The incidence rates of post traumatic stress disorder in returning combat soldiers are about 30%. Since PTSD greatly increases the likelihood of drug abuse and addiction, we need to be ready to support returning soldiers with the respect and treatment they deserve.
Post traumatic stress disorder is a mental disorder that affects people who have been exposed to a terrifying and perceived life threatening situation. While the threat to life is usually a threat to the PTSD sufferer’s life, the threat to another (spouse, child or friend) can also induce symptoms of post traumatic stress disorder. Violent crime, rape and other traumas can all induce PTSD, as can terrorist attacks such as Sep 11; but at greatest risk of PTSD are soldiers who have faced combat, and it is estimated that about 30% of all combat soldiers will suffer the effects of PTSD to some degree. The symptoms of PTSD are anxiety, recurring nightmares, flashbacks, sleep disorders, an inability to enjoy life and sometimes even irritability or feelings of aggression. The symptoms of PTSD generally occur within a month of exposure to a life threatening trauma, but may not occur for many months or even years after the event. To be diagnosed as a stress disorder, the symptoms must present for more than one month. A presentation of PTSD greatly increases the likelihood of substance abuse and dependence, and trauma survivors often use escape into alcohol or other dugs to minimize the symptoms of the disorder. Ultimately though, substance abuse exacerbates the anxiety and other symptoms associated with the disorder, and greatly lengthens the recovery process. Addictions professionals used to regard the dual problems of addiction and PTSD and separate and distance entities that required distinct treatments; and prevailing wisdom called for the addiction to be treated first, and to wait for a bettering of drug taking behaviors before tackling the PTSD. With a greater understanding of the disorder, and after witnessing appalling recidivism rates, it is now generally accepted that treatment for the two conditions must be integrated and comprehensive for any bettering of dual addiction and stress disorder symptoms. Therapeutic approaches to the treatment of a dual diagnosis of addiction and PTSD are cognitive therapy, peer group therapy with other PTSD sufferers, private counseling and pharmacological treatment of the symptoms of PTSD. Anti depressants and anxiolitics can be very effective when targeted against the symptoms expression of PTSD. I count myself lucky that I’ve never been subject to any life threatening trauma or violent attack; and while I’ve never served in the armed forces, when I hear the soldier’s accounts of their daily experiences in Iraq, I cannot imagine a more terrifying and stressful period of life than that endured by our soldiers patrolling the hostile and dangerous streets of Baghdad and other cities. We need to be therapeutically ready for a massive increase in substance abuse and destructive behaviors amongst soldiers returning from combat zones, and we need to have necessary access to treatment at the ready for those soldiers that need help overcoming the legacy of combat. Regardless of your views on the legitimacy of the war, the soldiers had no say in the political machinations that led to combat, and they deserve our respect and our compassionate treatment once returned home.