ABSTRACT
Alcohol and illicit drug misuse and dependence are common comorbid presentations in many people experiencing post-traumatic stress disorder (PTSD). Pre-trauma characteristics including pre-exposure substance misuse also predicts that an individual will be more likely to be exposed to traumatic experiences and may go on to develop PTSD. Some people exposed to an overwhelming traumatic experience involving intense fear, horror and helplessness may go on to develop PTSD. Research consistently demonstrates that the primary predictive factor relating to the development of PTSD is a dose-response effect related to traumatic exposure. In British combat veteran populations the commonest comorbid patterns are PTSD present with depression and alcohol abuse or dependence. As a rule, stimulant drugs will tend to increase the hyper-arousal symptom cluster of PTSD; with anger impulsivity anxiety, hyper-arousal and hyper-vigilance all increasing. The treatment of PTSD will ultimately require the individual to process the traumatic experiences by undertaking trauma-focused therapy.
