DURHAM, NC — Many servicemembers and veterans seeking treatment for alcohol problems have experienced the life-threatening stress of combat, many have post-traumatic stress disorder (PTSD), and many servicemembers and veterans seeking treatment for PTSD also have alcohol or other substance problems.
That’s according to a report in the journal Alcohol Research Current Reviews, which pointed out that sensitivity to these issues can influence how a therapist relates to the patient and also has possible implications for developing a treatment strategy.1
“Historically, clinicians have been concerned that patients need to reduce or resolve substance abuse before PTSD treatment can be successful. But research is showing that both disorders can be treated simultaneously,” wrote the researchers from the VA Mid-Atlantic Health Care Network Mental Illness Research, Education and Clinical Center in Durham, NC. “Here, we assess the scope of the problem and examine treatments that can be effective for treating each disorder individually as well as in tandem.”
The study emphasized that alcohol abuse disorder (AUD) and PTSD are common and severe problems in veterans and military service members and merit intervention.
“Fortunately, a number of psychological treatments and medications have been demonstrated as effective for each problem and should be incorporated into clinical practice whether the conditions occur independently or together,” researchers state, recommending when both conditions occur in the same patient, they should generally be addressed simultaneously, either in closely coordinated or integrated care.
“Contrary to earlier clinical concerns that substance abuse should be reduced or resolved before treatment for PTSD, it seems that for most patients the treatments can be performed simultaneously with good results,” study authors explained.
They urged adoption of a comprehensive treatment plan by combining modalities and targets.
“As in other areas of clinical practice, clinicians should systematically and frequently monitor patient progress to determine if some modification may be needed in the treatment protocol,” the researchers concluded. “It also is important to assess the patient’s medical status before prescribing pharmacotherapies. In many cases, especially those involving alcohol dependence, adjunct medications will prove useful.”
- Allen JP, Crawford EF, Kudler H. Nature and Treatment of Comorbid Alcohol Problems and Post Traumatic Stress Disorder Among American Military Personnel and Veterans. Alcohol Res. 2016;38(1):133-40. Review. PubMed PMID: 27159820; PubMed Central PMCID: PMC4872608.