The IDF Soldiers’ New Battlefield: Addiction

Besides honoring the fallen, this week our thoughts should also be given to those who came home from war and the difficulties they grapple with in their everyday lives. It is hard to win the battle against addiction alone

Whether it is a reaction to an event that occurred in the past year or to those that happened decades ago, Post-Traumatic Stress Disorder (PTSD) has no expiration date. Events in recent weeks indicate that many of those struggling with PTSD have been experiencing a deterioration in their mental and emotional state as a result of the isolation and lockdown we are all experiencing during the coronavirus pandemic.

Memorial Day in Israel, like Holocaust Remembrance Day, are particularly difficult days for Israeli society as a whole, and all the more so for those struggling with PTSD. On Israeli Memorial Day, we must bear in mind that the disorder affects those who suffer from it as well as those who surround them. As a result, mobilization, support, inclusion and understanding by the families of those struggling with PTSD are very meaningful and extremely crucial, as are attentiveness to the symptoms and needs of those struggling with PTSD, particularly during these difficult days.

PTSD is a mental disorder that may develop as a result of exposure to a traumatic event or events. One of the major symptoms is re-experiencing the threatening event or events in the form of images, memories, noises, smells, thoughts, hallucinations (flashbacks) and dreams. Other symptoms of the syndrome include avoidance of places, people and activities that are reminders of the traumatic event, and often, a significant decline in mood and functioning. According to various estimates, there are tens of thousands of individuals suffering from PTSD in Israel today. Of these, more than 15% were caused by traumatic events which occurred in wars, battles and acts of terrorism.

According to US data, many of those who suffer from combat fatigue or shell shock, i.e., PTSD, following active warfare during their military service, tend to abuse drugs, alcohol and prescription medications. More than 20% of military veterans in the US, who were diagnosed as suffering from PTSD also suffer from Substance Use Disorders.

Often, the use of harmful substances exacerbates the emotional reactions caused by PTSD, which in turn leads to increased drug and alcohol use, so that in fact, these are two phenomena that are not only related, but feed off one another.

Israel is a country where the military experience is a cornerstone of its existence. When virtually every citizen is required to enlist, one may assume that the portion of those who suffer from PTSD is higher than formally diagnosed, and consequently, so is the portion of Israelis struggling with addiction. This is particularly true when taking into account the multitudes who have experienced traumatic events, and consequent mental symptoms, even when not all  PTSD criteria are met. Even if the nature of the addiction and the frequency of use of certain substances vary from one country to the next, some things remain constant – including the direct relationship between the traumatic experience and the perils of addiction.

In light of these commonly co-occurring disorders, it is important to recognize that just as PTSD is a treatable disorder, so is addiction. Treatment of addiction has advanced immensely in recent decades and millions throughout the world have found relief for their pain and distress using appropriate medications, psychotherapies, self-help groups and various therapeutic frameworks.

The coronavirus pandemic is continuously teaching us that even in times of social distancing, when the face-to-face interaction between patient and therapist has been severed and therapy has shifted to online modalities, treatment continues to be readily available. Individuals in need of therapy, for both PTSD as well as for addiction, can find available online treatments and need not struggle with their challenges and pain alone.

Memorial days are hard for us all, and individuals find various manners to deal with them, some in ways which may be harmful to their physical or mental health. This is the right time to take a look at our immediate surroundings and lend a hand to those who may perhaps be too embarrassed or ashamed to ask for our help.

The writer is the co-founder and academic director of the Israel Center on Addiction (ICA)

About the Author
Professor Shaul Lev-Ran is a psychiatrist, deputy director of Lev HaSharon Medical Center, associate professor of psychiatry at the Sackler Faculty of Medicine at Tel Aviv University, and an affiliate scientist at the Centre for Addiction and Mental Health, Toronto, Canada. He is a member of the National Council for Mental Health (Israel) and of the Motivational Interviewing Network of Trainers (MINT), an international organization of trainers in motivational interviewing. He currently serves as president of the Israeli Society of Addiction Medicine (ILSAM). Lev-Ran completed his M.D. at Tel Aviv University, his residency in psychiatry at the Shalvata Mental Health Center, and his fellowship in addiction psychiatry at the Centre for Addiction and Mental Health at the University of Toronto. He is a graduate of the psychoanalytic psychotherapy program at Tel Aviv University, and has a master’s in health administration from the University of Haifa.
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