PTSD, Alcohol Problems, and Drug Abuse

"My first medication was alcohol ... when I was dead drunk, I would talk about these things. One time, I brought a foot locker home, and I had a North Vietnamese backpack in there, and I had two North Vietnamese pistols ... and a Cambodian flag and Cambodian medals, and some Cambodian pictures. One morning I woke up and I found that trunk all full of holes. And ... everybody was tiptoeing around.... I asked my mother. I said what happened? What happened to my trunk? ... She said 'You were talking all this crazy stuff, and you took a gun and started shooting that trunk up. Then you put holes in my wall and my floor and everything, I had to take that rifle away from you.'"

The combination of PTSD and alcohol abuse is devastating and may lead to loss of control and family or community violence. A vicious cycle may develop, with drinking to relieve tension, frustration, or unhappiness providing temporary relief, at the cost of worsening symptomatology and increasing tension. Native veterans are vulnerable to excessive alcohol use for several reasons:

• Drinking as a means to "socialize"
• Drinking as a means to share trauma
• Drug abuse

Drinking as a means to "socialize"

Alcohol is readily available in American Indian and Alaska Native communities, and drinking is considered to be one of the few ways available to be sociable. Drinking is also a well-entrenched aspect of military culture.

"... I walked in my aunt's place, and they're all in the basement. There was a party going on. My aunt and uncle, they're all drunk downstairs ... And so my coming home was more or less into the world of alcoholism."

Drinking as a means to share trauma

Alcohol use is often condoned as a socially acceptable way of facilitating emotional release and the sharing of traumatic memories. Yet, intoxication only creates a false sense of numbness that prevents the experience of genuine healing. Alcohol problems also can become a way to hide PTSD from oneself and from the world. Healing does not occur unless the veteran and family deal with the symptoms of PTSD without covering them up with alcohol.

"And I really dreaded the question of talking about it.... Probably the first time I ever said anything about the war--I came home drunk.... that was the only way I could tell my dad anything, tell him about what it was really like over there, when I was drunk... Later on, I felt real ashamed of it, you know... that I had to tell something under the influence of alcohol."

Drug abuse

Although not as common among Native veterans as alcohol abuse, drug abuse is a serious problem for as many as 1 in 7--more than twice the rate for white Vietnam veterans. Native veterans diagnosed with PTSD are much more likely to abuse drugs than are those without PTSD.