PTSD and Alcoholism

It should be noted, however, that to exclude patients with comorbid PTSD and AD who are taking psychotropic medications would not only make recruitment more challenging, it would also decrease the generalizability of the findings. Other issues that may have extra-medication bearing on findings include the different treatment settings noted across studies. As mentioned above, studies have been conducted at VA settings with male patients who have experienced combat, while others are in predominately female civilian populations, limiting the ability to compare findings across studies. Several comments about methodologic challenges in conducting these studies should be highlighted.

• This durable comorbidity has been found in large, small, representative, and targeted samples.
• Thus, a bar-served glass of Raksi (distilled local drink) was considered 2 units of ethanol and 1 mana (approximately 0.55 L) of Jand (domestically fermented beverage) was calculated as containing 3 ethanol units.
• Alcohol problems are more common for those who experience trauma if they have ongoing health problems or pain.

After a few months of individual and group treatment, the reduced daylight during winter months triggered memories of nighttime mortar attacks in Vietnam. The veteran experienced increased PTSD symptoms, marked craving for alcohol, and new-onset depressive symptoms, including anhedonia and suicidal ideation. He relapsed to heavy drinking, spent more time alone in his basement apartment, and considered ending his life.

PTSD and Alcoholism

A few differences were noted for example, the Hein study included subjects with sub-threshold PTSD and only one study included PTSD severity as a criterion for entry into the study (Foa et al. 2013). Similarly, the outcome measures were mostly comparable; reporting on alcohol consumption based on the Time Line Followback Method and PTSD symptoms using https://ecosoberhouse.com/ Clinician Administered PTSD (CAPS) or its derivative, the PTSD Checklist (PCL). Only two studies reported on a “clinically meaningful change” (Foa et al. 2013, Hien et al. 2015) and one study characterized subjects based on onset of PTSD and onset of alcohol dependence (Brady et al. 2005) but the validity of these subgroups is not well established.

First, four of the nine studies were conducted in primarily male veteran subjects; the rest had significant numbers of women. There is evidence of gender differences in medication response for both the antidepressants (Keers and Aitchison 2010) and naltrexone (Garbutt et al. 2014, Roche and King 2015). Other potential confounds include severity and chronicity of illness, type of trauma experienced, other comorbid diagnoses, concomitant psychotropic medications, and whether additional treatment resources were available (e.g., sober housing, robust addiction counseling services, etc.). Most of the studies allowed comorbid depressive disorders, drug use disorders, and subjects who were prescribed other medications. The randomized clinical trials treating AUD and comorbid PTSD were mostly well-designed studies that used similar inclusion/exclusion criteria, notably current DSM-IV diagnosis of alcohol dependence and PTSD, with current drinking requirements for entry.

Military culture

Up to a third of those who survive traumatic accidents, illness, or disaster report drinking problems. Alcohol problems are more common for those who experience trauma if they have ongoing health problems or pain. Mental health research supports that alcoholism and other substance abuse disorders rarely alcoholic rage syndrome manifest in an individual without underlying causes. The recent ability for therapists and recovery centers to address both the physical issue of addiction and the cooccurring mental health issues has seen a dramatic increase in the success of those in recovery from alcoholism and substance abuse.