Substance Abuse And PTSD

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The relationship between traumatic stress and substance abuse is complex. About half of all individuals who seek substance use disorder treatment meet the criteria for a current post-traumatic stress disorder (PTSD) diagnosis. Many individuals who suffer from PTSD will turn to substance abuse as a way to self-medicate or numb themselves to unpleasant feelings. Some people have reported that abusing substance also gives them a sense of control.

Self-medication with alcohol or drugs can eventually lead to dependence and a co-occurring mental health or substance use disorder. Treating both substance abuse and PTSD often requires formal addiction treatment which can address both conditions adequately.

The Link Between Substance Abuse, Stress And Addiction

Trauma can negatively impact the brain in many different ways. When faced with a stressful situation, the brain reacts with a “fight-or-flight” response and releases cortisol and norepinephrine (stress hormones) which increase alertness and help individuals take action against the perceived threat.

After a stressful situation, the brain stops sending the stress response and everything returns to normal. However, in cases of traumatic stress, individuals can remain in a state of hyperarousal. This continued stress response then develops into PTSD symptoms.

PTSD and Substance Abuse Fight or Flight

Due to the profound distress this constant hyperactive stress response causes, many people turn to drugs or alcohol to cope. Individuals with PTSD may choose to abuse substances for many reasons, including to help them get to sleep, avoid traumatic memories, forget about their current situation, deal with mood swings commonly associated with PTSD and numb themselves to intense emotions.

While abusing substances may make individuals feel better in the short-term, substance abuse is more likely to exacerbate PTSD symptoms and decrease someone’s overall quality of life. Proper treatment for post-traumatic stress disorder can help individuals recover in a healthy and meaningful way.

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What Is PTSD And Who Is Affected By It?

PTSD is one of the most emotionally debilitating mental disorders which can cause intense anxiety, intrusive memories and nightmare-like flashbacks that can interfere with daily life. This mental health disorder is caused by exposure to disturbing or distressing events or trauma.

Individuals do not need to experience a traumatic event first-hand to develop PTSD. People may witness an event, learn of trauma after it occurs to a close friend or family member or observe an unpleasant element of an event, such as blood or intimate details of abuse, and then develop symptoms of PTSD.

Events that may lead to the development of post-traumatic stress disorder (PTSD) include:

  • combat exposure
  • childhood abuse (physical or emotional)
  • sexual violence
  • physical assault
  • being threatened with a weapon
  • accidents (car or plane crashes, etc.)

This is not a complete list, as many traumatic events could potentially result in PTSD.

PTSD and Substance Abuse 5.2 Million Americans Affected

Many different types of people are affected by PTSD. An estimated 5.2 million American adults experience PTSD in the course of any given year, and individuals of all ages can experience post-traumatic stress disorder. However, some factors may increase the likelihood of someone developing this mental disorder after suffering a traumatic event.

Possible risk factors for developing post-traumatic stress disorder (PTSD) can include:

  • having problems with substance abuse, such as excessive drinking
  • experiencing intense or long-lasting trauma
  • having traumatic experiences early in life, such as childhood abuse
  • working a job that increases the risk of being exposed to traumatic events
  • having other mental health issues, such as anxiety or depression disorders
  • lacking a support system of family and friends
  • having blood relations with mental health issues

Signs And Symptoms Of Post-Traumatic Stress Disorder

Both PTSD and substance abuse have a wide array of symptoms which can manifest in different ways. Because each individual has their own unique experiences, each disorder may affect them differently.

Some people who suffer from PTSD may struggle with the fear of re-experiencing the trauma they were exposed to, while others may struggle more with depressive moods, negative self-talk or maintaining social relationships.

PTSD and Substance Abuse Common Struggles

Typically, PTSD is classified by symptoms that interfere with everyday life which persist for a month or more.

There are four general classifications for these symptoms, including:

  1. Avoidance: Purposely staying away from places, people and things that trigger memories of the traumatic event.
  2. Re-experiencing: Randomly experiencing flashbacks, frightening thoughts or nightmares related to the traumatic event.
  3. Arousal and reactivity: Trouble sleeping, constantly feeling tense or on edge, displaying random outbursts of anger or sadness or being easily startled.
  4. Cognition and mood symptoms: Distorted feelings of guilt, negative self-image, memory issues and loss of interest in activities that were previously enjoyable.

PTSD symptoms may vary in intensity. Typically, when stress levels are at their highest, PTSD symptoms are at their worst.

Signs And Symptoms Of Substance Abuse

Substance abuse is often defined as the inappropriate use, or misuse, of illegal or legal substances. This can include repeated use of drugs to alleviate stress and/or alter or avoid reality. Addiction occurs when a person can no longer control the impulse to use substances, even when negative consequences occur.

Signs and symptoms of substance abuse can include:

  • using more of the substance for a longer period than intended
  • having difficulty cutting down or stopping use of a substance
  • experiencing strong and intense cravings to use a substance
  • using a substance to the point where it causes issues at home, work or school
  • continuing to misuse a substance despite the interpersonal difficulties it may be creating
  • habitually using the substance in dangerous situations, such as operating machinery
  • needing more of a substance to feel the desired effects or feeling less of a “high” when using the same amount
  • experiencing withdrawal symptoms when ceasing use of a substance

If someone with PTSD is abusing drugs or alcohol to cope with the symptoms of this disorder, they run the risk of developing an addiction. Over time, substance abuse can gradually morph into addiction, and individuals experience behavioral changes in correlation to changes in their brain function.

The inhibition and reward centers of the brain become physically and chemically altered by chronic and extended substance abuse. These changes can make it very difficult, if not impossible, for someone to cease using substances on their own.

Treatment For Substance Abuse And Post-Traumatic Stress Disorder

Individuals struggling with post-traumatic stress disorder and substance abuse or addiction should seek a rehab center that specializes in dual diagnosis or co-occurring disorder treatment. Formal addiction treatment programs can help individuals develop personalized treatment plans that work to address both PTSD and substance abuse at once.

Some treatment facilities may be more experienced in treating those with PTSD than others, so it can be beneficial to ask about the staff’s experience before enrolling in a specific program.

Behavioral therapies are usually the most effective way to address PTSD. Common therapies used include dialectical-behavioral therapy (DBT) and prolonged exposure therapy. In combination with medications, such as antidepressants, behavioral and talk therapies can be very effective.


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