Impact of Substance Abuse on Disability Essay

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¶ … Substance Abuse on Posttraumatic Stress Disorder

What is the incidence of Substance Abuse in individuals with this disability?

According to a recent study by Janikowski, Donnelly and Lawrence (2007), "As a group, people with disabilities have a higher rate of alcohol and drug use problems when compared to the general population. Up to six million people with disabilities also have co-existing substance abuse problems and that these disabilities may present obstacles to recovery" (p. 15). People who experience or witness some type of psychological trauma do not always experience long-term emotional distress or engage in substance abusing behaviors. According to Volpicelli, Balaraman, Hahn, Wallace and Bux (1999), "Rather, the likelihood of experiencing adverse consequences is related to the victim's ability to cope with the trauma" (p. 256). Even the most resilient individual with sufficient coping skills, though, may not be able to avoid the onset of PTSD and will turn to substance abuse for relief. A study of Vietnam combat veterans with PTSD found that more than 50% eventually evinced indications of alcohol addiction; likewise, women who experienced or witnessed rape during their childhoods frequently report using alcohol to mitigate the symptoms of the resulting PTSD (Volpicelli et al.). Other researchers have determined that fully 40% of inpatients who were undergoing treatment for substance abuse also met the established criteria for PTSD (Volpicelli et al.). Given the large numbers of troops serving in enormously stressful combat zones in Afghanistan and Iraq today, it is reasonable to suggest that the incidence of PTSD among these returning combat veterans will equal or exceed those experienced by their also heroic Vietnam counterparts in ways that will contribute to their engaging in substance-abusing behaviors in the future as well (Mckelvey, 2008).

2.

What seem to be some of the reasons for this rate of abuse?

The high incidence of substance abuse among PTSD sufferers is not surprising because many people will have drink (or use other mind-altering substances) following a traumatic experience. As Volpicelli et al. point out, "After a traumatic event, people often report using alcohol to relieve their symptoms of anxiety, irritability, and depression. Alcohol may relieve these symptoms because drinking compensates for deficiencies in endorphin activity following a traumatic experience" (p. 256). Likewise, a Web site devoted to this issue states that, "An emerging body of research has documented a very strong association between Posttraumatic Stress Disorder (PTSD) and substance abuse. In most cases, substance use begins after the exposure to trauma and the development of PTSD, thus making PTSD a risk factor for drug abuse" (the link between PTSD and substance abuse, 2009).

Substance abuse, then, tends to provide PTSD sufferers with some temporary relief for their traumatic memories of an event but the rebound effect is profound and severe. When the effects of the abused substance wear off, the individual's endorphin levels return to their pre-abuse levels or even lower in ways that may in fact contribute to the onset of PTSD in the first place. In this regard, Volpicelli and his associates emphasize, "After the trauma is over, endorphin levels gradually decrease and this may lead to a period of endorphin withdrawal that can last from hours to days. This period of endorphin withdrawal may produce emotional distress and contribute to other symptoms of posttraumatic stress disorder" (p. 256).

3.

What are some important issues a rehabilitation counselor needs to be aware of that are specific to this disability type and substance abuse?

An old adage advises that, "There is no problem so great that drinking can't make it worse," and this is certainly the case with PTSD. As Janikowski and his associates (2007) emphasize, "Substance abuse treatment is a daunting prospect for clients, even under the best of circumstances. The challenges presented in treatment may be compounded when clients' face functional limitations from disabilities that co-exist with their addiction or drug abuse" (p. 16). Moreover, although PTSD has been associated with poorer outcomes in substance abuse treatment time and again, initial screening is rarely conducted with standardized and validated procedures (Janikowski et al.).

According to Green (2006), "Substance-abusing women with post-traumatic stress disorder (PTSD) may benefit significantly more from gender-specific programs designed to address PTSD and addiction problems simultaneously. These programs provide gender-specific content and address, in a comfortable setting (i.e., with only female participants), traumatic experiences and sexual assault" (p. 55). Likewise, men who suffer PTSD based… [END OF PREVIEW]

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