PTSD and Problems with Alcohol Use PTSD: National Center for PTSD

Thus, there could have been up to 4 days between the target day and actual data collection if calls were missed on Thursdays; 10% of calls were collected verbally. Participants were compensated $1 for every day of completed daily monitoring, with an additional $10 for completing 7 consecutive days of monitoring or $7 for 6 days of monitoring. The daily monitoring assessments completed during the interval between the baseline assessment and randomization to a brief behavioral intervention are the focus of the current study.

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• Participants in these trials for the most part improved over time regardless of the interventions.
• Evidence-based pharmacological treatments for alcohol use disorders (AUDs) evaluated in well-designed clinical studies are not being adopted in clinical treatment settings as evidenced by the low uptake of the use of medications to treat AUD (Jonas et al. 2014).
• Second, because this study focused on coping-related drinking motives, we excluded other relevant mediators that could support the self-medication hypothesis (such as “avoidant” coping, “maladaptive” coping; alcohol expectancies; negative urgency; and emotion regulation).
• The differing theories behind sequential versus integrated treatment of comorbid AUD and PTSD are presented, as is evidence supporting the use of integrated treatment models.

This menu of treatments could be based on biomarkers, demographics, and other patient characteristics, and it could identify promising alternatives if first-line treatments fail. Evidence indicates that concurrent treatment of PTSD and AUD can be safe and effective.30,39 Before reporting on concurrent treatment approaches, we describe evidence-based treatments targeting either PTSD or AUD. One 2022 review investigated the effectiveness of psychological interventions, such as exposure-based therapy and CBT, for people with adverse childhood experiences at risk of PTSD and SUD.

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Many research studies have shown that teenagers who have these experiences are more likely to engage in problem drinking, possibly as a way to minimize their PTSD symptoms. But since most previous studies have collected traumatic event and drinking data at the same time (e.g., “cross-sectional” studies), it has been unclear whether the traumatic event itself, or the posttraumatic stress symptoms that occurred after the traumatic event, caused problematic drinking in teenagers. Second, although treatments for PTSD and SUD have been disseminated systemwide within the VA, there is a dearth of literature about the effectiveness of these treatments for those in this population who have both conditions. In research and practice, several notable gaps exist in addressing co-occurring PTSD and AUD in military and veteran populations.

Treatments for AUD

Eye movement desensitization and reprocessing is one of the three most-studied treatments for PTSD.59 This therapy incorporates a variety of techniques, including prolonged exposure and cognitive restructuring, but it differs in that it applies these techniques in conjunction with guided eye movement exercises. Research finds that almost 50 percent of women will experience a traumatic event at some point in their lifetime. Women are more likely to experience trauma in the form of sexual assault or childhood trauma. Any traumatic event can cause PTSD, whether there is a threat to the physical, emotional, or social safety of yourself or someone else. Some studies have indicated that people who are diagnosed with PTSD and abuse alcohol may drink in an attempt to experience positive emotions.

However, another recent clinical trial found no advantage of prazosin (16 mg daily) over placebo in reducing PTSD symptoms, sleep disturbances, or drinking outcomes over 12 weeks. These null findings suggest that alcohol consumption may interfere with prazosin’s efficacy in improving PTSD symptoms 82•. One commonly noted barrier to treatment adherence in the use of prazosin is the short half-life of the medication. Some patients necessitate multiple daily dosing to achieve their desired dose and thus, medication compliance remains a challenge for some patients. Doxazosin is a longer acting alpha1 adrenergic antagonist that can be administered once daily.

Participants in these trials for the most part improved over time regardless of the interventions. Nevertheless, the results are disappointing from a research standpoint in that the effects of the target medication interventions were modest at best and no category of medication had consistent positive results across alcohol and PTSD outcomes. Nine RCTs were identified; three focused on medications to treat PTSD, four focused on AUD, and three to target both.

• Number of standard drinks for each beverage type was added together for total drinks per day.
• Fifty-six per cent of the participants reported a positive history of driving under the influence of alcohol.
• IRRs reflect the percentage increase in the rate of drinking as a function of PTSD symptoms, while holding all other variables in the model constant.
• If you have PTSD, plus you have, or have had, a problem with alcohol, try to find a therapist who has experience treating both issues.
• And similar to the model in which all motives were entered simultaneously, social and conformity drinking motives did not independently moderate the association between PTSD symptoms and same-day drinking.

Psychometric research on the TDR suggests that it is a more specific measure than the DMQ coping subscale, whose questions focus on depression and anxiety more generally (Hawn, Aggen, et al., 2020). After removing duplicates, the same authors independently screened the remaining titles and abstracts to identify articles that were clearly eligible or clearly ineligible. Eligible manuscripts were then reviewed in full and studies deemed ineligible were given a brief justification for removal. Finally, the authors checked reference lists of any recent systematic reviews or meta-analyses related to coping motives, PTSD, and harmful alcohol use.

Participants were also instructed in procedures for telephone daily Interactive Voice Response (IVR) and the drinking and ptsd accompanying pager system. Study procedures were approved by the masked institution Human Subjects Division Internal Review Board. The data that support the findings of this study are available from the corresponding author upon reasonable request. Mean and SD reflect the mean and standard deviation of the sum score for each measure reported.