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I’m an incarcerated honorably discharged veteran at the California Rehabilitation Center (CRC), in Norco, Calif., and I suffer from co-occurring disorder, which is a term describing people who suffer from two or more mental health disorders or medical illnesses. I wanted to write about the restorative impact and insight of post-traumatic stress disorder (PTSD) because substance-related disorders and PTSD are the most common of all co-occurring disorders.

According to the National Center of PTSD, approximately eight of every 100 Americans will suffer from PTSD. Additionally, a clinical study out of the Medical University of South Carolina in Charleston found that those seeking treatment for PTSD are 14 times more likely to also be diagnosed with a substance abuse disorder. One of the groups at greatest risk for developing both PTSD and substance abuse disorders is the veteran population.

However, too often, diagnostic criteria for PTSD are not listed in veterans’ medical records. Instead, military personnel are labeled as “broken.” That is how I used to perceive the traumatic events that shaped my thoughts and behavior.

Incarcerated people, including veterans, reporting a greater use of alcohol/drugs have experienced multiple traumas, including sexual abuse, consistent physical abuse, emotional abuse and exposure to military combat.

Individuals with co-occurring PTSD and substance-related disorders tend to show a more severe substance dependence and are generally self-medicating in order to reduce their pain and symptoms of depression and anxiety.

These people, including myself, often become dependent on alcohol, cocaine, cannabis and prescription drugs. Additionally, those with co-occurring substance-related disorders and PTSD are more prone to having other severe mental disorders.

In my case, I caused marital problems, incidents of domestic violence and maltreatment of my children. I was homeless, lost my job and got caught up in legal problems which led to my current incarceration. I also became suicidal.

Individuals like myself with co-occurring disorders experience more intense symptoms for each disorder. We have more life stressors, more medical and mental health problems, higher unemployment, higher arrest records, higher levels of depression and anxiety, less effective coping strategies, poorer response to treatment, and a higher vulnerability to drug/alcohol dependence than do those with either PTSD or a substance-related disorder alone.

It is essential that everyone (incarcerated people, veterans, etc.) who has a history of trauma or is concerned that they have PTSD be evaluated for substance use disorders. It is also just as important that all people who show signs of drug/alcohol abuse be evaluated for trauma history and symptoms of PTSD.

These individuals, including myself, frequently discover and rely on alcohol/drugs to relieve their pain. So, it’s important to examine the reasons behind the decision to turn to substances. Doing so eventually helped me uncover my pain, seek alternative ways to deal with challenges and got me to see myself as somebody who mattered. In my experience, people like us need integrated treatment.

I recommend the following management tools to help people with PTSD and co-occurring disorders decrease dependence on alcohol and drugs: mindfulness (to help recognize one’s yearnings and triggers); stress tolerance (to discover and manage one’s locus of pain/discrepancy); emotional regulation (to understand behavioral stages and to help teach oneself a sense of personal control in their own recovery); empathic regard (to help an individual(s) to understand their view of alcohol/drugs of being beneficial in managing their pain); and Interpersonal relationship effectiveness (to help teach better social skills interpersonal functioning).

The aim is always to treat the people in prison, not the disorders themselves.

As an individual and imprisoned veteran suffering from PTSD and co-occurring disorders most of my life, I will never stop fighting. I’m now 56 years old, and have come to understand the importance of surrounding oneself with supportive family and friends with an open communication of the offspring of PTSD.

(Additional reporting by Elena Townsend-Lerdo)

Disclaimer: The views in this article are those of the author. Prison Journalism Project has verified the writer’s identity and basic facts such as the names of institutions mentioned.

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Linden Sawyer

Linden Sawyer is a writer and veteran incarcerated in California.