MDMA: FDA Panel Rejects Drug Targeting PTSD Therapy

We turned to the experts for their insight on how one can best support their loved one. “You can help guide them, but you can’t make that choice for them, nor is it your fault if they don’t get sober,” explains Kushner as she considers the scenario of someone not being ready to get sober yet. Above all, she found herself confronting parts of herself that she’d worked to avoid with alcohol. “I have healthy relationships, a career that I can show up to every day, and a deep level of self-worth that I never imagined I’d ever have before I got sober,” Natasha says. Furthermore, it isn’t uncommon for those who binge drink to end up developing alcohol use disorder. This is a common condition, with a 2020 study stating about 14% of U.S. adults suffer from alcohol use disorder.

• “I don’t want to see this become just another expensive add-on therapy for people who can afford it when people are dying every day by their own hand because of PTSD.”
• AUDIT is a 10-item questionnaire developed by the World Health Organization to easily screen for excessive drinking and to assist in brief interventions for alcohol-related problems [44].
• This study is a single blind 6-arm randomized controlled trial, consisting of 3 arms for simultaneous SUD/PTSD treatment with the PTSD treatments consisting of PE, EMDR, and ImRs, and 3 arms for sequential SUD/PTSD treatment with the PTSD treatments also consisting of PE, EMDR, and ImRs.
• Research finds that almost 50 percent of women will experience a traumatic event at some point in their lifetime.
• The assessment of SUDs involves the monitoring of substance use behaviors (frequency and intensity of use) and biological markers of use (Tucker et al., 2011).

Many People With PTSD Turn to Alcohol to Self-Medicate.

Above all, she recommends folks find their own balance of offering support while also supporting themselves. She continued by explaining various resources like the 12-step program Alcoholics Anonymous, SMART recovery, recovery coaching groups, and therapeutic support groups. Seeking out an intensive outpatient program may be another step you take to find lasting recovery. He continued by sharing that those suffering from alcohol use disorder think about alcohol differently than those who don’t suffer from the disorder. Simply put, those with alcohol use disorder often obsess about when their next drink is, while those without it don’t drink more than they intend to nor anticipate their next drink. Alcohol use disorder is characterized by a consistent pattern of alcohol use that leads to immense impairment and discomfort.

PTSD and Alcohol Abuse

The psychologist asks consent of the patient for being contacted by telephone by a researcher to receive more information about the study. Potential participants receive written and oral information about the study and are invited for an informed consent procedure and screening of in- PTSD and Alcohol Abuse and exclusion criteria. All reasons of potential participants to decline participation in the study will be monitored. This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well.

Military trauma and stress exposure

Throughout treatment, substance use education, relapse prevention techniques, peer support, and 12 Step attendance is encouraged. In an open pilot trial among 46 male Vietnam Veterans participating in a partial hospitalization program, Transcend participants demonstrated significant improvement from baseline with respect to PTSD symptoms at post-treatment, 6, and 12 month follow-up. Transcend participants also experienced improvements in SUD symptoms, including decreased alcohol consumption, decreased polysubstance drug use, and decreased episodes of drinking to intoxication. Although these findings are promising, they remain preliminary, as Transcend has yet to be evaluated in a randomized controlled trial. Research also documents high rates of comorbid PTSD/SUD among Veterans (Centers for Disease Control and Prevention, 1988; Shipherd, Stafford, & Tanner, 2005). A recent study (Petrakis, Rosenheck, & Desai, 2011) using national administrative data from the Department of Veterans Affairs indicated that, among Veterans who had served in Vietnam era or later, almost half (41.4%) with an SUD were dually diagnosed with PTSD.

• When compared to a Twelve-Step Facilitation Therapy which did not address trauma, among a sample of 19 methadone-maintained patients, improvements were observed with respect to both SUD and PTSD symptom severity; however, no between group differences were observed.
• However, additional research on pharmacological agents based on shared neurobiology of AUD and PTSD would be useful.
• Studies have shown that a traumatic stimulus triggers people with PTSD and an alcohol use disorder to crave alcohol.
• Alcohol use also causes its own problem, related to both mental and physical health.
• Rates of probable PTSD were assessed in those who scored positive for alcohol misuse, and those who did not.

• Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group.
• Tryptophan degradation along the kynurenine pathway by causing the release of neurotoxic metabolites is reported to be increased in stress-related psychiatric disorders [28].
• Written informed consent from the participants is obtained during the screening process prior to the first assessment.
• However, although elevated CSF CRH suggests that brain CRH may be elevated, the specific brain tissues producing CRH elevations cannot be determined from CSF data alone.

These limitations notwithstanding, the research conducted to date can inform both clinical practice and future clinical and preclinical research. For example, clinical research suggests that PTSD patients with substance dependence, particularly those who are addicted to CNS depressants, may find the physiologic arousal resulting from substance withdrawal intolerable due to additive effects with preexisting arousal symptoms related to PTSD. Successful detoxification of these patients may thus require inpatient admission to permit vigorous control of withdrawal and PTSD-related arousal symptoms. One 2020 study found that people who experienced childhood trauma, particularly emotional and physical abuse, had a statistically higher lifetime rate of AUD. A 2023 study suggests post-traumatic disorders are among the most common co-occurring diagnoses in people with substance use disorder (SUD).

There were connections between exposure to specific traumas (most commonly sexual and physical abuse) and increased risk of early alcohol initiation and subsequent development of AUD, although these connections were only observed among EA women. Further research is needed to better understand the findings and to identify factors that are related to the development of AUD in AA women. The authors emphasized that even though AUD was found to be less common in AA women as compared to EA women, AUD is still prevalent and problematic among AA women. Furthermore, research shows that AA individuals experience more severe symptoms of AUD as compared to EA individuals (Mulia et al., 2009). Future investigations of AUD/PTSD are encouraged to examine racial/ethnic disparities in presenting characteristics and treatment outcomes in order to better inform our understanding of the influence of race and ethnicity on AUD/PTSD and assist in the development of more effective interventions. Substance use disorders, particularly abuse of and dependence on central nervous system (CNS) depressants, are common in patients with posttraumatic stress disorder (PTSD).

From Curiosity to Dependence: The 4 Stages of Alcohol Misuse