PTSD,+Alcohol,+and+War

__PTSD, Alcohol, and War__



According to Veterans Affairs Canada:  (Veterans Affairs Canada, @http://www.vac-acc.gc.ca/clients/sub.cfm?source=mental-health/support/factsshq)
 * War is a common factor in the development of PTSD.
 * There is a known link or common occurrence between alcohol use and those with PTSD.
 * Sixty to eighty percent of Vietnam veterans seeking PTSD treatment have alcohol use disorders.
 * Veterans over the age of 65 with PTSD are at increased risk for attempted suicide if they also use alcohol or experience depression.
 * Veterans diagnosed with PTSD and who use alcohol tend to be binge drinkers, which may be a response to memories or reminders of the trauma.

__Iraq War__ Two case studies were done of two veterans of the Iraq War who presented for combat-related treatment at a Veterans Administration Medical Center (Tuerk, Grubaugh, Hammer & Foa, 2009). In addition to PTSD, symptoms of re-experiencing, arousal, and avoidance, the veterans exhibited compulsive door and window checking behaviour that appears to be influenced by specific combat duties and traumatic events (Tuerk et al, 2009). These cases represent what the authors believed to be an increasingly common expression of PTSD in veterans of the Iraq and Afghanistan wars (Tuerk et al, 2009). Both veterans were treated with prolonged exposure therapy, which includes imaging and in vivo exposure to anxiety-provoking stimuli, processing of traumatic events, and self-assessment of anxiety (Tuerk et al, 2009). Measures related to PTSD and depression were obtained before, during, and after treatment. Treatment was associated with significant declines in symptom severity and improved functioning for both veterans (Tuerk et al, 2009).

__Kosovo Peacekeepers__ Peacekeepers were deployed to Kosovo and were evaluated before the mission which was August 2000 and at post-deployment on a number of mental health and functional impairment variables (Maguen, Stalmaker, McCaslin & Litz, 2009). Three models were looked at, in the first model avoidance and hyper-arousal symptoms that were presented by the victims with PTSD showed difficulties in employment, legal matters, family relationships and social functioning ( Maguen et al, 2009). The second model looked at emotional numbing which was a high predictor of violent behaviour especially in post deployment situations ( Maguen et al, 2009). Finally the third model looks at re-experiencing traumatic events that was also a high predictor for abusing alcohol (Maguen et al, 2009). Overall these three models are differentially associated with varying functional impairment outcome (Maguen et al, 2009).

__Persian Gulf War__ The Persian Gulf war, although brief, produced a large number of soldiers with PTSD (Tull, 2009). Approximately 40% of those diagnosed with PTSD had also used alcohol to alleviate the symptoms. This suggests that there are small, isolated incidents that bring about the onset of symptoms and alcohol use seems to alleviate these symptoms, which may be experienced as flashbacks, along with uncomfortable thoughts and feelings related to the event. (Tull, 2009)

Fast Facts:  Information derived from @http://www.medicalnewstoday.com/articles/149074.php
 * There is a high rate of comorbidity between alcohol use and PTSD symptoms for troops returning from Iraq and Afghanistan.
 * The comorbidity is likely to keep rising as troops come home from service.
 * War seems to be a common trigger in precipitating PTSD, and alcohol is likely something that is readily available in the army, and also upon returning from combat.
 * It seems to make sense that alcohol would be a common way to deal with the stress of combat related incidents, and the resulting PTSD experienced in later life due to its greater acceptance in society than illegal drugs.
 * The APA is looking at new ways to treat alcoholism as it co-occurs with illness like PTSD (APA, 2009)

War is a common issue in facilitating the onset of PTSD, due to the traumatic events inherent in that setting. Since it is expected that those involved in war are able to be strong and deal with things of a disturbing nature, it seems natural that they would feel bereft and without direction upon returning from the war. Because of the expectations placed upon soldiers in these positions, they may turn towards alcohol or other substance use rather than seek help from a therapist or other helping professional. Therefore, the commonality between soldiers diagnosed with PTSD, and their use of alcohol make it more difficult to break the cycle and deal with the symptoms that are plaguing them. (@http://www.enotalone.com/article/11325.html)
 * __Conclusions__**

There is a suggestion about endorphin levels as they relate to alcohol and PTSD. Following a traumatic event, endorphin levels rise and the one exposed to the trauma may experience a "numbing" quality regarding the intensity of the event ( www.vac-aff.gc.ca).

Following the traumatic event itself, endorphin levels begin to drop again, and so the victim begins to experience the physical and emotional effects of the event. Alcohol has the effect of releasing endorphins, so this would suggest a desire for those with PTSD to drink in order to continually numb the effects of re-experiencing the event ( www.vac-aff.gc.ca<span style="font-family: 'Comic Sans MS',cursive;">).

Since the body is not experiencing the event during symptoms of PTSD, the victim feels the need to compensate for the instability created by the mind around this past experience. The body cannot tell the difference between an "actual" event, and memories being recalled by the mind. Therefore, a victim of PTSD would find themselves in continual need of release from these symptoms, as though they were "actually" happening in the present moment ( www.vac-aff.gc.ca<span style="font-family: 'Comic Sans MS',cursive;">).

Alcohol provides temporary relief from the mind's recall ability, one way being in the release of endorphins. PTSD is characterized by repeatedly recalling the troubling event, which gives rise to actual physiological symptoms. Using alcohol is an attempt to interrupt the cycle of reactivity experienced by the individual. (National Institute of Health, 2009)

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