Alcohol Use Disorder and PTSD: An Introduction PMC

Some examples of events that may cause PTSD include gun violence, military combat, or intimate partner abuse. Four studies have evaluated medications targeting alcohol use in comorbid group of subjects. Three studies evaluated the Food and Drug Administration (FDA)-approved medication naltrexone; one of these studies also included disulfiram, which is also FDA approved for treating AUD. A fourth study evaluated topiramate; which although not FDA-approved is recommended as a second line treatment for alcohol use disorders (Johnson 2016) and therefore is included in this section.

Living With PTSD

In one case study of an OEF/OIF veteran, researchers examined the effectiveness of concurrent treatment of PTSD and SUD using prolonged exposure (COPE) therapy.45 COPE involves 12, 90-minute sessions that integrate relapse prevention with prolonged exposure therapy. The veteran who received the therapy reported reduced alcohol use throughout treatment, scored in the nonclinical range for PTSD at the end of treatment, and maintained treatment gains at a 3-month follow-up. A panel of advisers PTSD and Alcohol Abuse to the Food and Drug Administration voted 10-1 against the overall benefits of MDMA when used to treat post-traumatic stress disorder. They cited flawed study data, questionable research conduct and significant drug risks, including the potential for heart problems, injury and abuse. “If we rely on antidepressants for treatment, it can take several weeks before people experience amelioration of symptoms, if at all,” said Nora Volkow, MD, director of the National Institute on Drug Abuse.

Do People Use Alcohol to Cope with PTSD?

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). There are several general issues to consider when treating co-occurring alcohol dependence and trauma/PTSD.

Couples therapy

It can also be caused by learning that it happened to someone you care about (e.g., racial trauma) or being exposed to details of an extremely distressful event (e.g., a therapist hearing about a traumatic event from a client). Experiencing this condition can be challenging for your mind and body, causing symptoms like rapid heart rate, anxiety, and trouble sleeping. Fortunately, several treatment options can help manage symptoms, offer support, and improve your quality of life. Your exact treatment plan will depend on the severity of your symptoms, but healthcare providers often recommend psychotherapy, medications, and support groups. There is a small but growing literature of pharmacotherapies to treat AUD with comorbid PTSD. The conclusions from this review suggest that there is not one agent that has clear evidence of efficacy in this comorbid group.

The 1970 Controlled Substances Act made most psychoactive drugs illegal before any treatments were brought to market, and MDMA was classified as a Schedule 1 substance in 1985, which effectively ended any research. It wasn’t until 2000 that scientists at Johns Hopkins University were granted regulatory approval to study psilocybin anew. “It does seem that some of these molecules can be administered safely,” said David Olson, director of the University of California-Davis Institute for Psychedelics and Neurotherapeutics.

What’s the connection between CPSTD and addiction?

The highest prevalence rates of lifetime PTSD were observed in AIAN women, and the highest rates of comorbid AUD/PTSD were observed in AIAN men. Both the Werner and Emerson papers suggest the need to develop more tailored and comprehensive assessment methods, and develop more effective interventions to help reduce the heavy burden of trauma, PTSD and AUD in racial and ethnic minority communities. Eight of the veterans showed clinically reliable reductions in PTSD outcomes after treatment. Most of the veterans showed clinically reliable reductions in their percentage of days of heavy drinking.

PTSD Isn’t Limited to Veterans

• In one case study of an OEF/OIF veteran, researchers examined the effectiveness of concurrent treatment of PTSD and SUD using prolonged exposure (COPE) therapy.45 COPE involves 12, 90-minute sessions that integrate relapse prevention with prolonged exposure therapy.
• First, patients are randomly allocated to simultaneous PE, EMDR, or ImRs, or the SUD treatment only group.
• And of course, if someone is using alcohol to mask the symptoms of PTSD, that means they may go longer without realising they have PTSD, so the root cause of the symptoms goes untreated.
• Also, there may be opportunities for prevention during predeployment and postdeployment periods, but research on such programs is scarce.