Exploring the Complex Relationship Between Combat Veterans, Alcoholism, and PTSD

Veterans returning home, especially those who have participated in combat, have witnessed violence and killing, and have enlisted for more than one tour, are at greater risk of developing PTSD and alcoholism (AUD). According to the National Center for PTSD (part of the U.S. Dept. of Veterans Affairs), those who fought in Iraq and Afghanistan were 1 in 10 to return with an alcohol problem or SUD. War veterans with PTSD and alcohol problems tend to binge drink (down a lot). “[T]wo-thirds of veterans with PTSD also report chronic pain.”, which adds to the complexity of one’s mental and physical well-being.

The combination of PTSD and alcoholism or AUD (alcohol use disorder) are classified as suffering from co-occurring disorders. That means more than one disorder is happening simultaneously. “Almost 1 in every 3 Veterans seeking treatment for SUD (substance use disorder which can include alcoholism) have PTSD. Additionally, almost 1 of 4 Veterans with PTSD suffer from SUD.” The excellent news is appropriate treatment can help veterans manage all co-occurring disorders.

What is PTSD?

PTSD stands for post-traumatic stress disorder. Anyone witnessing an extreme event can develop PTSD. PTSD is a mental health condition that triggers an intense emotional and physical response in the person involved. The PTSD may start immediately, a month later, or even years after the event(s). According to the Mayo Clinic, PTSD symptoms can be grouped into four types:

Intrusive memories
Avoidance behaviors
Adverse changes in thinking or mood
Changes in physical and emotional reactions

There are multiple reasons one may develop PTSD, but for war veterans, it can include:

Living through dangerous events (repetitively)
Seeing another person hurt or seeing dead bodies
Feeling horror, helplessness, or extreme fear
Not feeling social support for feelings after the event

The most common symptoms for war veterans with PTSD are:

Reliving the event
Avoiding things that remind one of the events
Feeling keyed up or hyperarousal
Nightmares
Easily startled
Loss of interest in activities
Using drugs and alcohol to manage stress and intense feelings
Lack of sleep
Flashbacks

Sometimes veterans come home and function fine. But, as they age, the experiences during combat can trigger PTSD. This is known as Late-Onset Stress Symptomatology. However, it is different than PTSD.

Alcoholism and the Military

Many studies have been done on military personnel and alcoholism. Studies found heavy drinking is more likely among younger military members, low-ranking, non-Air Force, White, or Hispanic men. The high-stress levels for all military personnel are well documented, with PTSD being the most diagnosed disorder for veterans returning from combat. Sadly, alcohol use to self-medicate against feelings associated with trauma only worsens the condition and complicates recovery.

What is Alcoholism?

“Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” Alcoholism is a brain disorder because, like drugs, it changes how the brain functions and communicates with the body. AUD can be mild, moderate, or severe. Withdrawal symptoms also accompany alcoholism; depending upon the amount of alcohol consumed over some time, withdrawal symptoms can be dangerous. It is known that alcohol, considered a depressant, can make feelings of anger, depression, and anxiety worse. Because alcohol slows the brain’s ability to send messages and for the body to respond, it is more difficult for someone suffering from PTSD and alcoholism to make sense of reality.

Withdrawal Symptoms for mild to moderate AUD

Sweating
Shaking
Hallucinations
Anxiety
Depression
Sleep disruptions
Suicide

Long-term alcohol use can cause serious health issues, which include:

Stroke
Liver disease
Heart disease
Bowel, breast, and mouth cancer
Pancreatitis
Wet brain

According to the Veterans Administration, people who survive violent, traumatic events report drinking problems. Additionally, those who experienced pain and PTSD were associated with AUD symptoms. Veterans with comorbid (co-occurring) “PTSD/AUD were three times more likely to have attempted suicide in their lifetimes…Veterans accounted for over 14 percent of completed suicides in the U.S. in 2015.

Indeed, it is known that veterans suffering from mental health disorders and PTSD who also suffer from alcoholism will worsen their PTSD symptoms. These include:

Having no emotions
Being cut off from others
Feeling angry and irritable
Feeling depressed
Being jittery, on guard
Nightmares

The prevalence of PTSD and AUD reduces the protective psychosocial characteristics “such as perceived resilience, purpose in life, and dispositional gratitude….”

Obtaining veterans’ disability benefits can be complicated. If a veteran has PTSD, it must be service related; it cannot stem from something related to an experience in civilian life. If a service person is suffering from alcoholism, that alone will not make him/her/they eligible for benefits. The VA will consider whether the AUD impairs one’s ability to work. However, like PTSD, the AUD must be service related.

There are V.A. but also VA-approved facilities if a V.A. treatment program is filled or there isn’t one near you. The VA does cover alcohol rehab and, if properly diagnosed, treatment for PTSD and AUD. Community Care programs and additional assistance with TRICARE health plans can help pay for comprehensive treatment care.

Treatment for PTSD and AUD

Until the last few years, rehabs provided treatment for one condition, generally not multiple conditions. PTSD and other mental health disorders with AUD/SUDs must be diagnosed accurately and treated simultaneously. Treating one disease without the other leaves the client at greater risk of relapsing. A team of addiction experts and clinicians trained in mental health disorders and co-occurring addictions must work together to provide the most comprehensive care. Without the proper diagnosis and a continually updated treatment plan, it is difficult for a veteran to gain control of what is happening.

Based on the latest research, best practices approved by the authorizing bodies and the medical establishment can provide the veteran with ways to manage and reduce symptoms and live a productive life again. A variety of therapies are used to reduce PTSD symptoms, including medication for trauma and other mental health disorders that may be present. Integrated programs, including trauma-informed care, are the most promising approaches. Simultaneously, addiction treatment combined with mental health disorder treatment can help the veteran gain control over the addiction and stop self-medicating or acting on impulse. A facility where integrated approaches are practiced needs to be licensed, as does the team of addiction physicians and mental health clinicians.

Call today to find out how we can help restore your health and start your recovery journey.