Critical Incident Stress Management CISM

¶ … Stress and Drug Abuse

CISM

Discuss the relationship between stress and substance abuse following critical incidents

Sufferers of post-traumatic stress disorder (PTSD) and survivors of other forms of trauma exhibit far higher rates of substance abuse than the general population. They may suffer from "psychiatric disorders that are clearly reactive to the trauma of the crime to which anyone would be vulnerable….the horror and helplessness of being victimized [may] have somehow triggered a persistent pattern of distress which may be viewed as an exaggerated adaptive and protective response" (Chapter 21: Substance abuse and victimization, n.d, Tennessee Victim Assistance Manual: 776). Substance abuse can be one way to self-medicate from such exaggerated responses, particularly if the symptoms of PTSD are not identified and treated early on during the sufferer's illness.

Examples of critical incidents that can increase the likelihood of substance abuse include violent crimes like domestic violence: approximately 50% of all female alcoholics have been victims of domestic violence (Chapter 21: Substance abuse and victimization, n.d, Tennessee Victim Assistance Manual: 772). Of teens that have been sexually assaulted, "over one half of adolescent victims said that their first use of substances occurred after the year they were first assaulted" (Chapter 21: Substance abuse and victimization, n.d, Tennessee Victim Assistance Manual: 772).

One of the challenges of treating survivors of sexual assault for drug abuse is that the 'tough love format' favored by some substance abuse programs does not address the fact that survivors are indeed victims. The stress upon personal responsibility and making apologies to people whom the substance abuser has hurt in the past can simply intensify the feelings of blame and lack of self-worth that originally caused the addict to self-medicate.

The stress of combat or simply living in a military environment can also cause many current and ex-soldiers to self-medicate. AU.S. government study of Army soldiers who were screened 3 to 4 months after returning from deployment to Iraq found that 27% of the soldiers met the criteria for alcohol abuse (Substance abuse, 2011, Drug Abuse). Police officers, including those who investigate drug-related crimes are also at high risk for drug and alcohol-related abuse. This may be caused by a single traumatic incident, or simply the daily stress of investigating horrific incidents.