Armed Services Covenant

Lighthouse - A time for healing

Working with veterans of the armed forces

Some people try to cope with their Posttraumatic Stress Disorder (PTSD) symptoms by drinking heavily, using drugs, or smoking too much. People with PTSD have more problems with drugs and alcohol both before and after getting PTSD. Also, even if someone does not have a problem with alcohol before a traumatic event, getting PTSD increases the risk that he or she will develop a drink or drug problem.
Eventually, the overuse of these substances can develop into Substance Misuse Disorder (SMD), and treatment should be given for both PTSD and SMD to lead to successful recovery. The good news is that treatment of co-occurring (happening at the same time) PTSD and SMD works.

How common is co-occurring PTSD and SMD in Veterans?

Studies show that there is a strong relationship between PTSD and SMD, in both civilian and military populations, as well as for both men and women.

Specific to Veterans:

  • More than 2 of 10 Veterans with PTSD also have SMD.
  • War Veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to bad memories of combat trauma.
  • Almost 1 out of every 3 Veterans seeking treatment for SMD also has PTSD.
  • The number of Veterans who smoke (nicotine) is almost double for those with PTSD (about 6 of 10) versus those without a PTSD diagnosis (3 of 10).
  • In the wars in Iraq and Afghanistan, about 1 in 10 returning soldiers have a problem with alcohol or other drugs.

How can co-occurring PTSD and SMD create problems?

If someone has both PTSD and SMD, it is likely that he or she also has other health problems (such as physical pain), relationship problems (with family and/or friends), or problems in functioning (like keeping a job or staying in school). Using drugs and/or alcohol can make PTSD symptoms worse.

For example:

  • PTSD may create sleep problems (trouble falling asleep or waking up during the night). There can also be a high prevalence to Night Terrors which, can involve the individual reliving the experiences via sleep and studies have shown that lack of sleep can trigger or exacerbate issues of mental illness. You might ‘medicate’ yourself with alcohol or drugs because you think it helps your sleep, but drugs and alcohol change the quality of your sleep and make you feel less refreshed and more mentally unstable triggering symptoms of mental illness such as anxiety, paranoia and lack of motivation/concentration.
  • PTSD makes you feel ‘numb,’ like being cut off from others, angry and irritable, or depressed. PTSD also makes you feel like you are always ‘on guard.’ All of these feelings can get worse when you use drugs and alcohol.
  • Drug and alcohol use allows you to continue the cycle of ‘avoidance’ found in PTSD. Avoiding bad memories and dreams or people and places can actually make PTSD last longer and have a greater impact on the individual. You cannot make as much progress in treatment if you avoid your problems.
  • You may drink or use drugs because it distracts you from your problems for a short time, but drugs and alcohol make it harder to concentrate, be productive, and enjoy all parts of your life. Addiction also brings about other issues for the individual as issues can then impact on others such as family members or employers.

What treatments are offered for co-occurring PTSD and SMD?

Evidence shows that in general people have improved PTSD and SMD symptoms when they are provided treatment and support that addresses both conditions. This can involve any of the following (alone or together):

  • Individual or group LEAP programme
  • Specific psychological treatments for PTSD,working
  • Medications that may help you manage the PTSD or SMD symptoms
  • Being around others who are/have experienced similar issues, taking away taboo’s or feeling alone in one's experiences

Talk to Lighthouse about their recovery programme for specific symptoms like pain, anger, or sleep problems.

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