PTSD - I have some numbers

MSimon · Post by **MSimon** » Wed Mar 07, 2012 5:22 am

Epidemiological research has established high rates of comorbid PTSD and SUD. Among people with lifetime PTSD, lifetime SUD is estimated at 21-43%, compared with 8-25% in those without PTSD.[3] Even higher rates are found in clinical populations. For example, up to 75% of combat veterans with lifetime PTSD also met criteria for lifetime alcohol abuse or dependence.[3] In clinical SUD samples, the prevalence of lifetime PTSD ranges from 26 to 52%,[4-7] and for current PTSD the range is 15-41%.[5,8-13]

The prevalence of PTSD varies by sample. For example, current PTSD is more prevalent in females than in males: typically about twice the rate (e.g.[4,7,9]). Moreover, some substances of abuse show a higher association with PTSD than others (e.g. 'harder drugs' and polydrug use compared with alcohol or cannabis).[14] In a recent epidemiological survey of the Australian general population, PTSD was found in 24% of those with amphetamine-use disorder and in 33% of those with opioid-use disorder compared with 5.4 and 5.2% of individuals with alcohol-use disorder or cannabis-use disorder respectively.[15**]

http://www.medscape.com/viewarticle/564893_2

Note: the more severe the PTSD the more likely the drug use.

I also wrote a little on the subject:

http://classicalvalues.com/2012/03/we-m ... s-looking/

ladajo · Post by **ladajo** » Wed Mar 07, 2012 3:00 pm

For example, up to 75% of combat veterans with lifetime PTSD also met criteria for lifetime alcohol abuse or dependence.

What was the percentage of combat veterans without lifetime PTSD or current PTSD that met criteria for lifetime alcohol abuse or dependance?
What percentage of Combat Veterans were Subsatnce Use Disorder pre-PTSD onset? What percentage were not?

Which is the chicken, which is the egg?

As you know, military culture in general has a higher incidence of alcohol and even drug use (historically). Alcohol abuse remains a prime issue for the services. But that is a consideration, not a main theme.

In clinical S<ubstance> U<se> D<isorder> samples, the prevalence of lifetime PTSD ranges from 26 to 52%,[4-7] and for current PTSD the range is 15-41%.[5,8-13]

So this tells me, that in the subgroup of "Combat Veterans", a higher rate of comorbid Substance Use Disorder exists with PTSD, "up to 75%". But, in the (general?) sample of Substance Use Disorder populace without PTSD, the lifetime rate is 21 to 43%.

Considering:
lifetime PTSD showing lifetime SUD is 21-43% (general sample?)
lifetime SUD (no PTSD) 8-25% (of who?...general sample? This one does not make sense in context...)
<<<and>>>
clinical SUD sample population, lifetime PTSD is found in 26-52%
clinical SUD sample population, current PTSD is 15-41%.

So, it would seem they are saying that, on average, about 39% of (a clinical sample population base) Substance Use Disorder folks have lifetime PTSD, and 28% have current PTSD.

In your cited passage they do not cite the sourcing of PTSD. Did it onset before SUD or after? Was it a SUD environment related factor? Did SUD induce a PTSD prone environment or activities?

These are questions to consider in your argument. Does substance abuse create a higher chance of being in or invovled in PTSD onset events or activities? Does PTSD onset events or activities create a higher chance of substance abuse behaviour? Which is the chicken, which is the egg? I would argue it is both. And this point, unfortunately does not support your argument.

I applaud your call out of "combat veterans", but also point out that it is a subset of the national issue, and the chicken/egg question still applies.

And as a baseline, I repoint you to an earlier citation of yours:

After a single traumatic event, as many as one-fourth of people exposed will develop post-traumatic stress disorder, a psychiatric disorder characterized by anxiety, hyperarousal and persistent unwanted memories.

So if we say are taking the (limited) perspective that PTSD creates an abuse problem and walk the dog with your citations:

Up to 25% of folks exposed to a traumatic event can develop PTSD. Of these, about 39% (on average) with lifetime (they have or had it) PTSD will probably have had SUD, or 28% of current PTSD will probably have SUD. Note that these are 'clinical survey numbers' which lead to a qualitative assessment of normally higher incidence trending.
So in simple terms, of the populace 100%, some smaller group who will have a traumatic experience during life, say 2/3 or 66%, of those up to 25% will develop PTSD, now down to say 16.5%, and of those, about 39%, or 6.4% Total Pop can have PTSD and SUD in their lifetime, and about 28%, or about 4.62% of Total will have current PTSD and SUD.
These numbers seem high, and effectively say that ALL SUD should have PTSD, which is not what the study shows, given the latest Total Population reported lifetime and 'current' use rates.

It does not add up. And, the Chicken/Egg question remains.

I will give the study a read. I also offer this VA Task Group as a reference point if you have not already reviewed it:

http://www.queri.research.va.gov/sud/wwd/ptsd/

MSimon · Post by **MSimon** » Thu Mar 08, 2012 5:26 am

Well L, The chicken and egg are pretty well sorted if you were familiar with the literature.

1. Genetics - you have to be pre-disposed
2. Trauma - the trigger

No one in the field disputes the above. Now if you have an alternate theory and some research indicating that you have a better explanation I'd love to see it.

I came out with the above 2 points around 2002. Well before my view was common in the field. The data was so incontrovertible that even the NIDA had to join in (around 2005 or 2006 IIRC). Except the NIDA couldn't sign on to "trauma" so they came out with "environmental factors." My early adoption makes me something of an amateur expert.

Really. You should read up on the field if you want to become an expert in it. I started my reading program 15 years ago. With the internet and an intense reading program you might cut that to a year or two.

So let me see. I'm rather well read in the field and you don't like my take. You don't seem interested in doing your own mining in the data. I guess that leaves you with your previous and current prejudices. Excellent!

====

BTW howdja like ole Pat Robertson coming out against the War On Cannabis and the Liberals who support it?

So I guess I'm not the only one calling it a socialist enterprise. No surprise there - it was a Progressive project done in cahoots with the socons of the day. The two have since split to handle the work of making the US socialist more efficiently. The "left" handles economics and the "right" now handles the "moral " element. But it is one Party. The Statist Party.

Ever wonder why neither party repeals the work of the other? Why things move only in one direction?

It is past time to start shrinking the State.

ladajo · Post by **ladajo** » Thu Mar 08, 2012 12:52 pm

Well L, The chicken and egg are pretty well sorted if you were familiar with the literature.

1. Genetics - you have to be pre-disposed
2. Trauma - the trigger

No one in the field disputes the above. Now if you have an alternate theory and some research indicating that you have a better explanation I'd love to see it.

I agree that genetics can play, and I agree that Traumatic Experience can play. The part you are misrepresenting, is that they are not the only things that cacn bring on Substance Use Disorder.

If you read the literature properly, you would understand that, instead you seem to habitually cherry pick sentances that support your thinking, and ignore the context.

You still haven't proven your numbers. I once again showed you that you were misrepresenting, and you once again glossed over.

MSimon · Post by **MSimon** » Mon Mar 12, 2012 5:03 am

ladajo wrote:I agree that genetics can play, and I agree that Traumatic Experience can play. The part you are misrepresenting, is that they are not the only things that cacn bring on Substance Use Disorder.

According to the NIDA addiction is

1. Genetic
2. Environmentally triggered

Of course I'm open to the latest data. Got any? A link or two perhaps?

BTW - if there is a point I have made that you want corroboration on I can provide links. In vast quantities.

This data only accounts for around 30% of addiction. But isn't it a crime to punish people for their medical condition? I mean morally. Legally of course it is quite all right. And seems fine with you.

And to think this used to be a Christian nation. Well Pat Robertson gives me hope that it might be so again.

BTW this study:

http://powerandcontrol.blogspot.com/2004/09/heroin.html

Says that 70% of female heroin use can be attributed to sexual assaults in childhood. I had a heroin user comment on one of my posts a while back and he said the number was 100% in his experience. I'd say 70% is probably a fair cop.

So right there we have some idea on how to cut the number drug users by eliminating assaults by adults on children.

Or we could get similar results now by legalizing:

http://www.forbes.com/sites/erikkain/20 ... -portugal/

I'm going to post in full a bit I just did at one of my blogs:

The leftys tell us that if gun ownership is ubiquitous, the levels of gun violence will rise. It does not. It goes down.

The rightys tell us that if drugs are ubiquitous, the levels of addiction will rise. It does not. It goes down.

Both sides seem to have the same mental illness. Just about different things.

This police officer says it is no longer about fighting drugs - it is about fattening police paychecks with overtime:

http://www.youtube.com/watch?v=HmgeCeGk--I

And waddya know. Police Unions have hired a lobbyist to keep the Gravy Train Running.

Of course, police unions aren’t the only interest group with a stake in maintaining broken drug laws. The beer industry, alcohol corporations, and prison guard unions also contributed money to help Lovell stop Prop 19. Howard Wooldridge, a retired police officer who now helps push for legalization as a citizen advocate, told Republic Report that drug company lobbyists also fight to keep marijuana illegal because they view pot as a low-cost form of competition.

http://www.republicreport.org/2012/excl ... -on-drugs/

Drug Cartels - Legal and Illegal - support prohibition. Isn't it time you changed sides?

The War Is Over. Prohibition has lost. Sorry about that. Better luck with your social engineering schemes next time. And you know this experiment in social engineering was started in part by Progressives. I find myself considerably surprised that you would support a Progressive Program. No accounting for taste I guess.

MSimon · Post by **MSimon** » Mon Mar 12, 2012 5:31 am

The Progressives made a mistake. And to atone they intend to capitalize on it as the tide turns. Clever bastiches don't you think?

And you are playing right into their hands.

And I'm sure you are a true blue rock ribbed Constitutionalist. Could you point me to the Drug Prohibition Amendment? One of our other staunch prohibitionists in a moment of candor in an e-mail told me that the Constitutional issue was a glaring hole in the case for Federal Prohibition. But he will not say that in a public forum. Cowardly don't you think?

Seriously - if Drug Prohibition is the right thing to do shouldn't it be done legally?