Mental Health Issues: Alcohol Use Disorder and Common Co-occurring Conditions National Institute on Alcohol Abuse and Alcoholism NIAAA

PTSD has a crippling effect on every aspect of life, and many veterans turn to alcohol to cope with the symptoms, which can range from flashbacks of combat to feelings of numbness and disconnectedness from life. Unfortunately, a combination of PTSD and alcoholism in combat veterans only complicates the problem. The total number of lifetime trauma types, lifetime PTSD severity, and lifetime alcohol abuse or dependence was significantly linked to drinking to cope in bivariate and multivariate analyses. Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

  • In case a participant in the sequential condition is free of PTSD symptoms at the first follow-up measure (T1), the participant will still start with the PTSD treatment until these criteria of early response are reached.
  • In the DSM-5, the terms “alcohol dependence” and “alcohol abuse” were removed, and the two separate diagnoses were replaced with one diagnosis—AUD.7 The DSM-5 lists 11 symptoms for the disorder, and an AUD diagnosis now has levels of severity based on the number of symptoms presented.
  • When a stressor is identified, the HPA axis (in conjunction with other systems) prepares us for “fight or flight” by causing the secretion of stress hormones such as adrenaline and glucocorticoids.
  • Learn how having PTSD and alcohol use problems at the same time can make your symptoms of both, worse.

Also, new interventions that target this population should be developed and tested. Research on the factors leading to participant dropout and on ways of increasing treatment engagement and retention is critical. Recommended pharmacotherapies include acamprosate, disulfiram, naltrexone, and topiramate. Treatment availability and patient preferences are considerations when selecting a treatment. This study is a single blind 6-arm randomized controlled trial, consisting of 3 arms for simultaneous SUD/PTSD treatment with the PTSD treatments consisting of PE, EMDR, and ImRs, and 3 arms for sequential SUD/PTSD treatment with the PTSD treatments also consisting of PE, EMDR, and ImRs. Within the first 3 months after baseline, the three sequential treatment arms together form the SUD treatment only condition, as is depicted in the trial flow (Fig. 1).

Interventions for Prevention of PTSD and AUD

Since then, new participants all receive their entire treatment face-to-face at the location. However, when a therapist or patient is not allowed to come to the treatment facility center due to COVID-related symptoms, the session is delivered through video calling. For all sessions and assessments it is registered whether the session or assessment has been done by video calling or through a face-to-face session. The 3 treatment conditions will be compared with SUD treatment only condition (PE vs SUD; EMDR vs SUD; ImRs vs SUD) at 3-month follow-up (T1 measure) with a linear regression model.

A number of factors may have influenced the findings noted in this review, including gender differences, veteran vs. civilian status, and the various behavioral platform employed. In summary, Petrakis and colleagues conclude that clinicians can be reassured that medications that are approved to treat AUD can be used safety and with some efficacy in patients with PTSD, and vice versa. Addressing both disorders, either by pharmacological interventions, behavioral interventions or their combination, is encouraged and likely to yield the most effective outcomes for patients with comorbid AUD/PTSD. For additional review of the two papers addressing behavioral and pharmacological treatments for comorbid SUD and PTSD, refer to Norman and Hamblen (2017). Finally, two studies in this virtual issue focus on military personnel and veterans.

Treating Co-Occurring PTSD and AUD

Regular outpatient SUD treatment consists of 13 individual 50-min sessions (CBT or ACT) delivered by a psychologist (MSc) or cognitive behavioural therapist (BSc or MSc), supervised by a licensed healthcare psychologist. Regular inpatient SUD treatment consists of a 12-week CBT-based therapy program, of which the patient spends the first 6 weeks in the treatment facility receiving 24-h care. Patients in SUD day treatment follow a similar 12-week therapy program, for 3-days a week, 6-h a day. Timing and content of regular SUD treatment will not be modified due to or affected by participation in the study.

If you have PTSD, you may have trouble falling asleep or problems with waking up during the night. You may “medicate” yourself with alcohol because you think it’s helping your sleep. Problems with alcohol are linked to a life that lacks order and feels out of control. Because it is difficult to manage life with a drinking problem, it is harder to be a good parent.

Childhood Trauma and Alcohol

Between 30% and 60% of people seeking treatment for AUD have co-occurring PTSD,28 and the conditions may worsen each other. Thus, here, too, it’s important to be cognizant of the signs of ptsd and alcoholism PTSD in patients with AUD, and vice versa. Standard care for SUD treatment includes both cognitive behavioral therapy (CBT) [46] as well as Acceptance and Commitment Therapy (ACT) [47].

If substance abuse is significant, treatment may be the first step in a recovery plan, but it may also temporarily increase the symptoms of PTSD if the treatment facility is not addressing the co-occurring disorder first. In some instances, exposure therapy may be helpful in helping an individual learn how to assess fears and overcome past trauma. The best approach to treat PTSD and alcoholism in combat veterans is to seek a dual diagnosis treatment center. Although alcohol may help a person fall asleep, it negatively affects the quality of sleep, complicating the problems it is ingested to help. Because alcohol is a depressant, it also increases feelings of defensiveness, anger, and irritability, making it harder to cope with already-existing stress. While drinking may help to keep disturbing memories at bay, it prevents recovery from the painful event and complicates diagnosis and treatment.

Due to the COVID-19 outbreak in March 2020, the Jellinek treatment centers were entirely closed for new treatments for 6 weeks. The informed consent procedure and eligibility interview was conducted through video calling, however the baseline assessment was temporarily halted for participants who met the inclusion criteria. All assessments for patients that were already included were conducted by phone in line with lockdown restrictions. All included participants were informed about the changes in the procedure by a participant information letter about the modifications of the procedure. During these assessments an extra questionnaire on COVID-19 effects was temporarily included. This questionnaire consisted of 20 questions involving the effects of the Covid-19 outbreak on personal daily life and (mental) health.

  • Are there significant differences in the occurrence and trajectory of PTSD and AUD among racial and ethnic minorities?
  • Women, however, are twice as likely to develop PTSD and are 2.4 times more likely to struggle with alcoholism as a result.
  • Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions.
  • Subsequently, patients in this last group are randomly allocated to sequential PE, EMDR, or ImRs.

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