Co-occurring post-traumatic stress disorder and substance use disorder

Name of the Student
Professor’s Name
Medical Sciences
21st November 2016
Management of Comorbid Post Traumatic Stress Disorder and Substance Use Disorder
Post-traumatic stress disorder (PTSD) is a psychological disorder that stems from exposure to traumatic incidences. Such incidences may pertain to the concerned individual or might occur in their surroundings. The individual experiences the same traumatic response even after cessation of the traumatic event. Underlying depression is a predisposing risk factor for PTSD. PTSD is featured by intense fear, horror, panic and helplessness (American Psychiatric Association 78-112). On the other hand, Substance Abuse (SA) is defined as “A maladaptive pattern of substance use leading to impairment/and or distress within a 12 month period in one or more of different areas of functioning” (DSM-IV-TR) (American Psychiatric Association 78-112). Such functioning includes unacceptable social behavior, deviation from legal rules and continued use of a substance (even after impaired interpersonal relations due to substance abuse) (American Psychiatric Association 78-112).
Most individuals are suffering from PTSD resort to substance abuse for overcoming their traumatic experience. In fact, studies have implicated that PTSD is often comorbid with Axis-1 and Axis-2 disorders (like substance abuse). Approximately 50% individuals suffering from substance abuse are also affected with PTSD. Different classes of abused substances are associated with PTSD (American Psychiatric Association 78-112).

These substances include opiates, alcohol, cocaine, alcohol, amphetamines, analgesics, and anxiolytics. Individuals suffering from PTSD-SA experience heightened post-traumatic fear and horror. Management of PTSD-SA depends upon the nature of abused substance. Hence, management of comorbid PTSD-SA is challenging for healthcare professionals (Brown, Stout & Mueller 115-122).
Exposure therapy is beneficial for managing PTSD. Exposure therapy is administered to sensitize the individuals to a traumatic event and for developing resistance to such incidence. Cognitive behavioral therapy and relaxation therapies are also beneficial for managing PTSD. Anti-depressants like selective serotonin reuptake inhibitors (SSRI) are also used for managing underlying depression associated with PTSD. Rehabilitation programs like Alcoholics Anonymous and Narcotics Anonymous are effective in managing substance abuse. Pharmacological management is based on agonist substitution. The abused substance is replaced by an agonist with reduced habit forming properties. For managing comorbid PTSD-SA; two exposure-based therapies are popular. One such therapy is known as the concurrent treatment of PTSD and Cocaine Dependence (CTPCD). The another one is known as Substance Dependence PTSD therapy (SDPT) (Hien et al. 1426-1432).
Works Cited
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition- Text Revision.Washington, DC, American Psychiatric Association 2000 : pp. 78-112
Brown, P. J., Stout, R. L., Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 1999; (13): pp. 115-122
Hien, D. A., Cohen, L. R., Miele, G. M., Litt, L. C., Capstick, C. (2004). Promising treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry, 2004; (161): pp. 1426-1432.