Battling PTSD and substance abuse

Veterans who suffer post-traumatic stress disorder also often battle substance abuse and addiction, medical researchers say.

But those afflictions usually are treated independent of one another. Some therapists even refuse to treat PTSD before patients have been "clean" for up to six months, one researcher said.

An emerging therapy, however, aims to more effectively cure patients by treating PTSD and substance abuse together.

Using a $2.1 million grant from the National Institutes of Health, researchers at the Medical University of South Carolina and the Ralph H. Johnson VA Medical Center will treat about 90 veterans of Operation Enduring Freedom and Operation Iraqi Freedom who suffer both conditions.

Sudie Back, who is leading the research, said "PTSD and addictions have been treated very separately" in the past.

"Patients go from one clinic to another and often there is no communication between treatment providers," said Back, a professor in MUSC's Department of Psychiatry. "But for many people, the problems are interrelated. They drink to fall asleep and forget their nightmares or they take drugs so they won't be on guard all the time."

Nick Fields, a 31-year-old veteran who served as an Army specialist in Iraq in 2003 and 2004, can relate.

The Charleston resident used heroin, painkillers and marijuana to cope with recurring nightmares that involved him, alone and with malfunctioning equipment, being chased by insurgents.

"They would overcome me," Fields said. "But when I used drugs, I didn't have nightmares. If I was stressed out, I'd smoke a joint. It helped out temporarily but it wasn't fixing anything."

Fields said he eventually realized drugs "only masked the problems."

"My PTSD was still there," he said. "You can't treat one without fixing the other."

Fields said he plans to undergo the experimental therapy, which combines proven methods of treating each condition.

Back, who has studied the new treatment in civilian populations in the U.S. and Australia, said it "merges the gold standards in treatments."

"They'll get one therapist in one clinic who treats both issues," she said.

Three therapists will treat 90 veterans beginning in December.

Patients will meet with their doctors in weekly 90-minute sessions for 12 weeks to discuss coping with substance cravings and overcoming traumatic memories, Back said.

Therapists also would involve patients' friends and families "so they understand how addiction works and how they can help," she said.

That's good news for Fields' mother.

"I know she's very concerned about me," Fields said. "She's in touch with my doctors as much as I am."