It has been difficult for researchers to accurately assess the prevalence of alcohol and other substance use disorders but few of us have escaped indirect experience with their effects on others. There is a particular group of individuals that have an increased likelihood for developing such disorders. They are the veterans of our armed forces. Unique stressors such as exposure to combat operations contribute to this increased risk. It is the task of the Department of Veterans Affairs to effectively treat the substance use and other co-morbid psychological disorders experienced by our nation’s veterans.Military veterans may be exposed to lengthy and frequent overseas deployments, to direct combat, the death of fellow service personnel, and other stressors that contribute to an increased risk. Posttraumatic stress disorder, also know as PTSD, is an amalgamation of symptoms that can occur as a result of combat trauma as well as noncombat trauma such as training accidents and sexual assault. It becomes easy to understand how symptoms such as insomnia, reliving traumatic memories, being at a constant state of hyper alertness, or feeling alienated from others when returning from a lengthy deployment may contribute to viewing the use of alcohol, cannabis and other drugs of abuse as an attractive option. Unfortunately, the abuse of alcohol and other drugs offer zero to little long term effectiveness at reducing psychological symptoms and are more likely to exacerbate and prolong these symptoms. The co-morbidity between substance use disorders, PTSD and other psychological disorders also presents unique treatment challenges.
During the past decade, there have been advancements in the systematic study and development of treatments that can improve chances for sobriety from alcohol and drugs as well as reduce symptoms of PTSD and other psychological disorders. In decades past, there was an ideology in the mental health field that in order to effectively treat mental health disorders, the substance abuse disorders must be treated both separate and prior to mental health symptoms. Research has shown the contrary that both the underlying mental health symptoms (to include PTSD) and the substance use disorders are best treated concurrently. Evidence based treatments including Motivational Interviewing, Seeking Safety, and other Cognitive Behavioral Therapies have been proven in clinical trials to offer effective long term treatment for substance use disorder and the co-morbid disorders such as PTSD, depression, and other mood and anxiety disorders.
Motivational Interviewing is a set of skills utilized at the most common points of entry that a patient visits with healthcare providers. It is utilized in such places as primary care visits, diabetes checkups, or urgent care visits. Its aim is for healthcare professionals to encourage the patient from the contemplative stages that may occur prior to seeking substance abuse treatment to the treatment and maintenance stages of sobriety. Seeking Safety is used particularly with patients who experience co-morbid substance abuse disorders and PTSD. The goal is for the patient to achieve a feeling of safety in coping with their emotions, relationships, and behaviors. Other Cognitive Behavioral Therapies have been developed to specifically address a reduction in PTSD and depression symptoms as well as achieve sustained sobrieties.
Our nation’s veterans often return with wounds that are not visible to x-rays, blood tests and other diagnostic tests the healthcare field has traditionally relied upon to assist with diagnosis. Through the use of systematic research, the Department of Veterans Affairs is able to provide proven treatments that address these allusive disorders of substance abuse, PTSD, and other mental health disorders. Evidence based treatments are utilized by West Palm Beach VA Medical Center mental health providers to provide our nation’s veterans with the health care they deserve.
