdisorders occurs among clinical populations. A majority 75% of combatVietnam veterans with posttraumatic disorders are diagnosed withsubstance dependence. The prevalence of posttraumatic disordersvaries by the sample. For example, more than three-quarters of womenand men with co-occurring substance abuse have posttraumaticillnesses. Women diagnosed with co-occurring substance abuse are morelikely to meet the criteria for drug abuse than those not associatedwith addiction. The prevalence of disorders in women is twice thatassociated with their male counterparts. Besides, posttraumaticailments are highly related to the abuse of hard drugs and poly drugscompared with alcohol and marijuana. Specifically, the associationof posttraumatic disorder is associated with 33% abuse of opioidscompared to5.3% use of alcohol and marijuana (Dolan 78).
Research has revealed that thehigh association between the two disorders is because posttraumaticmalady leads to substance misuse. From a developmental perspective,childhood related traumatic stress reduces the development ofself-regulatory mechanisms on the behavioral and neurobiologicallevels and consequently increases the risk of substance misuse. It isobserved that individuals may self-medicate with various drugs as astrategy for coping with the post-traumatic syndrome. The secondexplanation for the great relationship between the two disordersnotes that the use of drugs increases the likelihood of exposure totrauma. Third, according to the susceptibility hypothesis, substanceabuse is associated with increasing the chances of developingpost-traumatic disorder after exposure to traumatic incidences. Thegraduation to PSTD occurs due to increased vulnerability in both thebiological and psychological levels of an individual. Therelationship between the two disorders may be mediated by a thirdvariable like absentminded as well as individual differences incoping skills (Wormer 89).
Despite the lack of a solitaryclarification for the relationship between the two disorders,empirical support has indicated that post-traumatic disorders lead tothe development of substance abuse. Laboratory experiments have foundevidence supporting the crave for substances after experiencingtraumatic situations. Individuals diagnosed with posttraumaticdisorders indicate a higher response to trauma-related hints thanneutral cues. Other experiments indicated that greater use of drugsis related to conditions associated with disturbing emotions,interpersonal conflict or physical discomfort compared to neutral orpleasant situations. Patients with early and complex traumaexperience various problems such as impulsivity, self-destruction,vulnerability, victimization and suicidal ideation. Posttraumaticdisorder reduces the patient’s ability to benefit from substanceabuse treatment. Patients diagnosed with substance abuse have a poorrate of adherence to treatment and a shorter period of self-denial.They are the most difficult to treat compared to those diagnosed witheither of the disorders alone. Although there is a clear indicationof the negative influence of comorbid post-traumatic disorder ontreatment, there requires more research on the relationship (Wormerand Rae 89).
Dolan, Joshua. Treatmentof Dual Diagnosis Post Traumatic Stress Disorder and Substance UseDisorders: A Meta-Analysis.Milwaukee, WI: [email protected], 2012. Print
McDermott, WalterF. UnderstandingCombat Related Post Traumatic Stress Disorder.Jefferson, NC: McFarland, 2012. Print.
Wormer, Katherine, and Rae,Diane . AddictionTreatment: A Strengths Perspective.PacificGrove, CA: Brooks/Cole–Thomson Learning, 2003. Print.