According to a new study by the VA San Diego Healthcare System, prolonged exposure therapy is more effective at treating PTSD than coping skills therapy for patients who also have an alcohol use disorder. The research will provide clinicians with important guidance for helping veterans cope with both PTSD and problem drinking.
When the researchers compared patients who were given prolonged exposure treatment with those given coping skills treatment, they found that both methods effectively reduced PTSD symptoms and heavy drinking. However, patients receiving prolonged exposure therapy had significantly lower scores on a measure of PTSD symptoms.
The study was led by Dr. Sonya Norman, who is a researcher at the San Diego VA, the director of the PTSD Consultation Program for the National Center for PTSD, and a professor of Psychiatry at the University of California San Diego.
“The research is not showing concerns that PTSD patients with alcohol use disorder can’t handle exposure to be true,” said Dr. Norman. “The main takeaway of the study for me is that we may be doing a disservice to veterans if we don’t offer them the best treatments we have available for PTSD, such as prolonged exposure.”
People suffering from both PTSD and alcohol use disorder tend to have shorter periods of abstinence from drinking and a greater risk of suicide and homelessness. Compared to individuals with just one disorder, these patients also tend to have more legal and psychological problems.
During prolonged exposure therapy, patients gradually confront memories, feelings, and situations related to their trauma. The goal is for them to be able to face these experiences without triggering anxiety and stress.
While previous studies have shown that prolonged exposure therapy is the most effective treatment for PTSD, many therapists do not offer this particular psychotherapy to problem drinkers out of concern that it will cause them to drink more.
However, the results of the new study show that prolonged exposure therapy is more effective at treating PTSD regardless of whether patients also have alcohol use disorder. The researchers concluded that many patients are not getting the best available treatment because of their issues with alcohol.
“The next stage of this research, is to learn how to make prolonged exposure even more effective for patients with PTSD and alcohol use disorder,” explained Dr. Norman. “We are now conducting a study where we are combining medication to help reduce drinking with prolonged exposure to see if the combination helps patients complete prolonged exposure and benefit even more from the treatment.”
The study is published in the journal JAMA Psychiatry.