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Long Tours Put Vets at Greater Risk for PTSD, Substance Abuse


 

NEW YORK — The incidence of posttraumatic stress disorder is likely to be significantly higher in the current population of veterans because of long and repeated tours of duty, said Dr. John A. Renner Jr., associate chief of psychiatry at the VA Boston Healthcare System.

Clinicians and scientists have known since the 1960s that limiting exposure to combat to 1 year helps reduce the incidence of PTSD, but today a large cohort of troops has had repeated exposures of more than 1 year, said Dr. Renner, also a faculty member at Boston University.

“Statistically … that's going to have a major impact,” Dr. Renner said during a panel discussion on substance abuse and mental health among veterans and active duty military sponsored by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.

Veterans of the Iraq and Afghanistan conflicts are often 22- and 23-year-olds who have been deployed two, three, or four times in many cases, said Dr. Loree K. Sutton, a brigadier general in the Department of Defense Military Health System. These troops were constantly exposed to danger and improvised explosive devices, and, operated in places where they often were unable to identify the enemy, she said.

Another difference between today's combat veterans and those from other eras is the increased number of soldiers returning with chronic pain syndromes, said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health. More soldiers are able to survive combat injuries but that translates into living with more pain and the potential for abusing prescription pain medications, she said.

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