It is commonly known that many people use alcohol in response to elevated levels of stress. However, it is less commonly known that Veterans and firefighters are disproportionally at risk for alcohol use disorder (AUD) in relation to the general population (Herrold, 2014). Worldwide AUD prevalence rates range from 0%-16% but for Veterans it reaches as high as 36% (Herrold, 2014). Therefore, it seems logical to hypothesize that the innate stressful nature of both of those occupations could be correlated to, if not partially responsible for, the increased prevalence of AUD in both the Veteran and firefighting communities.
In a study recently published by the University of Houston entitled “Distress Tolerance Plays Role in Alcohol Use and Abuse Among Firefighters”, researchers interviewed over 600 trauma-exposed firefighters to study the relationship between their distress tolerance, which is your actual or perceived ability to withstand emotional distress, and AUD. What they found was that firefighters with greater PTSD symptom severity reported higher levels of alcohol use to cope with negative emotional states. They also found that years in the fire service, occupational stress and alcohol consumptions were all significant predictors of socially-motivated alcohol use (Zegel, 2019).
PTSD and depression symptoms are often co-occurring conditions and as a result have very similar treatment methods. As of recently one of the most interesting potential treatment methods for major depressive disorder is transcranial magnetic stimulation (TMS). The possibility of being able to use TMS to treat patients suffering from depression is exciting for several reasons some of which being that it is a non-invasive treatment method and that it doesn’t produce side effects that typical SSRIs can induce. The overlapping symptoms of co-occurring AUD and PTSD have the ability to exacerbate each other but because TMS allows for specifically targeted activation or inactivation of particular brain regions, TMS has the potential to show whether or not the improvement of one symptom has the potential to improve other symptoms as well. Amy Herold’s article “Transcranial Magnetic Stimulation: Potential Treatment for Co-Occurring Alcohol, Traumatic Brain Injury and Posttraumatic Stress Disorders” as well as many other prior studies have shown that the prefrontal cortex (PFC) is likely the optimal stimulation site for reducing alcohol craving which will help guide future studies.
Although these articles focused on different aspects of addiction, it is evident that there is a relationship between occupational stress levels and an individual’s affinity for risky addictive behaviors. This is incredibly important for developing more effective clinical treatment plans for Veterans and firefighters alike who are struggling with AUD and addiction. As suggested by the first article, distress tolerance is heavily related to the motivation to consume alcohol and as suggested by Herold’s article, TMS might be an effective means at treating patients with depression or PTSD symptoms. For future research it might be interesting to conduct an experiment that evaluates the utility of TMS in reducing alcohol craving and consumption.
References
Herrold, A., Jordan, N., High, W. M., Babcock-Parziale, J., Chambers, R. A., Smith, B., Evans, C. T., Li, X., Mallinson, T., & Jenkins, S., Pape, T. L. B. (2014) Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury. Journal of Rehabilitation Research & Development, 51, 1397-1410. doi: 10.1682
Herrold, A., Kletzel, S., Harton, B., Chambers, R. A., Jordan, N., & Pape, T. L. B. (2014) Transcranial magnetic stimulation: potential treatment for co-occuring alcohol, traumatic brain injury and posttraumatic stress disorders. Neural Regeneration Research, 9, 1712-1730. doi: 10.4103
Zegel, M., Tran, J. K., & Vujanovic, A. A. (2019) Posttraumatic stress, alcohol use, and alcohol use motives among firefighters: The role of distress tolerance. Psychiatry Research, 282. doi: 10.1016
https://www.sciencedaily.com/releases/2019/12/191203133841.htm
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