Traditional PTSD therapy doesn't trigger drug relapse
People with addiction aren't getting effective treatment for PTSD due to incorrect presumptions
July 20, 2020
Science Daily/Johns Hopkins Medicine
Researchers have now demonstrated that behavior therapy that exposes people to memories of their trauma doesn't cause relapses of opioid or other drug use, and that PTSD severity and emotional problems have decreased after the first therapy session.
About a quarter of people with drug or alcohol use disorders also suffer from post-traumatic stress disorder (PTSD), which is typically caused by a traumatic or stressful life event such as rape or combat, and which leaves the person with intense anxiety. However, patients and health care providers have been reluctant to pursue the gold-standard treatment for PTSD -- cognitive behavioral therapy -- because they anticipate that thinking and talking about traumatic events during therapy will cause relapse.
Johns Hopkins researchers have now demonstrated that behavior therapy that exposes people to memories of their trauma doesn't cause relapses of opioid or other drug use, and that PTSD severity and emotional problems have decreased after the first therapy session.
These findings were published June 29 in the Journal of Traumatic Stress.
This work originated from a larger project in which Jessica Peirce, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, and her colleagues tested how to get often reluctant patients in addiction treatment to participate in PTSD therapy. In a 2017 article in the Journal of Consulting and Clinical Psychology, her team showed that patients with opioid dependence attended on average nine exposure therapy sessions for treating PTSD when given money as an incentive, compared with only one session without the incentive.
Building on this earlier work, for the new study, her team examined week-to-week comparisons of cravings for opioids or other drugs before and after therapy sessions, self-reported days of drug use, and other distress. The researchers found there was no increase in use of opioids or other drugs, or in reported instances of stress after therapy sessions to treat PTSD. By the ninth therapy session, PTSD severity scores decreased, on average, by 54% compared to the first session.
"Now that we have evidence that treating PTSD won't impact recovery, patients can request therapy, and mental health providers have a duty to make it available to their patients," says Peirce. "There is a lot more resilience within this population than many health care providers give them credit for, and not offering the proper treatment is doing patients a disservice."
https://www.sciencedaily.com/releases/2020/07/200720092838.htm
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Can be reached in the United States at 800-273-8255, then press 1
Can be reached in Europe at 00800-1273-8255 or DSN 118 (The toll-free service in Europe may not be available through all carriers or in all countries.)
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General Veteran’s Health Wellness Resources
VA.gov Guide: Geriatrics and Extended Care
Boston University School of Medicine: Health and Wellness: Soldier and Family
Free Resources for Veterans with PTSD, Other Mental Health Challenges AARP
List of Health-Related Resources for Service Members, Veterans, and Military Families Rand.org
Military.com is one of the leading websites for military members, veterans and their families
Find a PTSD Therapist US Dept. of Veteran Affairs
Guide to Hearing Health for Veterans
PTSD in Military Veterans
Veterans Guide. org Common Mental Conditions Experienced by Military Service Members
TriCare Health & Wellness (DHA) trinare.mil
Guide to Creating a Peaceful Home To Improve Mental Health for Veterans
Chronic Pain: What it is and how proper testing helps
Chronic pain: More common in veterans than in nonveterans
Memory Care Resources for Veterans Assisted Living Research Institute
Medicare for Veterans: A Comprehensive Guide FL
Five Ways to Cope with PTSD
U.S. Army Public Health Center
PTSD, Substance Abuse, and Mental Health Help for Veterans
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12 Ways To Stay Positive While Recovering On Crutches
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Invisible aligners for military, discounted
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Disabled Veterans: A Guide To Discrimination, Other Barriers, And Resources
Safety for Elderly: Guide
Disabled Veterans: A Guide To Discrimination, Other Barriers, And Resources
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Safety for Elderly: The Ultimate Guide
Assisted living for people with mental health disorders
A Guide to Equine Therapy
Nursing Home Abuse
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VA Benefits for Seniors
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Seniors’ guide to medication management
Veterans’ Mental Health Issues
Mental Conditions Eligible for VA Disability
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Partial Hospitalization Program in California
Why Mental Health Support Is Important for Black Women
Guide to End-of-Life Planning for Veterans and Families
Veterans Guide to Paying for Assisted Living & Home Care
Veterans And Substance Abuse: Scope, Risks, And Treatment
Caregiver’s Guide to Senior Health
Suicide Facts and Statistics
Military-Related Sites for those in Service to Our Country.
4 Dimensions of Wellness
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Small Business Loans for Veterans
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List of resources for veterans’ financial security
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Predatory car sales to military members (avoiding and spotting scams)
Financial Assistance for Recovering Addicts Provided by LendEDU
A Veteran’s Guide to Starting A Small Business
101+ Resources For Military Families And Veterans
A guide to home repair grants for veterans Commercial insurance site
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We help Veterans become Homeowners
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How To Keep Elderly Loved Ones Safe From Online Scams
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Survivor and Dependent Social Security Benefits
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Comparison of Medicaid and VA Pensions Long Term Care Benefits and Eligibility Requirements
Free grants for veterans
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VA Benefits for Seniors
Comprehensive Military Discount Guide Listed By Each State
Darn Tough active duty, veterans and dependents 20% off
Digital money for seniors
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My Next Move for Veterans (Career Resources)
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A Single Mother helps struggling low-income single mothers
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Veterans and Military Service Information
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How to Apply to College
Guide to Trade and Vocational Schools
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Drug Testing Testing.com helps patients and caregivers understand lab tests
The Correlation Between PTSD in Veterans and Addiction
Rehab Treatment for the LGBTQ+ community US
LGBTQ+ Community looking for drug rehab
Substance Use Resources for Students from Historically Marginalized Groups
Contingency Management Helps Veterans Stay Drug-Free, an addiction-fighting method. Provided by Sunshine Behavioral Health
Guide to Substance Abuse in Veterans Provided by 449 Recovery.org
Contributed by Drug Rehab Connections: Alcohol Self-Assessment Test
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Stages of Recovery OH
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What to Know About Binge Drinking NH
Alcohol Consumption During COVID NH
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CDC US Drug Overdose Death Statistics USA
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U.S. Military Veterans and Addiction Addiction Guide
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How to Help an Alcoholic General
What Is Inpatient Treatment/Rehab? IL
Indiana Drug & Alcohol Treatment IN
Top Signs of Opioid Addiction MS
Concise Recovery San Fernando Valley
Signs & Symptoms of Drug Addiction MS
National Drug Addiction (Rehab) Hotline US
Veterans’ mental health care guide US
Addiction and Mental Health Resources for Veterans US
Rehab resources in Idaho ID
Utah In-Network Addiction Rehab Center UT
Resources for Loved Ones of Alcoholics OH
Advaita Integrated Medicine NC
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Active Marketing: Addiction Treatment US
Top Rehabs: curated list US
Start Your Recovery Find local rehab centers US
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Substance Abuse Articles & Education
Alcohol Misuse Among Veterans (American Addiction Centers, TN)
Veterans and Addiction Treatment (American Addiction Centers)
First Sign of Substance Abuse (Arrow Passage Recovery, OH)
Anxiety and Addiction (Iris Healing)
Dealing with Adolescent Behavior Problems (Pacific Beach Health, CA)
What Are The Types Of Mental Health Disorders? (Ripple Ranch Recovery, TX)
The Connection Between Depression and Addiction (San Diego Detox, CA)
Learn about TRT for Veterans (Immortal Male)'
Alcohol Withdrawal Treatment Program (Soledad House, S. CA)
What is an intervention? (Choice House, CO)
Stimulant Addiction Treatment (Mile High Recovery Center, CO)
What Is Polysubstance Abuse? (Rise Above Treatment, S.CA)
California Addiction Treatment
Preventing Substance Use Among Veterans
Eating disorders and addiction
Parent’s Guide to Fentanyl addicted.org
Protecting Children From Online Drug Dealers addicted.org
Nutritional deficiencies - a public health concern
PTSD Resources
See our section on PTSD, TBI collection of research papers
The following three resources were provided by Megan Bishop, Outreach Specialist outreach@alcohol.org. www.alcohol.org
These are some of their most popular evidence-based articles on PTSD and addiction:
Treatment Options for PTSD and Addiction
Private Post Traumatic Stress Disorder Treatment Options
The Link Between PTSD and Alcoholism
Dual Diagnosis Signs | Symptoms | Treatments (Opus Health, Costa Mesa CA)
Dual Diagnosis Treatment L.A., CA
Breaking the Cycle: Dual Diagnosis Addiction Treatment for Lasting Recovery
Online PTSD Self-Test (J. Flowers Institute)
How to Design a Home with PTSD in Mind
Military Skills Translation Resources for Veterans and Active Duty Service Members
Veteran source for vetted defense and private security jobs & personnel Provided by Silent Professionals.
Grants and Financial Support for Single Mothers in 50 States Provided by Sarah West, Webmaster
How to get help with the transition back to civilian life, housing and financial help, employment support and much more. Help for American Veterans
College Degree Opportunities: Understanding a Veteran with PTSD
Veteran’s Guide to Saving on Housing Costs
Provided by a commercial site, RentPath, LLC.. Find Military Housing
Resource Guide for Homeless Veterans Provided by RentDeals.com
Scholarships and Grants for Veterans and Military Families
Jobs for Veterans - Veteran’s Guide to Job Search in 2020 Provided by Novoresume.com
“Our Vision is to Fight Galactic Unemployment”
Scholarships for U.S. Army Veterans Financial Aid for Veterans, Their Spouses, and Children
Guide to Getting Discounts on Moving Services
Financial Relief & Discount Guide For Veterans With Disabilities
Military Scholarships for Active Duty Members and Veterans
Military-friendly MBA Programs: What to Look For
How Assisted Living Supports Disabled and Senior Veterans Provided by Assisted Living Research Institute, a community focused organization that is dedicated to enhancing the lives of older adults through research.
Choosing a Trade Career for Returning Service Members
Military Storage Guide: Storage Tips for Active Duty and Military Personnel
Home Renovation Grants For Veterans
Veterans Returning To School Face Unique Challenges CUNY
Veterans Fishing License Discounts & Exemptions: All States
Veteran Rights and Discrimination FL, MN, CO, TX
Military Resume Example & Writing Guide
How to Write a Cover Letter
Military-to-Civilian Resume Examples
Military to Civilian Cover Letter Examples
Internet Safety Guide
Free grants for veterans
Directory of grants for single mothers
A Guide to Active Duty Storage
Veteran-Owned Small Business (VOSB) Guide for Contractors
Common Online Scams
Small businesses, big advantages: 11 resources to help veteran-owned businesses grow
Best military-friendly colleges
Moving Companies With Military Discounts
Why Veterans Should Start a Business in the U.S.
8 Small Business Grants for Veterans
Business startup costs calculator
How to Get an LLC
How to Choose the Perfect Retail Space
Can A 100% Disabled Veteran own a Business?
Tips And Strategies For The Best Ways To Hire Veterans
11 Free Programs To Help Veterans Succeed As Entrepreneurs
How to write a CV – Tips and advice to help you land a job
Which skilled trades align well with veteran skills?
Self-Assessment Tools for Senior Drivers
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Veterans’ Mental Health Issues
Looks at depression among veterans, PTSD in military veterans, anxiety after military service, co-occurring disorders and substance abuse treatment and mental health assistance for veterans
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Discusses the culture of alcohol abuse within the military, the connection between PTSD & alcohol abuse, provides statistics and a list of FAQs regarding alcohol abuse in military personnel and veterans
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Provides statistics of U.S. veterans with substance addiction, understanding how mental health and chronic pain effect addiction, finding treatment at AAC and other support groups for veterans
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PTSD and Addiction Among Veterans: Causes, Comorbidity, and Treatment
April 2, 2019
By: Cassidy Webb
While the United States is fighting a fatal drug epidemic that is at fault for the deaths of far too many young people, veteran substance abuse continues to pose a growing problem in the nation. As military personnel are returning home from deployment, they are suffering from a vast variety of mental and physical health problems as a result of their experiences. With the comorbidity of co-occurring mental illnesses, such as Post-traumatic Stress Disorder (PTSD), and substance abuse being so prevalent, many veterans are suffering in silence from the progressive, chronic disease of addiction.
PTSD and Veterans
Due to the nature of military service and combat, many veterans are frequently exposed to life-threatening events that can lead to the development of PTSD. When stress is brought on by a traumatic experience, the brain enters a fight or flight response causing the alteration of brain chemicals and heart rate. Adrenaline begins to flow and blood pressure rises. While this response is a natural way for people to protect themselves against harm, those who experience this stress persistently after the danger has passed may have PTSD.
Symptoms of PTSD can begin shortly after the traumatic event occurs and could last a lifetime without treatment. These symptoms can include:
Recall of memories from the event or flashbacks
Difficulty coping with and expressing emotions
May avoid situations that remind them of the traumatic event
Jittery composure or unprecedented anger
Difficulty sleeping
Feelings of hopelessness or despair
Although statistics vary depending on the length of time in the military and the severity of the trauma, there is substantial evidence that veterans suffer from high rates of PTSD. In a study on veterans from Iraq and Afghanistan, it suggests that 14% suffer from PTSD and 39% suffer from alcohol abuse. For Vietnam veterans, rates of PTSD have been found to be as high as 31%. Despite the high necessity for treatment, as many as 50% of veterans who have PTSD do not receive the treatment they need.
PTSD can be a terrifying disorder that is difficult to cope with. For this reason, many veterans turn to alcohol or drugs to cope with their emotions.
Co-Occurring Disorders
The symptoms of PTSD are severe and can cause a lot of emotional distress on those who suffer from it. Unfortunately, many find solace by turning to drugs or alcohol to suppress their emotions and manage their symptoms as drugs and alcohol can increase pleasure, decrease anxiety, and distract an individual from their emotions. The comorbidity of PTSD and drug abuse is so severe that studies have found that nearly 52% of men and 28% of women with PTSD also have a substance use disorder.
While drugs and alcohol may allow individuals with PTSD to cope with their emotions in the short term, this often turns into a pattern of abuse that can lead to an addiction. After a substance is abused over an extended period of time, it becomes harder for the brain to regulate healthy amounts of dopamine. When the substances are suddenly removed, a person may experience a shortage of dopamine resulting in withdrawal symptoms. In turn, using substances to cope with the symptoms of PTSD can actually worsen symptoms. An affected person may suffer from insomnia, impaired judgment, and may engage in risky behaviors such as impaired driving or other illegal, dangerous activities.
Dual-Diagnosis Treatment
The cycle of PTSD and drug abuse is a vicious one if left untreated. On the other hand, if a person seeks treatment but only one condition is treated, they are left highly susceptible to relapse. Fortunately, forms of integrated therapy like dual-diagnosis can help treat both mental illness and substance use disorders simultaneously.
In order to get away from the persistent fight or flight mode that is so common with a PTSD diagnosis, it is important that the individual learns to identify and cope with their PTSD triggers by working closely with psychiatric and addiction specialists. Dual diagnosis therapy will generally consist of different treatment modalities, such as group therapy, individual therapy, cognitive behavioral therapy, and trauma-informed care. Individuals will be encouraged to look at their past and get to the root of their problems as well as learn of healthy coping techniques like deep breathing, meditation, and yoga.
Another benefit of dual diagnosis therapy is that clients will be able to get the right medications, like antidepressants and anti-anxiety drugs, to better treat their mental health. This combination of counseling, support, and medical treatment is typically used to help an individual with co-occurring PTSD and addiction reach a place where they are mentally and physically stable.
Treating addiction hand in hand with mental illness increases the likelihood of maintaining sobriety in the long term, and with the proper diagnosis and medications, symptoms of PTSD can be effectively managed.
Cassidy Webb is an avid writer from South Florida. She advocates spreading awareness on the disease of addiction. Her passion in life is to help others by sharing her experience, strength, and hope. cassidy@recoverylocal.org
What the New York Times gets wrong about PTSD
May 19, 2016
Science Daily/Drexel University
In analyzing the articles the New York Times has written about post-traumatic stress disorder over the last 35 years, researchers found some troubling trends in the influential paper's coverage.
Believe it or not, both the public and policy-makers often get their ideas from the media. When those ideas are formed about something as serious and impactful as posttraumatic stress disorder, it's important for the media to tell the story in the right way.
With that in mind, Drexel researchers examined how the country's most influential paper, the New York Times, portrayed posttraumatic stress disorder (PTSD) from the year it was first added to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (1980) to present day (2015).
"Mass media shape public awareness about mental health issues and affect mental illness problem recognition, management, and treatment-seeking by providing information about risk factors, symptoms, coping strategies, and treatment options," said Jonathan Purtle, DrPH, assistant professor in Drexel's Dornsife School of Public Health and the study's principle investigator. "Mass media also influence community attitudes about mental illness and educate policymakers about whether and how to address them."
Between 1980 and 2015, 871 news articles mentioned PTSD. In their American Journal of Orthopsychiatry paper, Purtle and his co-authors, Katherine Lynn and Marshal Malik, pointed out three specific issues in the Times' coverage that could have negative consequences.
"New York Times portrayals of populations affected by PTSD do not reflect the epidemiology of the disorder."
The Drexel team found that 50.6 percent of the Times' articles focused on military cases of PTSD, including 63.5 percent of the articles published in the last 10 years.
In actuality, Purtle's past research showed that most PTSD cases are related to noncombat traumas in civilians. The number of civilians affected by PTSD is 13 times larger than the number of military personnel affected by the disorder.
Occurrences are also much more likely in those who survive non-combat traumas, which include sexual assault (30-80 percent of survivors develop PTSD), nonsexual assault (23-39 percent develop it), disasters (30-40 percent) and car crashes (25-33 percent), among other causes. Veterans of the wars in Afghanistan and Iraq have just a 20 percent occurrence of PTSD.
However, coverage like that in the Times leads the general public to believe that a PTSD diagnosis requires some military component. And 91.4 percent of all legislative proposals involving PTSD between 1989 and 2009 focused only on military populations, with 81.7 percent focusing on combat as a cause (the next highest cause was sexual assault, at 5.5 percent).
"PTSD was negatively framed in many articles."
Self-stigma attached to PTSD has been identified as a strong barrier to seeking treatment.
As such, with fewer and fewer articles over the years mentioning treatment options (decreasing from 19.4 percent of all PTSD-focused articles in 1980-1995 to just 5.7 percent in 2005-2015), it is particularly harmful when articles focused on negative portrayals of those with PTSD.
Purtle and his researchers found that 16.6 percent of the articles were about court cases in which the defendant potentially had PTSD, while 11.5 percent of other articles talked about substance abuse.
"These negative themes could create misconceptions that people who have PTSD are dangerous and discourage employers from hiring prospective employees with the disorder," Purtle said.
"Most themes in the New York Times PTSD articles pertained to proximal causes and consequences of the disorder."
Most articles in the study's 35-year focus centered on the traumatic exposure that led to PTSD, as well as the symptoms that result from the disorder. They rarely told stories of survivors and prevention.
Although nearly three quarters of articles mentioned a traumatic cause of PTSD, concepts such as risk/protective factors or prevention were barely mentioned. Risk/protective factors were only mentioned in 2.6 percent of articles and prevention was only mentioned in 2.5 percent.
Almost a third of the articles reviewed discussed some kind of symptom -- nightmares (13.1 percent of the time), depression (12.3 percent) and flashbacks (11.7 percent) being most common.
"This narrow focus could inhibit awareness about PTSD resilience and recovery and constrain discourse about the social determinants of traumatic stress, which is needed to garner political support for policy interventions," the Drexel team wrote.
What Can Be Done?
Purtle, Lynn and Malik believe that broadening the discourse on PTSD can lead to better outcomes. Some ways that that can be achieved are focusing on survivor narratives that discussing resiliency and recovery, or talking about research that doesn't wholly focus on the military causes of the disorder.
https://www.sciencedaily.com/releases/2016/05/160519121152.htm