★ PTSDIY · Field Manual ★ Part III ★
Chapter 14
Fuel and substances
What goes in changes what comes out
FM 14-FUL-101Audit time 2 weeks
14-1.Mission brief
Alcohol, cannabis, caffeine and food all shape your nervous system. Many people use them to manage symptoms, which makes sense. This chapter is about seeing what they actually cost you, without shame.
14-2.Intel
Alcohol worsens sleep quality and PTSD symptoms over time even when it helps short-term. VA/DoD guidelines recommend against cannabis as a PTSD treatment; current evidence does not show benefit and suggests it may complicate recovery. Regular meals keep blood sugar and mood steadier.
14-3.Short-term vs. long-term
| Substance | Short-term | Longer-term |
|---|---|---|
| Alcohol | Takes the edge off; helps you fall asleep | Fragmented sleep, more anxiety and nightmares, dependence |
| Cannabis | Calmer, may block dreams | Tolerance, rebound nightmares when stopping, motivation dips |
| Caffeine | Alert, sharp | Jittery, more startle, poor sleep if late in the day |
| Skipped meals | Nothing obvious | Irritability and energy crashes that feel like symptoms |
14-4.Field procedures — the two-week audit
| 01 | Log, don't changeFor two weeks, write down what you drank, used, ate and when. No judgment. | 2 min/day |
| 02 | Rate the next daySleep, mood and symptoms, 0–10. | 1 min |
| 03 | Find the patternWhat reliably shows up before a bad day? | 15 min |
| 04 | Change one thingPick one adjustment and run it for two weeks. | — |
14-5.Rules of engagement
Warning — Do not stop heavy daily drinking suddenly on your own. Alcohol withdrawal can cause seizures and can be fatal. Get medical help to taper safely.
14-6.Common faults & corrections
| ✕ | Fault: "It's the only thing that helps me sleep"Correction: It helps you pass out, then wrecks the second half of the night. See Chapter 13. |
| ✕ | Fault: Quitting everything at onceCorrection: One change at a time is how changes stick. |
14-7.Call for backup
PTSD and substance use are best treated together, not one after the other. Ask a provider about integrated treatment. The SAMHSA helpline (1-800-662-4357) is free, confidential and open 24/7.
Companion episode — [IN PROGRESS]
PTSDIY · FM 14-FUL-101 · Part III14