Veterans with Co-Occurring PTSD and SUD - Research Paper Example

Veterans with Co-Occurring PTSD and SUD Veterans with Co-occurring PTSD and Substance Abuse Statement of need The United States of America depends on veterans when it comes to handing its foreign policies especially in peace keeping missions. Being one of the world’s superpowers, USA has a mandate of restoring peace in war-torn nations. This happens with the help of the marines, both in the army and the navy. On most occasions, the war become intense and hence have adverse effects on the participants especially the individuals who on the ground to fight the wars. One of the most significant health defects that come as a result in participating in these wars is Posttraumatic Stress Disorder, also known as PTSD (Wheeler, 2014). Veterans suffering from PTSD are also expected to suffer from drug and substance abuse. The topic of PTSD and substance abuse is relevant to our society in the sense that it is directly linked to the patriots who serve in the marines and who are charged with the responsibilities of protecting the foreign interests of the United States of America. Those aside, PTSD and drug abuse are menaces that hinder the functionality of veterans while in the war fields. It is important to note that this interference can be detrimental during combat because it is imperative that all officers are in their best health before setting out to war (Wheeler, 2014). PTSD is always accompanied by substance and drug abuse which in turn lead to Substance Use Disorder (SUD). One ought to note that this problem is prevalent amongst military and civilian populations. In addition, it is worth noting that the problem occurs in equal proportions in both males and females in the civilian and military populations. The condition is common amongst veterans to an extent that three of every ten veterans suffering from PTSD have substance use disorder. This topic is therefore relevant to social work practice in the sense that military personnel suffering from PTSD have the right for medication or therapeutic interventions that would assist them in going through the trauma during and after war. The government of the United State has taken an initiative to ensure that the interests including healthcare interest are taken care of amicably. This, as a matter of fact, incorporates the interests of veterans with PTSD and SUD (Wheeler, 2014). It is only through this that the works done by these patriots can be appreciated and acknowledged by to only the government of the United States of America but its citizens at large. As an initiative to address the plights of veterans, the US government has created an entire department charged with the responsibility of taking care of the interest of veterans, both in the war fields and the retired ones. The US Department of Veterans Affairs has a number of responsibilities including ensuring that veterans with PTSD and SUD are assisted through therapeutic processes and medication. In addition, the department is aimed at sensitizing veterans to come out and disclose their conditions. It is only through this that they can be assisted (Wheeler, 2014). Research questions What are the historical and present treatment procedures used to treat veterans suffering from PTSD and SUD? Have these medical procedures been effective in treating PTSD and SUD or have they failed to yield the expected results? What is the percentage of veterans affected by co-occurring PTSD and SUD? What is the probability that veterans suffering from PTSD will also suffer from SUD? What has been done both in the past and the present to urge veterans to come out clean and report cases of PTSD and SUD and seek medical assistance willingly? Literature review Introduction This section of the paper seeks to review four articles related to Veterans with Co-occurring PTSD and Substance Abuse including the article used for the presentation. The articles were obtained after an unequivocal research in the internet to come up with critically researched journals and articles relevant to the topic of the study. One of the articles was retrieved from the National Center for PTSD and it is entitled ‘Towards Integrated Treatment for PTSD and Substance Use Disorder’. The other article, ‘Promising Integrated Treatment Model to Help Veterans with Co-occurring PTSD and Substance Use Disorders’ is the second article while ‘PTSD and Substance Abuse in Veterans’ which was retrieved from the website of the US Department of Veterans Affairs was the third article used to meet the objectives of this assignment. Towards Integrated Treatment for PTSD and Substance Use Disorder This article that was compiled by the National Center for PTSD provides a comprehensive discussion on the importance of understanding co-occurring PTSD and SUD amongst veterans. It indicates that a number of casual ways of countering the effects of PTSD and SUD have been proposed including common susceptibility and self medication. The article further assets that veterans suffering from either PTSD or SUD are currently being sensitized against the trauma that comes with the notion that the presence of one disorder presents a high risk for the occurrence of the other (National Center for PTSD, 2010). The article further provides some important statistic concerning the prevalence of PTSD. For instance, the article reveals that veterans seeking the treatment of PTSD are more likely to meet the various criteria used to identify drug dependent patients. The article also provides a comprehensive discussion on a number of sequential and concurrent treatment procedures used to treat PTSD and SUD. However, as I read through the article, I failed to come across the measures that can be used to persuade veterans suffering from the co-occurring medical complications to seek medical assistance (National Center for PTSD, 2010). Promising Integrated Treatment Model to Help Veterans with Co-occurring PTSD and Substance Use Disorders As opposed to the first article, this article is focused on the theories that have been used in the past in a bid to explain the origin of PTSD and SUD (Robb, 2014). The article uses three hypotheses to try and explain the origin of PTSD. The firth theory is that PTSD causes SUD. According to this hypothesis, PTSD challenges self-regulatory skills of veterans and hence makes them susceptible to getting involved in substance abuse. The second theory is that veterans suffering from PTSD are more likely to involve themselves in risky behaviors. As a result of this, their likelihood of experiencing traumatizing events is increased (Robb, 2014). The other theory is that people suffering from SUD have unsubstantiated and undefined biological and psychological vulnerabilities. As a result of this hypothesis, the increased biological and psychological susceptibilities increased the chances of developing PTSD. Aside from the theories presented to explain the origin of PTSD, the article further discussed the improvement of patient care that has been championed by the progression of treatment (Robb, 2014). The paper asserts that it was only ten years ago when patients of PTSD received treatment through sequential procedures. The procedures compelled the veterans suffering from PTSD to undergo a drug abstinence program and stay clean for a period of time before commencing another medication aimed at treating PTSD. However, the progression of PTSD treatment in the recent years has made it possible for PTSD patients to undergo concurrent treatment. During concurrent treatment, patients are treated of both PTSD and SUD simultaneously (Robb, 2014). PTSD and Substance Abuse in Veterans This article provides important insights on PTSD and Substance Abuse amongst Veterans and provides recommendations on how patients can counter the effects of these conditions amicably without suffering further health complications. The article also provides some relevant statistics concerning the prevalence of PTSD. According to the article, two of every ten veterans suffering from PTSD are also diagnosed with SUD. That aside, the article also reveals that war veterans suffering from both PTSD and SUD are always binge drinkers. In addition, six of every veteran with PTSD also smokes nicotine (National Center for PTSD, 2015). The article also discusses the problems associated with PTSD and SUD. They include sleeping problems, numbness and substance abuse. The paper also recommends some treatment procedures that can be used to treat these conditions. It highlights cognitive processing therapy (CPT) as the major current treatment procedure used to treat PTSD. In addition to CPT, the paper also recommends prolonged exposure as another significant procedure that can be used by specialized medical practitioners in helping veterans with PTSD to overcome the symptoms associated with this medical complication (National Center for PTSD, 2015). Rising to the Challenge of Treating OEF/OIF Veterans with Co-Occurring PTSD and Substance Abuse This was the article used during the class presentation. It is worth noting that this article narrowed down the research on PTSD to the veterans who served in the Operation Enduring Freedom or what was popularly referred to as Operation Iraqi Freedom in Iraq and Afghanistan (Desai, Harpaz‐Rotem, Rosenheck, & Najavits, 2009). The objectives of the study was to investigate the percentage of soldiers and marines of the Operation Enduring Freedom or Operation Iraqi Freedom who reported substance use and mental health problems and other barriers that might result to their limited engagement in treatment. The study was also aimed at finding out the treatment outcomes for veterans suffering from substance use disorder (SUD) and co-occurring posttraumatic stress disorder (PTSD). It is worth noting that primary data was not used for the purposes of this study due to the difficulty in obtaining the data. Only secondary data was used. This data was obtained by reviewing a collection of sources including academic journals, books, speeches and reports on Operation Enduring Freedom or Operation Iraqi Freedom. The findings of the study were based on the relevant effects of double diagnosis of both PTSD and SUD. Problems relate to sequential treatment of the illnesses were also reviewed (Desai, Harpaz‐Rotem, Rosenheck, & Najavits, 2009). The major strengths of the study were the facts that the study projected the future challenges associated with PTSD and SUD and that the study sought data from relevant sources. However, this research failed to use primary data that would have otherwise been obtained from interviews and answering of questionnaires. Hypotheses Veterans seeking treatment for their SUD and PTSD conditions show less chances of relapse and improved coping skills. Part 1 Data collection The participants of this research study will be patients suffering from co-occurring PTSD and SUD. This implies that all the participants will have to be self-proclaimed patients because not all patients suffering from these illnesses come out to communicate their condition due to the stigma associated with the conditions. It is worth noting that patients already diagnose with co-occurring PTSD and SUD are the ones easily reached and it is for this reason that they will be helpful in meeting the objectives of this research. The respondents of this research will have to be veterans diagnosed with co-occurring PTSD and SUD but who have not entered a correctional program. One ought to note that those who have entered a correctional program may have progressed quite well in their healing process and perhaps would not provide the right information needed in the completion of the research. A total of 28 respondents will be chosen for the purpose of this study. The data will be collected from these respondents at a six month interval and in a two year follow up. This implies that data will be collected from these respondents just before they subscribe in a correctional program and again six months later after their subscription. After the data collection, a follow-up will be done after two years in order to monitor the progress of the veterans during their program. This implies that all the 28 respondents of this study will each be subjected to three separate cycles. Another important factor is the fact that all the respondents of this study will be required to have entered the program at the same time in order to ease the process of data collection and follow-up procedures. How consent will be obtained from the participants It is noteworthy that every study involving the human beings as the respondents or sources of data requires that consent is obtained from them. This study is not left out. The study on veterans diagnosed with co-occurring PTSD and SUD will require a signed consent from the participants in order to proceed with the data collection process. This will be done because not every veteran diagnosed with co-occurring PTSD and SUD will be willing to act as a participant of the study. It is for this reason that the consent will be needed to ascertain their willingness to be respondents of the study. One ought to note that there are no special considerations for obtaining the consent from participants. The only requirement for one to be eligible for signing the consent form will be the fact that he or she is diagnosed with co-occurring PTSD and SUD and that they have not began any correctional program. A consent form will be circulated to more than the required number of veterans diagnosed with co-occurring PTSD and SUD. This implies that the consent forms will be more than the 28 number of participants required for the purposes of this study. This will in turn ensure that the right number of participants is obtained because some veterans will not agree with the terms contained in the consent forms. It is important to note that the consent forms will contain all the information regarding the study. Also included in the consent forms will be a confidentiality guarantee. This guarantee will state categorically that the information derived from the participants will not be used for any other purpose apart from the purpose indicated in the consent form. Additionally, the guarantee will assure the participants that the information obtained from them will not be disclosed to any other individual or entity apart from the one mentioned in the consent form. The participants will be required to read and understand the terms and conditions of the study written in the consent forms. This will be followed by an acknowledgement from then participants that they have read and understood the information contained therein. After this acknowledgement, the participants will be required to sign the consent form to indicate that they are willing to participate in the study. Thos unwilling to participate in the study will also be required to sign at a relevant place to indicate their unwillingness to participate in the study. It is important to note that both the unwilling and the willing participants will be required to provide a brief explanation for their decisions. Data collection methods Owing to the nature of this study and the projected proximity of the participants, a number of data collection procedures will be used to meet the objectives of this study. The data collection methods will be: a) One-on-one interviews b) Questionnaires Both direct interviews and questionnaires will be used to collect data for this study. For the interviews, open ended questions will be used. For the questionnaires, on the other hand, closed questions will be used in order to ease the process of data compilation and analysis. In both cases, both qualitative and quantitative data will be obtained. Only post data will be needed for the purposes of this study. This is because the participants will be more likely to be well conversant with post data as compared to pre data. As already noted, all the participants of the study will have to undergo three separate cycles. These are the first data collection process before they subscribe with a correctional process, the second data collection process after six months following their subscription with a correctional process and a follow-up which will be conducted after two years. After data collection, the data obtained will be kept safely at the University’s data center in which all information contained therein is retrieved only by the relevant personnel. For this reason, the confidentiality of the participants and the information obtained from them will be upheld fully. Part 2 Findings Variables of the study Independent variable a) Veterans diagnosed with co-occurring PTSD and SUD who have not joined a correctional program. Dependent variables a) The willingness of veterans suffering from co-occurring PTSD and SUD to come out and communicate their conditions b) The stigma that is associated with co-occurring PTSD and SUD c) The treatment outcomes for veterans diagnosed with co-occurring PTSD and SUD The data collected will be analyzed with the help of a number of methods including tables, graphs and pie charts. The data will also be analyzed through the tabulation of data and subsequent comparison of results with the help of means, modes and medians. During this process, I hope to discover the outcomes of treatment or correctional procedures applied to veterans diagnosed with co-occurring PTSD and SUD. I also hope to discover the willingness of veterans suffering from co-occurring PTSD and SUD to come out and communicate their conditions with the hope of getting assistance. Strengths of the study a) The study is limited to veterans diagnosed with co-occurring PTSD and SUD and hence finding respondents of the study will not be a major problem. b) Consent will be obtained from the respondents first before further action is taken hence all the participants will have agreed to act as respondents for the purposes of this study. Limitations of the study a) The time intervals for data collection are quite long and hence respondents may not be stationed at their expected stations during the second and subsequent data collection processes and follow-ups. Gaps in the study It is important to note that the study has some gaps that ought to be taken into strict consideration during a similar study that will be conducted in the future. For instance, the measures that ought to be taken to persuade veterans suffering from co-occurring PTSD and SUD are not taken into consideration during the study. Another important gap of the study that needs consideration is the fact that the study has not distinguished between the effects of prolonged exposure to therapy and natural recovery of the disease. References Desai, R., Harpaz‐Rotem, I., Rosenheck, R. & Najavits, L. (2009). Treatment of homeless female veterans with psychiatric and substance abuse disorders: Impact of “Seeking Safety” on one‐year clinical outcomes. . Psychiatric Services, 59: 996–1003. National Center for PTSD. (2010). Towards Integrated Treatments for PTSD and Substance Use Disorders. Retrieved on 27th May, 2014 from http://www.humana- military.com/library/pdf/integrated-treatments-ptsd-substance-use.pdf National Center for PTSD. (2015). PTSD and Substance Abuse in Veterans. Retrieved on 27th May, 2014 from http://www.ptsd.va.gov/PTSD/public/problems/ptsd_substance_abuse_veterans.asp Robb H. (2014). Promising Integrated Treatment Model to Help Veterans with Co-Occurring PTSD and Substance Use Disorders. Retrieved on 27th May, 2014 from http://www.naadac.org/assets/1959/aar_summer2014_ce_article.pdf Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Read More