Post-traumatic stress disorder (PTSD) is a mental illness that can affect people who have experienced or witnessed a traumatic event.
Such events include:
- sexual assault
- military combat exposure
- natural disasters
- childhood physical abuse
- serious accidents or injuries
- the death of a family member or close friend
When left untreated, PTSD can significantly reduce one’s quality of life. To cope, some people turn to alcohol, opioids, or other drugs.
A person who regularly uses drugs to decrease PTSD symptoms may receive a dual diagnosis, also known as co-occurring disorders.
This diagnosis is given to people who experience a substance use disorder alongside another mental health disorder. Typically, the symptoms of one disorder worsen the symptoms of the other, and vice versa.
The Link Between PTSD And Addiction
During a traumatic experience, the brain produces a higher level of endorphins. Endorphins are chemicals that reduce physical and emotional pain and promote a sense of well-being.
Once the traumatic event ends, though, the endorphins decrease and the pain returns. To make up for the reduced endorphins, some people with PTSD self-medicate with alcohol or other mood-boosting drugs, which temporarily boost endorphin levels and positive feelings.
With continued drug or alcohol use, a person’s tolerance increases. In other words, as time passes, they will need higher and higher doses of the drug to relieve their symptoms.
At this point, the person has developed a substance use disorder (SUD). Also called drug or alcohol addiction, SUD affects about 46.4 percent of people with a PTSD diagnosis.
Substance Abuse Can Worsen Symptoms Of Post-Traumatic Stress Disorder
Both PTSD and alcohol or drug addiction involve triggers. A PTSD trigger is a person, place, feeling, or other stimulus associated with a traumatic experience, such as the place where it occurred. A trigger can make a person feel as though they’re reliving the traumatic incident, which causes severe anxiety and distress.
In alcohol or drug abuse, a trigger is a stimulus the person associates with drug use. Examples include a party where drugs are present, an old friend the person used to drink alcohol with, or stress (since some people use drugs or alcohol to deal with stress). Such triggers can cause intense cravings for drugs or alcohol.
Experiencing PTSD triggers along with substance abuse triggers can worsen the symptoms of both disorders. For example, when a person feels distressed due to a PTSD trigger, they may rely on drugs to cope.
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Since drug or alcohol abuse often causes people to withdraw from family and friends, the person may then self-isolate. Isolation can intensify distress, making the person more likely to continue using drugs. This creates a vicious cycle in which the symptoms of both disorders feed off each other.
PTSD symptoms are grouped into four categories: avoidance symptoms, intrusive memories, mood changes, and emotional changes. They may begin immediately after the traumatic event or take years to appear. They vary from person to person, and they often come and go.
- avoiding talking or thinking about the event
- avoiding activities, places, or people that trigger memories of the event
- flashbacks (episodes in which the person feels as though the event is happening again)
- frequent, upsetting memories of the event
- nightmares about the event
- emotional or physical distress in response to a trigger
- negative thoughts about oneself or others
- emotional numbness
- lack of interest in activities previously enjoyed
- memory problems
- trouble maintaining relationships
- trouble experiencing positive feelings
- irritability, which may lead to angry outbursts or aggressive behavior
- difficulty sleeping
- difficulty concentrating
- self-destructive behavior, such as driving too fast or binge drinking
- intense shame or guilt
- always feeling “on guard”
- being easily startled
Like PTSD symptoms, symptoms of drug or alcohol abuse can vary from person to person, but typicallly include:
- frequent, intense urges to use a drug
- needing higher doses of the drug over time to achieve the same effect
- avoiding professional and personal responsibilities
- withdrawing from family members and friends
- self-destructive behavior, such as driving while under the influence of the drug
- weight gain or loss
- red eyes
- lack of interest in activities previously enjoyed
- loss of motivation
- loss of energy
- loss of interest in maintaining personal hygiene
- withdrawal symptoms (such as anxiety, fatigue, sweating, or vomiting) when trying to quit the drug
Treatment Programs For PTSD And Addiction
If you or a loved one suffers from co-occurring PTSD and addiction, it’s important to find a treatment plan that targets both conditions. In particular, look for a dual diagnosis rehab program that provides trauma-informed care.
Dual Diagnosis Rehab Programs
Dual diagnosis rehab programs help patients recover from PTSD (and any other co-occurring mental health issues) while they detox from alcohol or drug use.
The programs often provide cognitive behavioral therapy (CBT), which is a type of psychotherapy that teaches patients to challenge negative thoughts and feelings about themselves and their experiences. For instance, therapists can help patients challenge feelings of guilt or shame surrounding the event.
Therapists can also help patients develop relapse prevention and coping skills, such as meditation, exercise, and journaling.
These practices can reduce symptoms of PTSD such as anxiety, agitation, and flashbacks. With decreased symptoms, a person is less likely to turn to drugs or alcohol as a coping mechanism.
In addition, patients can take advantage of psychiatry services. When prescribed and monitored by a psychiatrist, antidepressants and anti-anxiety medications can further reduce PTSD symptoms and make recovery easier.
The treatment programs are available on an inpatient or outpatient basis, depending on the patient’s needs.
Inpatient treatment programs offer 24/7 monitoring and care, which is recommended for people whose diagnoses make it difficult to function in daily life. Outpatient programs allow people with more mild diagnoses to regularly attend the treatment center while still living at home.
When people with PTSD and addiction experience triggers or additional trauma, they’re more likely to relapse. That’s why more and more rehab programs are taking a trauma-informed care approach.
This treatment approach aims to prevent situations that could trigger a person’s PTSD symptoms or cause further trauma.
It’s guided by six principles:
- safety: Staff members respect patient privacy and create an environment where all patients feel physically and emotionally safe.
- trustworthiness and transparency: Patients and their families receive clear, honest explanations of the drug rehab program and its operations.
- peer support: During addiction treatment, patients receive support from fellow trauma survivors so they can feel less alone and more hopeful.
- collaboration and mutuality: Each patient plays a role in designing their own treatment plans.
- empowerment, voice, and choice: Staff members work hard to ensure all patients feel validated and empowered to use their voices and make decisions regarding their treatment options.
- cultural, historical, and gender issues: The program does not tolerate discrimination based on qualities such as race, ethnicity, sexual orientation, gender identity, or religion. It also strives to meet each patient’s racial, ethnic, and cultural needs.
When a rehab center puts each of these principles in place, patients with PTSD and addiction have a much higher chance of recovering from both disorders.
Find Help For A Dual Diagnosis Today
Recovering from PTSD and addiction isn’t easy. However, no one has to do it alone. Dual diagnosis rehab programs combine addiction treatment with the treatment of PTSD to reduce the risk of relapse and help patients break free of both conditions.
Through individual and group therapy, you or your loved one will learn essential skills for managing symptoms of both disorders, identifying triggers, and preventing relapse.
To explore treatment centers near you that specialize in dual diagnosis and trauma-informed care, contact the AddictionResource.net helpline today.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Mayo Clinic— Drug Addiction (Substance Use Disorder)—Symptoms and Causes
- Mayo Clinic—Post-Traumatic Stress Disorder (PTSD)—Symptoms and Causes
- National Center for Biotechnology Information—Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment
- National Center for Biotechnology Information: National Institutes of Health—The role of uncontrollable trauma in the development of PTSD and alcohol addiction
- Substance Abuse and Mental Health Services Administration— SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach