Chapter 4: Substance Use Disorder

Introduction

Operational Stress Injuries have been found to have a reasonably high chance of occurring with a substance use disorder.

Some people say that they began to use drugs or alcohol as a form of self-medication – hoping to relieve themselves of the troubling symptoms of their OSI.

What the medical community agrees on is that OSIs and substance use problems should be treated together – and by multi-disciplinary teams.⁴⁴

Usually, people with both an OSI and a substance use problem are treated in groups that do not include people with an addiction only as their needs are different.

Harm Reduction

Most people are familiar with Alcoholics Anonymous (AA),⁴⁵ a many decades old all-volunteer model of alcohol addiction recovery. AA demands complete abstinence.

The harm reduction model is not an all or nothing approach like AA. It is designed to be paced and supports gradual change. You and your therapist will develop strategies to cut down on your alcohol and/or drug use. Some people will quit alcohol or drugs altogether. Others will cut down until they feel they are back in control. An overall feature of the harm reduction approach is to prevent the negative consequences of substance use and improve health.