Dealing with PTSD symptoms can worsen substance use disorder. Because the two disorders are closely related, it is important to treat them simultaneously.
Post-traumatic stress disorder (PTSD) occurs in response to severe traumatic events that threaten a person’s life or safety. An estimated 20% of people who experience trauma will go on to develop PTSD as a result. Because of the intensity of symptoms and impact on quality of life, it is common for those with PTSD to rely on alcohol or drug use to cope with symptoms. One study showed that 46.4% of people with lifetime PTSD had co-occurring substance use disorder.
The Connection Between PTSD and Drug Addiction
PTSD is caused by changes in the brain’s circuitry as a result of repeated shifts in stress hormones. The repetitive memories of trauma and increase in stress hormones have long-term implications on the brain structure and influence physical and emotional responses to stress and triggers over time. The impact of PTSD on survivors is life-changing and frequently interferes with all aspects of life. Those struggling with PTSD simply want peace from the physiological and emotional symptoms; that can lead to drug or alcohol use in an effort to self-medicate. Unfortunately, substance use offers only temporary relief and often results in a cycle of addiction and worsening PTSD symptoms.
Treatment of Co-occurring PTSD and Substance Use
When someone is struggling with PTSD and substance use disorder, it may seem wise to treat one condition at a time. Unfortunately, treating only one condition can exacerbate symptoms of the other since both conditions are intertwined. An alternative to siloed treatment is a dual diagnosis program, which simultaneously treats mental health conditions like PTSD and substance use disorder. The Recovery Village Cherry Hill at Cooper offers comprehensive dual diagnosis treatment to address both trauma-related symptoms and challenges with substance abuse.
Psychotherapy is an important aspect of dual diagnosis treatment and helps people establish a safe and supportive place to process trauma, recognize triggers and learn coping strategies. Treatment techniques such as cognitive processing therapy and psychoeducation can help people make sense of the many challenges they face. Therapy helps clients recognize some of the underlying issues that lead to self-medication through substance use, which may help prevent relapses and recovery setbacks.
Medication is another important tool that can reduce withdrawal symptoms and trauma symptoms. Detoxification can be a difficult process, so your treatment team works closely to monitor your symptoms and keep you safe. Certain substance use disorders, including those for alcohol and opioids, can benefit from medication-assisted treatment programs that help manage withdrawal as a whole. In general, your medical detox team may also offer treatment for individual symptoms to make your detox more comfortable.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is a condition that can emerge for survivors of traumatic situations. These events create a neurobiological reaction in the body: stress hormones overload the system and can wreak havoc on one’s emotional, mental and physical health. PTSD symptoms can vary, and there are generally four types of symptoms people experience:
- Re-experiencing symptoms: Triggers and reminders of the traumatic event cause the sensation of re-living the experience through flashbacks, intrusive thoughts and nightmares.
- Avoidance symptoms: In an effort to reduce the impact of triggers and memories, the person restricts their behavior. They may avoid other people or try to distract themselves from painful memories to avoid feelings.
- Arousal symptoms: Those who experience arousal symptoms may startle easily or be hypervigilant about their surroundings. Sleep issues are common, as well as irritability and tension.
- Mood and cognitive symptoms: Negative self-evaluation, memory problems, feelings of guilt and anhedonia (the inability to feel pleasure) are common mood symptoms related to PTSD.
Anyone who has experienced a traumatic event can develop PTSD, but some may be more prone to it than others due to:
- Genetic factors
- Gender (women are more likely to develop PTSD than men)
- Childhood trauma
- Lack of support after the trauma
- Duration of traumatic events
- The presence of other mental health issues or substance use disorder
- Additional stress/losses after the traumatic event
The causes of PTSD vary. Once thought of as a combat veteran condition, PTSD is now widely known as a condition that can impact anyone. Some of the causes of PTSD are:
- Sexual or physical assault
- Childhood abuse
- Natural disasters
- Political warfare
- Combat experiences
- Finding out about a traumatic event or injury of a loved one
- Vehicle accidents or housefires
Complex post-traumatic stress disorder is a form of PTSD that goes beyond the typical symptoms to include struggling with self-organization, relational functioning and processing emotions. CPTSD can emerge especially for people who have had multiple traumatic experiences in their lifespan.
Yes. Due to the underlying factors and challenging symptoms of PTSD, survivors are more prone to addiction than most.
Reactions to traumatic events have four phases:
The impact phase encompasses the reactions to the event, including shock, physical symptoms, and feelings of fear and sometimes guilt.
In the rescue phase, the traumatized individual begins to process what has happened and accept it as reality.
In the intermediate recovery phase, the individual begins to adjust and return to life beyond the trauma.
The long-term reconstruction phase is the rebuilding stage and long-term recovery from the traumatic event.
There is no specific timeline for recovery from PTSD. Some people may recover as fast as six months later, while others can struggle with symptoms for years. It largely depends on the nature of the trauma and the genetic makeup of the survivor.
Effects of Substance Use on PTSD Symptoms
Drug and alcohol use can have a detrimental impact on people suffering from PTSD. PTSD symptoms are often worsened by substance use and withdrawal.
- Alcohol use can worsen anxiety and depressive symptoms and increase impulsivity. These factors can impact one’s ability to make good decisions and respond to emotions in safe ways.
- Marijuana use can increase anxiety in some people, exacerbate mood disorders and can co-occur with other types of substance use disorders and physical and mental health challenges.
- Stimulant use increases physiological responses, which can result in heightened PTSD symptoms in people with the disorder.
Helping Someone with PTSD and Drug Addiction
When someone is struggling with PTSD and addiction, the world can feel like a lonely place. Finding the right words or actions to offer support can feel daunting. If you are trying to support someone with addiction and PTSD, there are some phrases and comments that are best left unsaid:
- Try not to make statements that minimize their traumatic experience or challenges with addiction.
- Avoid trite comments such as “you’ll get over it” or “it could be worse.”
- Avoid shaming comments or making the person feel guilty about their challenges with addiction or response to trauma.
If you or a loved one has been struggling with PTSD symptoms and addiction, reach out to The Recovery Village Cherry Hill at Cooper. Our licensed clinicians and therapists offer comprehensive, evidence-based dual diagnosis programming to support your treatment and recovery needs.
U.S. Department of Veterans Affairs. “Treatment of Co-occurring PTSD and Subst[…] Use Disorder in VA.” National Center for PTSD, July 13, 2020. Accessed November 11, 2021.
Bremner, J Douglas. “Traumatic stress: effects on the brain.” Dialogues in Clinical Neuroscience, December 2006. Accessed November 11, 2021.
National Institute of Mental Health. “Post-Traumatic Stress Disorder.” MedlinePlus, October 14, 2021. Accessed November 11, 2021.
Ford, Julian D. “Complex PTSD: research directions for no[…], and public health.” European Journal of Psychotraumatology, May 19, 2015. Accessed November 11, 2021.
U.S. Department of Veteran Affairs. “Cannabis Use and PTSD Among Veterans.” National Center for PTSD, August 4, 2021. Accessed November 12, 2021.
U.S. Department of Veterans Affairs. “Reactions Following Disaster and Mass Violence.” National Center for PTSD, September 24, 2018. Accessed November 11, 2021.
Herbst, Ellen D.; et al. “Use of Stimulants and Performance Enhanc[…]tic Stress Symptoms?” The American Journal of Psychiatry, February 1, 2017. Accessed November 11, 2021.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.