The Link Between Substance Abuse and PTSD

Post-traumatic stress disorder (PTSD) is a mental health disorder that occurs when a person experiences (directly or indirectly) or witnesses, a traumatic event, or series of events. People who suffer from PTSD often suffer for many years, if not an entire lifetime, after these traumatic events occur. During periods of high anxiety and stress, many PTSD sufferers turn to drugs or alcohol, as a means of numbing emotional pain, or escaping reality.

People seeking treatment for drug or alcohol addiction often find it difficult to recover, because their substance abuse is related to undiagnosed or untreated PTSD. When someone struggling with substance abuse also has mental health disorder, it is known as a co-occurring disorder.

Co-occurring disorders are difficult to treat because one disorder can mask the other. Just as an addict may face a more difficult recovery if their PTSD is not addressed, someone hoping to confront issues surrounding PTSD may disregard drug or alcohol use because they believe the activities to be unrelated.

In the past, mental health disorders like PTSD and substance abuse may have been treated separately. Often one disorder was thought to be a more significant issue, and was treated first, before the other disorder. Today, it is understood that both disorders must be addressed in tandem to ensure long-term recovery.

What Is PTSD?

 PTSD is often about power. Traumatic events, or a series of traumatic events, can leave a person feeling powerless and out of control. This feeling can manifest itself during dreams and other flashbacks. The helplessness felt by an individual during these flashbacks can lead to debilitating anxiety and stress.

When PTSD is allowed to fester or go unresolved, unhealthy reactions are likely to occur. These reactions may include violent outbursts or panic attacks. Reactions in public or in front of family members can lead to feelings of guilt and shame, and eventually to depression and substance abuse.

Causes Of PTSD

 A leading cause of PTSD is military combat. In fact, Post-traumatic stress disorder has been separately known as “shell shock” or “combat fatigue,” after each of the World Wars. A veteran may experience PTSD after service that involves gruesome battlefields, battlefield injury, or capture by the enemy. Soldiers are built up to be confident and have pride, for success in battle, and the realities of war can leave them feeling helpless and unable to control their actual environments.

PTSD rates are high among rape victims, genocide survivors, and people imprisoned for political or ethnic reasons. Any sexual, psychological or physical abuse can lead to PTSD. Anyone who has to work in an environment that includes injuries, death, or destruction (police officers, firefighters, medical personnel) is susceptible to developing PTSD. Post-traumatic stress disorder can also be caused when someone lives through the death of a loved one, or lives through a natural disaster.

PTSD and Substance Abuse Statistics

Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.

Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.

Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.

* Source – Journal of the American Medical Association –

Specialized Treatment Strategies for PTSD and Addiction

Concurrent Treatment of PTSD and Substance Abuse Disorders Using Prolonged Exposure (COPE) – Prolonged exposure therapy forces the patient to remember and revisit the source of trauma. The patient learns to confront and deal with the memory, and is discouraged from avoidance. COPE has been shown to both improve PTSD and curb substance abuse.

Integrated Cognitive-Behavioral Therapy (non exposure) – Because the memories of trauma can be painful, and a trigger for other dangerous behaviors, this alternative to exposure approach focuses on education, anxiety reduction, and the development of coping skills. This approach has a lower attrition rate, and is also supported by empirical study.

Eye Movement Desensitization and Reprocessing (EMDR) – Treatment for emotional pain is assumed to take many months, or many years. EMDR has been shown to improve PTSD over a period of a few 90 minute sessions. It is believed that eye movement is related to how a person deals with memories. Through training, the right patient may be able to retrain the brain to experience these memories differently. Only patients with a certain readiness to work with a therapist will benefit from EMDR.

Physical Exercise – One of the allures of substances like opiates, or alcohol, is the pleasure sensation that is chemically stimulated in the brain, especially for those suffering with anxiety and depression. Exercise and physical activity can also stimulate the release of similar chemicals.

Peer Groups and Family Counseling – Just as with any substance abuse treatment, family counseling, group therapy, or 12-step groups, provide support for people who have co-occurring disorders.

Balanced Anti-Addiction and Psychotherapeutic Medication – There are a growing number of medicines that have been proven to combat addiction. Antidepressants or anti-anxiety drugs are effective in regulating the moods of people suffering from PTSD.