'They've been exposed to the most horrible traumas imaginable'

Study: Nova survivors who drank alcohol before Hamas attack more likely to suffer PTSD

Sheba Medical Center, Ben-Gurion University researchers surprised to find alcohol caused more psychological problems than psychedelics on survivors of Hamas’s Oct. 7 rave massacre

Reporter at The Times of Israel

Family members visit the site of the Nova music festival massacre, six months after the October 7 Hamas terror assault, in Re'im forest, near the Gaza border, April 7, 2024. (Chaim Goldberg/Flash90)
Family members visit the site of the Nova music festival massacre, six months after the October 7 Hamas terror assault, in Re'im forest, near the Gaza border, April 7, 2024. (Chaim Goldberg/Flash90)

Researchers at Sheba Medical Center and Ben-Gurion University say that being under the influence of alcohol – and not drugs – worsened the psychological impact of Hamas’s horrific attack at the Nova music festival on October 7, 2023.

On October 7, 2023, about 4,000 civilians were attending the open-air music and dance festival near Kibbutz Re’im in southern Israel when hundreds of Hamas-led terrorists burst through the border from Gaza and rampaged murderously, slaughtering 364 people amid other atrocities, including gang rape and mutilation of victims.

During the Hamas ambush on the outdoor rave, festival attendees were forced to act quickly; some escaped by running away, while others hid for hours to survive. At the time of the attack, a significant proportion of the participants were under the influence of drugs and alcohol.

“Alcohol consumption led to increased anxiety, stress and depression,” said Dr. Nitza Nakash, Director of the Clinic for Cognitive Behavioral Therapy at Sheba Medical Center, who conducted the study with Prof. Mark Weiser, Prof. Joseph Zohar, Prof. Raz Gross and medical student Tal Malka.

The research was co-authored by Ben-Gurion University Prof. Hagit Cohen with contributions by BGU students Gal Levi and Yarden Dejorno of the psychology and pharmacology departments.

“The people who were under the influence of alcohol had higher rates of post-traumatic symptoms, depression, anxiety and disassociation,” Weiser told The Times of Israel.

The findings were published in the prestigious peer-reviewed World Psychiatry around the first anniversary of the attack.

A grab from a UGC video posted on the Telegram channel ‘South First Responders’ on October 9, 2023, shows a Palestinian terrorist walking around the Nova music festival, near Kibbutz Re’im in southern Israel on October 7. (South First Responders/AFP)

How did alcohol and drugs impact the stress of survivors?

October 7 saw some 1,200 Israelis killed and 251 taken captive into Gaza. Some of those kidnapped were dragged away from the music festival, with their abductions shared on social media.

Sheba Medical Center treated 232 survivors from one week to two months after the festival. The researchers sought to identify how alcohol and recreational drugs impacted the cognitive and stress response to the horrific event.

Researchers chose 126 survivors who met certain criteria, ruling out additional traumas and previous history of mental health disorders. The average age of the participants was 28; more than half were men. Additionally, 57.7 percent reported using psychoactive drugs at the festival, including MDMA, cannabis and LSD in various combinations.

Israelis visit the site of the Nova music festival massacre, in Re’im, southern Israel, February 28, 2024. (Tomer Neuberg/Flash90)

“We hypothesized that psychedelic drugs would cause higher levels of anxiety among the survivors,” Cohen told The Times of Israel. “But alcohol affected people’s memory motor skills and increased the risk for Post-Traumatic Stress Disorder (PTSD).”

Weiser said the researchers also expected people who used drugs to be hyper-vigilant, more alert and more aware of their surroundings so that the attack would “hit them more directly.”

“But we were wrong,” Weiser said. “Alcohol and not drug use was associated with higher rates of post-traumatic symptoms, depression and anxiety.”

Alcohol also caused survivors to have a greater sense of dissociation, which is when people become detached from their feelings or report feeling numb.

A Nova party survivor at the Secret Forest retreat center in Cyprus, in an undated photo. Her bracelet is the entrance token from the party on the date of the massacre.  (Courtesy)

The researchers believe that disassociation disrupts the processing and integration of traumatic memories. It could increase the probability of developing PTSD because trauma-related memories persist in a fragmented and unprocessed state.

“You have a memory of what happened, and you’ve got to process and internalize this,” Weiser said. “You don’t forget about it because it happened, but you have to find a way to give it a place in your mind so that you can move on with your life.”

The researchers hypothesize that alcohol interferes “in the normative, healthy consolidation of memories to keep them in the place that they should be,” he said.

People at the festival who did not use any drugs or alcohol had significantly less difficulty coping with the trauma, the researchers said.

‘Programmed to survive’

Israelis are concerned about young people in the aftermath of October 7 and the war, Weiser said.

“These unfortunate young people were exposed to a very severe trauma,” Weiser said. “Many of them do need our help, but the majority are not psychiatrically impaired, even though they’ve been exposed to the most horrible traumas you can imagine.”

Anemone wildflowers bloom in Re’im, southern Israel, Monday, Feb. 12, 2024, at the site of a cross-border attack by Hamas on the Nova music festival. (A/Maya Alleruzzo)

He emphasized that research shows that most people who are exposed to trauma, no matter how severe, will be okay.

“We’re programmed in our DNA to survive,” he said.

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