Posttraumatic Stress Disorder and Addiction are Not Defenses for Robbery
> 1/16/2006 8:19:24 AM

Jason Battista, better known to residents of Connecticut, New York and Jersey as the “Bandage Bandit,” was sentenced last Wednesday in U.S District Court to 75 months in jail.  The Valhalla, NY resident was convicted of robbing or attempting to rob 15 banks in the three states.  While his crimes could almost be considered pedestrian in our media saturated culture, Battista made headlines at the end of last year when he made a unique request for leniency in his sentencing.  Battista, a former Wall Street trading clerk, claimed that witnessing the September 11th terrorist attack and collapse of the World Trade Towers contributed to his cocaine problem, which in turn forced him to turn to robbery as a means of supporting his addiction.

Unfortunately for Battista, federal prosecutors got all that they were asking for when the judge handed down his sentence.  Even though he was resoundingly denied, the Bandage Bandit’s infamous plea does raise the important question: what is the relationship between traumatic events and drug and alcohol addiction?  Can a traumatic event, such as 9/11 be used to explain a drug problem, and therefore, the actions that might result from that addiction?

After poring over the voluminous literature that has been published on the comorbidity of drug addiction and post traumatic stress disorder, the answer appears to be… maybe.  To start, I’d like to answer my second question first, a much simpler task.  As prosecutors in the case were quoted as saying by the AP, "Addicted individuals are encouraged to seek help for their problems instead of resorting to this type of serious criminal behavior."  No matter the circumstances, drug addiction should not be offered as an excuse or reason for committing a crime.  

With that being said, research in the field of psychology and addiction does point to a strong relationship between PTSD and drug abuse and dependence.  This connection was noticed as far back as the Vietnam War era when doctors noticed that as many as 75% of combat veterans with lifetime PTSD also suffered from alcoholism.  In research published in the Archives of General Psychiatry in October of 1998, Drs. Chilcoat and Breslau found that, “Adjusted for race, sex and education, persons with a history of PTSD had a 4.5-fold increase in the risk of drug abuse or dependence compared with those who were not exposed to a traumatic event.”

In a more recent overview of “Substance Use Disorders in Patients With Posttraumatic Stress Disorder” from the August 2001 American Journal of Psychiatry, Drs. Jacobsen, Southwick and Kosten  concluded that, “Clinical and epidemiologic studies confirm that comorbidity of PTSD with substance use disorders is common and that the symptoms of patients with this comorbidity tend to be more severe and more refractory to treatment than those of patients suffering from either disorder alone.”

Another study published in the February 1998 issue of the American Journal of Psychiatry presented research by Dr. Najavits, et al. that focused on Cocaine dependence with and without PTSD.  This study provides an interesting angle in that it was performed as part of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study.  Interviewing and screening patients that presented for treatment of cocaine abuse, Najavits, et al. discovered a statistically significant difference between PTSD sufferers and non-PTSD sufferers in medical and psychological addiction severity but not in other areas of addiction severity that were tested.  They also found no difference between the two groups in areas such as addiction recovery (measured in attitudes and behaviors relevant to recovery from substance abuse), beliefs about substance abuse and relapse prediction.  So, while there is evidence that the addiction itself might be stronger for those who suffer from PTSD, the underlying attitudes remain similar to those that effect individuals that do not suffer from PTSD.  

One hypothesis that attempts to explain the link between drug addiction and PTSD is the self-medication hypothesis.  Basically, suffers of PTSD find relief from their symptoms in the dulling embrace of drug addiction and prefer the negative effects of the latter to the hyperarousal and often frightening symptoms of the former.  Chilcoat and Breslau found support for this idea in the results, but also noted that their findings were also “consistent with the possibility of a shared vulnerability for drug addiction and PTSD after a traumatic event.”

This is backed up by another finding that Chilcoat and Breslau reported: “Persons with a history of exposure [to traumatic events] without PTSD showed no increased risk of drug abuse.”  This means that the comorbidity truly only links PTSD and drug abuse, and not any traumatic event with an increase of drug use.

September 11th was an event whose magnitude cannot truly be described in words, and its effects on individuals across the country were as varied in nature as they were in severity.  There is little doubt that Jason Battista was negatively affected by the events of that day.  Whether or not he developed PTSD in the wake of 9/11 and that his disorder contributed to his cocaine addiction is another story.  As the judge in his case made abundantly clear, no matter what the mental and physical state of a person in the wake of 9/11, those events and any anguish that follows do not give that person a blank check to commit crime.  Battista, if he truly is suffering from PTSD and cocaine addiction, should seek treatment and counseling in prison, because it will be a while before he can seek it as a free man.

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