Steven L. Batki, M.D. (www.altamirarecovery.com) discusses Alcohol Dependence and PTSD with Alta Mira. Dr. Batki is also a consulting physician with Alta Mira Recover in psychiatry, addiction psychiatry, and addiction medicine. PTSD and SUD (substance use diagnosis) in Veterans: 1. Epidemiology of co-occurring PTASD and SUD's 2. Interactions of PTSD and SUD's 3. Treatment approaches for PTSD and SUD's "Clinicians face difficult challenges in the treatment of veterans with co-occurring alcohol use disorders (AUDs) and chronic PTSD." "Effective treatment are needed for patients with alcohol dependence and PTSD who may not be adequately managed with current therapies." PTSD & SUDs Co-morbidity -Common -May share common psychological underpinnings -Problematic -- Assessment -- Morbidity -- Treatment -- Outcome Focus on Insensitivity: Alcohol, TBI and PTSD * Violence, suicide, accidents, marital disruption, work impairment and health problems. Epidemiology of Co-occurring PTSD/SUDs -In SUD patients, the prevalence of lifetime PTSD ranges from 30-40% and for current PTSD 15.41% - 3 to 4 times the rate of substance abuse in PTSD patients vs the general population - In SUD patients the prevalence of lifetime PTSD raises 26% to 53% - 30 to 40 % of these patients have substance abuse problems (*Data from San Francisco Veterans Center) Relationships between PTSD and Alcohol Dependence Alcohol -Most common substance of abuse in veterans with PTSD -May be an attempt to "Self-Medicate" or response to symptoms such as insomnia, anxiety and hyper-arousal. --Heavy alcohol use may actually cause these problems to be more severe Alcohol and substance abuse have a bidirectional relationship with PTSD -Risk factors for development of PTSD -moderators of PTSD symptom severity -potential consequences of PTSD AUDs & PTSD share some common neurological mechanisms. Co-occurrence of AUDs and PTSD is associated with: - worse psychological and medical outcomes - higher rate of relapse to substance use - higher rates of hospitalization

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