PTSD-related drinking to cope and changes in drinking risk levels in a nationally representative sample

Area of Science:

• Psychiatry
• Addiction Medicine
• Epidemiology

Background:

• Posttraumatic stress disorder (PTSD) is frequently linked to high-risk alcohol consumption.
• Individuals may use alcohol as a coping mechanism for PTSD symptoms, potentially sustaining problematic drinking patterns.

Purpose of the Study:

• To investigate the association between drinking to cope with PTSD symptoms and changes in World Health Organization Risk Drinking Levels (WHO RDL) over three years.
• To analyze these associations in individuals with PTSD symptoms using a large national survey dataset.

Main Methods:

• Utilized data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC).
• Included participants reporting past-year alcohol use and PTSD symptoms at baseline.
• Defined WHO RDL (low, moderate, high, very high) based on drinks per drinking day at baseline and 3-year follow-up.
• Employed multinomial logistic regression to model changes in WHO RDL based on PTSD-related drinking to cope, stratified by baseline risk levels.

Main Results:

• Among low-risk baseline drinkers, drinking to cope with PTSD symptoms significantly increased the odds of escalating to higher WHO RDL at follow-up (OR=2.62).
• Among moderate-to-very high-risk baseline drinkers, drinking to cope was associated with lower odds of reducing WHO RDL (1-level reduction OR=0.39; 2-level reduction OR=0.41).

Conclusions:

• PTSD-related drinking to cope is a significant risk factor for the escalation and persistence of problematic alcohol use.
• Interventions specifically addressing drinking to cope with PTSD symptoms are essential for preventing and treating alcohol use disorders in this population.