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Post-Traumatic Stress Disorder (PTSD) and Substance Abuse

PTSD and substance abuse seem to be related, but why are some groups such as Veterans more likely to develop these disorders?

When an individual experiences a situation experienced as traumatic, it is possible for the brain to have a disproportionate response in reaction. Issues tend to arise when the body’s stress responses persist after the danger has passed, and it is no longer necessary to protect that person from harm. This can result in Post-Traumatic Stress Disorder, or PTSD.

The media is filled with studies and reports about PTSD, especially in the case of veterans returning from military service. However, trying to understand and treat PTSD is no simple task.

The anxiety and stress that are such a large part of PTSD often drives people to abuse drugs or alcohol as a way to numb their pain and/or gain some measure of control in their lives. PTSD and substance abuse can so often go hand-in-hand, and it is crucial to create a comprehensive treatment plan for these dual diagnosis clients. Treating both disorders simultaneously has yielded the best results.

PTSD and substance abuse

What is PTSD?

PTSD is an anxiety disorder which occurs in response to a negative event or trauma. Anyone at any age can develop PTSD as a result of physical or psychological trauma. Most commonly, PTSD affects people who have witnessed violence, engaged in warfare, survived domestic violence, or have been the victim of a sexual and/or violent crime. Additionally, some groups may have a higher likelihood of developing PTSD, such as rape survivors or veterans of war.

According to the United States National Library of Medicine, around 3% of adults in the United States are battling PTSD today, and up to 8.8% of the population may deal with PTSD at some point in their lives. Fortunately, there are treatments and therapies that can be effective in reducing tol he symptoms of PTSD.

Every person reacts differently to high-stress or traumatic situations, and most of them will not develop a mental disorder afterwards. Nevertheless, anyone dealing with a major traumatic event should receive therapy and be monitored for any possible emerging PTSD symptoms.

Signs and Symptoms of Post-Traumatic Stress Disorder

For a PTSD diagnosis, the symptoms must interfere with one’s daily life and persist for at least a month. Because each individual case is unique, everyone will experience PTSD in slightly different ways — but there are a number of common symptoms, including:

  • Feelings of numbness or detachment
  • Inability to sleep
  • A decrease in memory
  • Difficulty concentrating
  • Generalized anxiety
  • Feeling on edge or easily startled
  • Having nightmares, flashbacks, or feelings of reliving the event

Because of the link between PTSD and substance abuse, any changes in drug or alcohol use should be carefully monitored. If a person begins displaying signs of substance abuse in the wake of a significant trauma, that may be one more indicator of possible PTSD.

According to the US Department of Veterans Affairs, a link between substance abuse and PTSD has been observed. In fact, almost one-third of Veterans seeking treatment for a substance use disorder also suffered from PTSD.  They also report that 1 in 10 soldiers returning from serving in Iraq and Afghanistan have a substance abuse disorder revolving around drugs or alcohol.

Continued research into why groups such as veterans are at a higher risk of developing PTSD will hopefully lead to more effective rehabilitation treatments, as well as effective preventative measures.

How is PTSD Related to Substance Abuse?

Those who struggle with PTSD are particularly vulnerable to using drugs and alcohol as a means of self-medicating their disorder. However, the anxiety associated with PTSD is lifted only temporarily by substance abuse. Drugs can increase pleasure, decrease anxiety, and provide a distraction from emotions difficult to confront, but these effects are only fleeting.

Drugs also increase the brain’s levels of dopamine, one of the most important chemical messengers for indicating pleasure and telling a person to feel happy. By throwing the brain’s chemistry off balance, these substances create a “high” by overloading the normal functions of the chemical systems that control brain activity.  

Unfortunately, coming down from this high can be miserable, which often encourages a person to use again and alleviate their withdrawal symptoms. When confronted once again with the constant stress and anxiety of PTSD, getting high to forget one’s problems again seems like an easy, if only temporary, solution.

Through this consistent drug use, a person avoids dealing with the core issues of their disorder, and is prevented from making progress towards true recovery and stability. Substance use can actually exacerbate PTSD by amplifying the negative effects and symptoms while interfering with the brain’s ability to properly handle emotions and stress responses.

What is Dual Diagnosis

This term is used to describe the coexistence of a drug and/or alcohol addiction and a psychiatric disorder. For these people, addiction and mental health disorders tend to feed into one another creating a vicious cycle of abuse.

For example: a person who has a mental health disorder such as depression or bipolar, and who also struggles with a substance abuse disorder is considered to be dually diagnosed. Because of the way these illnesses become entangled, the only option for effective recovery involves therapy for both disorders simultaneously.

Treatment of Post-Traumatic Stress Disorder & Substance Abuse

Many PTSD and substance abuse disorder treatment programs differ in clinical approach, but often improve an individual’s well-being either way.


When a person’s drug dependence is significant, the first step in a detailed treatment plan will typically be detoxification. This is the process where the body is purged of substances. One must be aware of how the withdrawal symptoms that occur during this period can be difficult to endure. It is also impossible to make meaningful progress toward treatment before the body is clean of addictive substances.

Detox should always be monitored by a medical professional in a controlled setting. This is the safest way to begin addiction treatment, and also allows for the client to have their withdrawal symptoms alleviated by medicine and/or other therapies.

Cognitive Behavioral Therapy (CBT)

PTSD and substance abuseThis model of psychiatric therapy has become the standard of care for the vast majority of modern addiction treatment strategies. Simply put, CBT involves changing an individual’s behavior by working to change thought patterns and negative cognitions, while also addressing emotions/feelings. CBT is widely adaptable for addressing a range of disorders, and can come in a variety of forms when applied to substance abuse and dual diagnosis treatment.

Individual Therapy

Individual therapy is one of the most common options available to clients in need of psychiatric  care. This component of treatment often begins with a longer intake session, followed by regular one-on-one meetings with a therapist. The client works with their therapist on changing unhealthy patterns in their thought processes, feelings (emotions) and actions/behaviors.

Group Therapy

Also effective for many clients is group therapy, where people share their stories of addiction and recovery with a group, and find strength in the mutual support. These meetings are typically moderated by a clinician, and may work towards a number of different kinds of goals, depending on the needs of the group members present.

Other Forms of Therapy

More specialized therapy programs are also available, depending upon a person’s specific situation. Marriage or couple’s counseling and family therapy are terrific options to strengthen the bonds with loved ones and solidify a support system. Involving friends and family in the recovery process educates them more about the realities of a substance use disorder, and how to best support their loved one in recovery.

12-Step Programs

12-step programs are another tried and true structure that have benefitted a large number of individuals struggling with substance use disorders. It is possible to work a 12-step style process into a more controlled therapy setting as well.

Medication Therapy

There is no medicine that can stop addition in its tracks, but there are a number of medications that can help a person refrain from using substances.  Because of the interconnectedness of dual diagnosis clients, psychotherapeutic meds such as mood stabilizers or anti-anxiety medications may be utilized to address mental health concerns.

Comprehensive Treatment

Treating two disorders concurrently is complex, and Futures of Palm Beach is equipped to offer different options to meet the needs of clients with co-occurring disorders , such as PTSD and substance abuse. Learn more about our PTSD treatment by contacting us today to understand more about the intake and treatment process at Futures.

At Futures, working with clients to find a treatment plan that is comfortable and effective for them is the first step. Every client has his/her own unique needs, and everyone must take their own journeys through treatment and recovery. Contact us to talk about starting the next phase of your life, today.