TRICARE SUBSTANCE ABUSE TREATMENT FALLS SHORT

TRICARE SUBSTANCE ABUSE TREATMENT FALLS SHORT, EXPERTS SAY
NEXTGov
By Bob Brewin


By sending troops diagnosed with drug and alcohol addiction to 20-day treatment programs at civilian rehabilitation centers, the Defense Department is taking a Band-Aid approach to dealing with a problem of epidemic proportions, psychiatrists, former combat commanders and treatment experts on the front lines of veteran care told Nextgov.

Such a short stint at an inpatient facility can only begin to chip away at addiction and will do little to help troops cope with the combat experiences that many of them have tried to suppress with alcohol or drugs, experts said.

Combat veterans rarely talk about the experiences that sit at the core of post-traumatic stress disorder and are reluctant to share them in a civilian setting with patients who have no military service, let alone combat experience, said Jack Downing, president of We Soldier On, a Leeds, Mass.-based shelter and rehabilitation center for homeless veterans.

The facility provides beds and housing for 295 veterans, including a 39-unit apartment complex in nearby Pittsfield it developed and then sold to veterans.

Residents’ service spans generations, from a 92-year old WW II veteran to Vietnam veterans and about 35 who served in Afghanistan and Iraq.

Downing said the preponderance of his residents arrive addicted to alcohol and drugs, some of which have been prescribed by the Military Heath System or the Veterans Affairs Department. Recovery, he said, begins with addiction treatment and then moves on to dealing with the effects of war.
read more here

How PTSD and Addiction Can Be Safely Treated Together
By MAIA SZALAVITZ
TIME
August 15, 2012
The vast majority of people with addiction have suffered significant previous trauma, and many people who struggle with addiction suffer from post-traumatic stress disorder (PTSD) simultaneously. But the treatment of these patients has posed a conundrum: experts have believed that PTSD treatment should not begin until the addicted person achieves lasting abstinence, because of the risk that PTSD treatment may trigger relapse, yet addicted people with untreated PTSD are rarely able to abstain for long.

Now, a new study suggests that there may be no need to wait. Researchers found that using exposure therapy — the gold-standard treatment for PTSD, which involves exposure to memories and reminders of patients’ past trauma — can successfully reduce symptoms of PTSD, even when people with addiction continue to use drugs. And, although exposure therapy requires patients to face some of their worst fears, it does not increase their drug use or prompt them to drop out of treatment more than ordinary addiction therapy, the study found.

“The exciting thing in my view is that [the study] supports people with drug and alcohol problems having access to other forms of psychological interventions, rather than being fobbed off and told to sort out their alcohol or drug problem first,” says Michael Farrell, director of the National Drug and Alcohol Research Center at the University of New South Wales in Sydney, Australia, where the research was conducted.
Read more