Efficacy of chemical dependency treatment as a function of combat in Vietnam.

Traumatized combat veterans frequently attempt to escape the chronic anxiety, insomnia and nightmares characteristic of post-traumatic stress disorder by self-medicating with alcohol and drugs. The elimination of alcohol and drugs through chemical-dependency treatment, therefore, might be expected to precipitate an exacerbation of stress symptoms and predispose veterans to new cycles of abuse. The relationship between combat and post-treatment substance abuse has not been subjected to empirical study. This paper examines treatment-completion and post-treatment abstinence rates (treatment efficacy) as a function of level of combat when combat veterans are provided trauma-oriented therapy concurrently with treatment for chemical dependency. The experimental results suggest that, under these conditions, treatment efficacy does not vary with level of combat. The absence of combat-level effects is explained in terms of the interactive dynamics of chemical-dependency and post-traumatic stress disorder.