The Relation Between Substance Use and Trauma-Statistics

Substance Abuse Treatment Tx of Trauma Related Disorders

One of the things I hope to accomplish is for you and I to look at Dual Diagnosis from both of our sides of the table and develop some new ways to look at Dual Diagnosis to make our treatment more effective.

Dual Diagnosis

Q) What relationships have you seen between Substance Abuse and PTSD? —the Dual Diagnosis

Patients with dual diagnosis, compared to those with PTSD or SA alone, show higher rates of Axis I and II disorders, more psychosocial problems, more inpatient substance abuse treatment admissions, more medical conditions, and a worse clinical course. (Blaine, J., et. al, 2003)

PTSD is predictive of a 5 time increase in the probability of alcohol and drug abuse and dependence—60% of women and 20% of men alcohol recovery programs report sexual abuse as children. 80% of both report physical abuse. 90% of those in the hospital report trauma in their background.

Approximately 64% of clients seeking treatment for substance abuse have one or more co-occurring psychiatric disorders. Dually diagnosed clients are more difficult to assess and treat, have more complex health service needs, and often require services from a variety of systems (e.g. mental health, substance abuse, medical) that are generally not connected. (Amodeo, M. et.al. 2004)

Q) How do treatment outcomes with dual diagnosis compare to treating SA alone?

Q) What differences have you noticed between male and female dual diagnosis patients?

Compared with men, women enter substance abuse treatment at a younger age, are more likely to be unemployed and have few marketable skills, and have more young children for whom they are responsible and have more concerns. . . Comorbid psychiatric problems are more prevalent in women than in men, and women typically have more psychiatric problems than men. Many drug-dependent women have been sexually abused as children, suffer from post-traumatic stress disorder, and have significant problems forming healthy relationships with men. (Amodeo, M. et.al. 2004)

Substance abuse reduces a person’s ability to concentrate, to be productive in work and life in general, to sleep restfully, and to cope with traumatic memories and external stressors. Substance abuse can increase emotional numbing, social isolation, anger and irritability, depression and the feeling of needing to be on guard (hypervigilance)

Traumatized people are more likely than others of similar background to abuse alcohol both before and after being diagnosed with PTSD. For example:

Approx. 50% of people who have survived multiple traumatic experiences report problematic alcohol use

Approx. 30% of people who survive accident-single incident traumatic experiences, especially if troubled by persistent health problems or pain report problematic alcohol use.

Up to 80% of Vietnam vets seeking PTSD tx have alcohol use disorders

Compared to adolescents who have not been sexually assaulted, adolescent sexual assault victims are 4.5 times more likely to experience alcohol abuse or dependence, 4 times more likely to experience marijuana abuse or dependence, and 9 times more likely to experience hard drug abuse or dependence

Adolescents with PTSD are 4 times more likely than adolescents without PTSD to experience alcohol abuse or dependence, 6 times more likely to experience marijuana abuse or dependence, and 9 times more likely to experience hard drug abuse or dependence

As many as 50% of adults with both alcohol use disorders and PTSD also have one or more other serious psychological or physical problems.