Trauma May Increase Substance Abuse
Most workers are back on the job, resuming their daily activities after the terrorist attacks, but some are quietly dealing with lingering fear, grief or survivor guilt. It's a worrisome time, partly because some people may turn to alcohol or drugs to ease their anxieties and emotional pain – a common reaction among those suffering from post-traumatic stress disorder (PTSD), according to the American Journal of Psychiatry.
Substance abuse can spike in times of strife and war. For example, Japan – a nation with no previous addiction problems – experienced its first such difficulty in the late 1940s, an occurrence many attribute to the aftermath of World War II. At that time, many Japanese began taking methamphetamines. Strict control laws, heavy criminal penalties, compulsory hospitalization for dangerous addicts and a public awareness campaign later controlled the problem, according to Public Health Reports.
It's impossible to predict how many people may fall victim to substance abuse as a result of recent events. Experts suggest that about 70% of Americans have endured at least one traumatic event in their lifetimes. Most suffer no long-term effects, but about 8% experience problems. Over time, symptoms may worsen, according to Alcohol Research and Health magazine. In TIME magazine, Jeffrey Kluger writes of the "exponential geometry" associated with such trauma. "Lose a single person in an accident, and the lives of five or six more people – family and friends – are rocked. Each of those five or six lives may touch five or six more, and those still more." In cases involving deaths in the thousands, Kluger notes, "the very mental health of the nation can be shaken."
Alcohol balances endorphin levels, which is one reason experts believe PTSD may lead to substance abuse. In traumatic circumstances, levels spike to numb emotional or physical pain. After the event, when levels return to normal, some may drink as a reaction to endorphin withdrawal. Over time, individuals may require more and more alcohol for the same effect.
What's more, studies suggest that such alcohol use may spike not during or immediately following trauma, but afterward. Researchers have studied how animals react to PTSD and say those results model human behavior. In a study of rats, all were exposed to electric shocks but only some were allowed to escape the current. Alcohol preference and consumption increased among rats experiencing the inescapable shocks, but contrary to researchers' expectations, consumption did not spike considerably on the days when they received shocks. Rather, it soared in following days. Dr. Joseph Volpicelli and University of Pennsylvania researchers call this reaction "the happy hour effect." And they note that even among humans who drink socially, consumption rates increased after, but not during, exposure to stress.
In the workplace, this may mean more substance abuse-related problems and on-the-job risks. If employees come to work impaired or if they take drugs and/or drink on the job, they could cause accidents and threaten the safety of others. And even if drug or alcohol use occurs after hours, hangover effects could diminish productivity.
In these turbulent times, managers may want to devote extra attention to such problems and become familiar with how to best link workers with assistance or direct them to an employee assistance program. Experts suggest that PTSD and substance abuse problems be treated concurrently. Signs of alcohol use could be evident in performance, such as increased errors, poor judgment, inability to meet deadlines, pattern absenteeism or tardiness and complaints from customers or coworkers.
Coping with PTSD in the workplace could be a long-term challenge, especially if the U.S. stand against terrorism involves significant military action. Experts note that there seems to be a strong relationship between psychological problems following war, particularly PTSD, and the subsequent development of alcoholism and drug problems. If so, private employers will need to work with government to ensure that veterans, as well as other victims of PTSD, have full access to the kind of care they need.
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The American Psychiatric Association maintains the Web site http://www.apa.org/. It provides a variety of resources on PTSD. The organization also offers information on trauma at
http://helping.apa.org/daily/tassey.html
The National Clearinghouse for Alcohol and Drug Information at the Substance Abuse and Mental Health Services Administration maintains a large body of information and materials on alcohol and substance abuse prevention, intervention and treatment. To obtain information, see
http://www.health.org
The National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health sponsors studies and conducts biomedical and behavioral research related to the causes, consequences, treatment and prevention of alcoholism and alcohol-related difficulties. View information online at
http://www.niaaa.nih.gov
Articles reviewed for this report:
Allen, Carol Easley. "Veterans, Victims and Violence." The Nation's Health. Proquest. April 2000, p. 3.
American Psychological Association. "Understanding Alcohol-Related Disorders and Their Treatment, Psychologists Play a Vital Role." Internet [helping.apa.org/therapy/alcohol.html]. Obtained September 24, 2001.
Carroll, Linda and Charlene Laino. "Terror's Emotional Aftermath." MSNBC.com, Internet [stacks.msnbc.com/news/627976_asp.htm]. September 13, 2001.
Danitz, Tiffany. "Drowning the Demons of War." Insight on the News, March 3, 1997, p. 14.
Goode, Erica. "Stress from Attacks Will Chase Some into the Depths of Their Minds, and Stay." New York Times on the Web, Internet [www.nytimes.com]. September 18, 2001.
Greberman, Sharyn Bowman and Kiyoshi Wada. "Social and Legal Factors Related to Drug Abuse in the United States and Japan." Public Health Reports. Infotrac. November/December 1994, pp. 731-738.
Jacobsen, Leslie K., Steven M. Southwick and Thomas R. Kosten. "Substance Use Disorders in Patients with Posttraumatic Stress Disorder." American Journal of Psychiatry. Proquest. August 2001, pp. 1184-1190.
Kluger, Jeffrey. "Attack on the Spirit." TIME. Proquest. September 24, 2001, p. 94.
McConnell, Artie. "Beholden to Bin Laden, Taliban Can't Hand Terrorist Mastermind Over to US." Eurasianet.org, Internet [www.eurasianet.org/departments/insight/articles/eav09 2101a.shtml]. September 21, 2001.
Sinai, Joshua. "Islamist Terrorism and Narcotrafficking in Uzbekistan." Defense & Foreign Affairs Strategic Policy. Proquest. May 2000, pp. 7- 8.
Tassey, John. "Coping with the Aftermath of a Disaster." American Psychological Association. Internet [helping.apa/org/daily/tassey.html]. Obtained September 24, 2001.
Volpicelli, Joseph, et al. "The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction." Alcohol Research and Health. Proquest. Vol. 23, No. 4, 1999, pp. 256-262.
Substance abuse can spike in times of strife and war. For example, Japan – a nation with no previous addiction problems – experienced its first such difficulty in the late 1940s, an occurrence many attribute to the aftermath of World War II. At that time, many Japanese began taking methamphetamines. Strict control laws, heavy criminal penalties, compulsory hospitalization for dangerous addicts and a public awareness campaign later controlled the problem, according to Public Health Reports.
It's impossible to predict how many people may fall victim to substance abuse as a result of recent events. Experts suggest that about 70% of Americans have endured at least one traumatic event in their lifetimes. Most suffer no long-term effects, but about 8% experience problems. Over time, symptoms may worsen, according to Alcohol Research and Health magazine. In TIME magazine, Jeffrey Kluger writes of the "exponential geometry" associated with such trauma. "Lose a single person in an accident, and the lives of five or six more people – family and friends – are rocked. Each of those five or six lives may touch five or six more, and those still more." In cases involving deaths in the thousands, Kluger notes, "the very mental health of the nation can be shaken."
Alcohol balances endorphin levels, which is one reason experts believe PTSD may lead to substance abuse. In traumatic circumstances, levels spike to numb emotional or physical pain. After the event, when levels return to normal, some may drink as a reaction to endorphin withdrawal. Over time, individuals may require more and more alcohol for the same effect.
What's more, studies suggest that such alcohol use may spike not during or immediately following trauma, but afterward. Researchers have studied how animals react to PTSD and say those results model human behavior. In a study of rats, all were exposed to electric shocks but only some were allowed to escape the current. Alcohol preference and consumption increased among rats experiencing the inescapable shocks, but contrary to researchers' expectations, consumption did not spike considerably on the days when they received shocks. Rather, it soared in following days. Dr. Joseph Volpicelli and University of Pennsylvania researchers call this reaction "the happy hour effect." And they note that even among humans who drink socially, consumption rates increased after, but not during, exposure to stress.
In the workplace, this may mean more substance abuse-related problems and on-the-job risks. If employees come to work impaired or if they take drugs and/or drink on the job, they could cause accidents and threaten the safety of others. And even if drug or alcohol use occurs after hours, hangover effects could diminish productivity.
In these turbulent times, managers may want to devote extra attention to such problems and become familiar with how to best link workers with assistance or direct them to an employee assistance program. Experts suggest that PTSD and substance abuse problems be treated concurrently. Signs of alcohol use could be evident in performance, such as increased errors, poor judgment, inability to meet deadlines, pattern absenteeism or tardiness and complaints from customers or coworkers.
Coping with PTSD in the workplace could be a long-term challenge, especially if the U.S. stand against terrorism involves significant military action. Experts note that there seems to be a strong relationship between psychological problems following war, particularly PTSD, and the subsequent development of alcoholism and drug problems. If so, private employers will need to work with government to ensure that veterans, as well as other victims of PTSD, have full access to the kind of care they need.
====================================================
The American Psychiatric Association maintains the Web site http://www.apa.org/. It provides a variety of resources on PTSD. The organization also offers information on trauma at
http://helping.apa.org/daily/tassey.html
The National Clearinghouse for Alcohol and Drug Information at the Substance Abuse and Mental Health Services Administration maintains a large body of information and materials on alcohol and substance abuse prevention, intervention and treatment. To obtain information, see
http://www.health.org
The National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health sponsors studies and conducts biomedical and behavioral research related to the causes, consequences, treatment and prevention of alcoholism and alcohol-related difficulties. View information online at
http://www.niaaa.nih.gov
Articles reviewed for this report:
Allen, Carol Easley. "Veterans, Victims and Violence." The Nation's Health. Proquest. April 2000, p. 3.
American Psychological Association. "Understanding Alcohol-Related Disorders and Their Treatment, Psychologists Play a Vital Role." Internet [helping.apa.org/therapy/alcohol.html]. Obtained September 24, 2001.
Carroll, Linda and Charlene Laino. "Terror's Emotional Aftermath." MSNBC.com, Internet [stacks.msnbc.com/news/627976_asp.htm]. September 13, 2001.
Danitz, Tiffany. "Drowning the Demons of War." Insight on the News, March 3, 1997, p. 14.
Goode, Erica. "Stress from Attacks Will Chase Some into the Depths of Their Minds, and Stay." New York Times on the Web, Internet [www.nytimes.com]. September 18, 2001.
Greberman, Sharyn Bowman and Kiyoshi Wada. "Social and Legal Factors Related to Drug Abuse in the United States and Japan." Public Health Reports. Infotrac. November/December 1994, pp. 731-738.
Jacobsen, Leslie K., Steven M. Southwick and Thomas R. Kosten. "Substance Use Disorders in Patients with Posttraumatic Stress Disorder." American Journal of Psychiatry. Proquest. August 2001, pp. 1184-1190.
Kluger, Jeffrey. "Attack on the Spirit." TIME. Proquest. September 24, 2001, p. 94.
McConnell, Artie. "Beholden to Bin Laden, Taliban Can't Hand Terrorist Mastermind Over to US." Eurasianet.org, Internet [www.eurasianet.org/departments/insight/articles/eav09 2101a.shtml]. September 21, 2001.
Sinai, Joshua. "Islamist Terrorism and Narcotrafficking in Uzbekistan." Defense & Foreign Affairs Strategic Policy. Proquest. May 2000, pp. 7- 8.
Tassey, John. "Coping with the Aftermath of a Disaster." American Psychological Association. Internet [helping.apa/org/daily/tassey.html]. Obtained September 24, 2001.
Volpicelli, Joseph, et al. "The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction." Alcohol Research and Health. Proquest. Vol. 23, No. 4, 1999, pp. 256-262.