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Alcohol Use Disorders and Comorbid Post-Traumatic Stress Disorder in US Military Veterans: Etiology and Current Treatment Approaches

  • Lorig K. KachadourianEmail author
  • Elissa McCarthy
  • Ismene L. Petrakis
Reference work entry

Abstract

Post-traumatic stress disorder (PTSD) is commonly observed in the US military, particularly among those exposed to combat. PTSD has been shown to be highly comorbid with substance use disorders (SUDs) , particularly alcohol use disorders (AUDs). Research has been conducted to better understand not only why these disorders commonly co-occur but also how best to treat those who present with these dual diagnoses. The current chapter reviews the literature on the potential mechanisms that have been proposed to account for the high rates of comorbidity between PTSD and SUDs with a focus on AUDs and considers both psychological and biological perspectives. This chapter also examines psychotherapeutic approaches to treating these disorders, including those treatments developed specifically for those with comorbid PTSD and SUDs. In addition, pharmacological interventions are discussed, including those typically used to treat either PTSD or alcohol dependence (AD) alone. Recommendations for future directions are discussed throughout.

Keywords

Posttraumatic stress disorder comorbidity Alcohol use disorders Substance use disorders Psychotherapy Pharmacotherapy US military veterans 

List of Abbreviations

AD

Alcohol dependence

AUD

Alcohol use disorder

COPE

Concurrent treatment of PTSD and substance use disorders using prolonged exposure

CPT

Cognitive processing therapy

CRH

Corticotropin-releasing hormone

CTPCD

Concurrent treatment of PTSD and cocaine dependence

DSM

Diagnostic and Statistical Manual of Mental Disorders

FDA

Food and Drug Administration

HPA

Hypothalamic–pituitary–adrenal

PE

Prolonged exposure

PTSD

Post-traumatic stress disorder

SUD

Substance use disorder

VETR

Vietnam Era Twin Registry

Notes

Acknowledgments

The authors wish to acknowledge the Clinical Neurosciences Division of the National Center for PTSD (NCPTSD) and the VISN 1 Mental Illness Research, Education, and Clinical Center (MIRECC).

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Lorig K. Kachadourian
    • 1
    • 2
    Email author
  • Elissa McCarthy
    • 3
  • Ismene L. Petrakis
    • 2
    • 3
  1. 1.National Center for PTSDVA Connecticut Healthcare SystemWest HavenUSA
  2. 2.Department of PsychiatryYale University School of MedicineNew HavenUSA
  3. 3.VA Connecticut Healthcare SystemWest HavenUSA

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