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Post-Traumatic Stress Disorder (PTSD) and Addiction: What You Should Know
Substance use disorders and post-traumatic stress disorder (PTSD) are both chronic, debilitating mental health conditions that frequently coincide. Approximately 30% of the US population will experience a substance use disorder during their lifetime, with 8% experiencing PTSD. In light of this, individuals with co-occurring issues typically require a holistic and comprehensive treatment plan to achieve better outcomes.[1]
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Table of Contents
Key Points
- Post-traumatic stress disorder (PTSD) is a mental health disorder triggered by the experience of traumatic events.
- Addiction and substance use disorders are frequently found together with trauma and PTSD.
- Official studies report that 27% of women and 51% of men with lifetime PTSD also had a diagnosable substance use disorder.
- When PTSD and addiction are both present, they create a unique set of challenges that necessitate specialized and individualized treatment.
What is PTSD?
PTSD is a mental health disorder typically triggered by a life-threatening event or one that causes intense fear, helplessness, or horror.[2] Examples of some traumatic events that could lead to PTSD include physical or sexual assault, accidents, emotional abuse, natural disasters, combat experiences, and more.Â
It’s important to note that not everyone who experiences trauma will develop PTSD, as the disorder results from a combination of factors, including the severity of the trauma, the individual who experiences it, and your available support systems.
PTSD manifests in a wide range of symptoms that can significantly disrupt your daily life. These symptoms are typically categorized into four clusters:[3]
- Intrusion Symptoms: Individuals with PTSD often experience intrusive thoughts, memories, or flashbacks of their traumatic event. The intrusions can be highly distressing and may lead to physical reactions (such as sweating or an increased heart rate).
- Avoidance Symptoms: To cope with the distressing nature of their memories, individuals with PTSD may avoid reminders of the traumatic event, including specific places, people, or activities, sometimes to great inconvenience.Â
- Negative Changes in Mood and Awareness: PTSD can cause continual negative changes in a person’s mood and thinking patterns, which can manifest as feelings of detachment, guilt, or continued negative beliefs about oneself or others.
It’s also important to recognize that the onset of PTSD symptoms can vary. Some people may experience symptoms shortly after the traumatic event, while others may not develop them until months or even years later. Additionally, complex PTSD refers to traumas that are typically enduring or prolonged in duration and can bring about further complications to the overall picture.Â
PTSD can have a profound impact on various aspects of an individual’s life. Many individuals with PTSD can also struggle with substance abuse as a way to cope with their symptoms, which are known as co-occurring or dual-diagnosis conditions.
What Are Substance Use Disorders?
A substance use disorder is a serious mental health condition characterized by the frequent usage of psychoactive substances, such as drugs or alcohol, despite their detrimental effects on your physical, mental, and social well-being.[4] These disorders are defined by a loss of control over ongoing substance use, increased tolerance or withdrawal symptoms, and a preoccupation with obtaining and using the drug(s) in question.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a substance use disorder can be diagnosed with the following criteria, with most addictions requiring at least two items being present:[5]
- Using a substance in escalating amounts or for a longer period of time than was intended.Â
- A persistent effort to cut down on using the substance is present, and/or unsuccessful efforts to stop.Â
- A significant amount of time is spent obtaining, using, or recovering from the substance’s effects.Â
- Cravings to use the substance in question.Â
- Substance use impairs your ability to fulfill major obligations at work, at school, or at home.
- Continuing to use the substance despite it causing significant social and/or relational issues.Â
- Substance use causes you to cut back on or stop important social or recreational activities.Â
- Using the substance when it is dangerous to do so.
- Ongoing substance use despite an awareness that it may cause or worsen other physical or psychological issues.Â
- Tolerance, as defined by either: Â
- Requiring larger or more frequent doses of the substance to achieve the desired effects;
- Withdrawal symptoms are present when the substance use is stopped (Note: no documented withdrawal symptoms need to be present for hallucinogens, PCP, or inhalants).
What Is The Correlation Between PTSD And Substance Use?
PTSD and issues with substance use and addiction are known to frequently co-occur with one another.[6] Understanding this connection is vital for individuals battling these conditions in order to guide them toward the appropriate treatments and support.
Self-Medication
Many individuals with PTSD turn to drugs or alcohol as a means to cope with the overwhelming emotional pain and distress caused by their traumatic experiences. The substance provides a temporary escape from the haunting memories, flashbacks, nightmares, and anxiety that accompany trauma, but substance abuse and PTSD can often lead to compounding struggles on the whole.
The Escalation of Trauma
Substance abuse can also lead to a dangerous escalation of trauma. Those with PTSD may engage in risky behaviors while under the influence, putting themselves in situations that retrigger their traumatic memories or expose them to new traumas. This can create an ongoing cycle in which trauma leads to substance use, which in turn leads to more trauma.
Impaired Decision-Making
PTSD can impair an individual’s decision-making abilities and judgment, making them more susceptible to substance misuse. They may prioritize short-term relief over long-term health and well-being, believing that substances are their only means of survival in the face of their ongoing emotional pain.
Substance-Induced Disorders
Conversely, substance abuse can induce symptoms similar to PTSD, blurring the lines between the two conditions. Substance-induced disorders can sometimes manifest as hallucinations, delusions, or severe mood disturbances, which can complicate the diagnostic process. Furthermore, complex PTSD and addiction can also be frequently experienced together, as many individuals who have experienced prolonged exposure to trauma(s) may attempt to ameliorate their symptoms with drugs or alcohol.Â
Recognizing the correlation between PTSD, complex PTSD, and substance use is the first step to take toward effective treatment. Integrated treatment approaches, which combine therapies for PTSD with strategies for addiction management, offer you the best chances of healing.
PTSD, Addiction, and Substance Use Disorder Statistics
Per the US Department of Veterans Affairs, 27.9% of women and 51.9% of men with lifetime PTSD also had a diagnosable substance use disorder.[7] Women with PTSD were over two times more likely to meet the criteria for alcohol abuse and over four times more likely to meet the criteria for drug abuse than women without PTSD.
Up to 59% of adolescents with PTSD subsequently develop addiction and substance abuse issues.[8]
Treatment for PTSD and Addiction
When PTSD and drug addiction co-occur, they create a unique set of challenges that necessitate specialized and individualized treatment. Addressing both conditions simultaneously is essential for a successful recovery journey. An integrated treatment approach, often referred to as dual diagnosis or co-occurring disorder treatment, recognizes that PTSD and addiction are interconnected and require a comprehensive plan.
Psychotherapy
Psychotherapy, also known as talk therapy or counseling, plays a central role in treating co-occurring PTSD and addiction. Several therapeutic modalities have proven effective:
- Cognitive Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors. It is particularly useful in addressing the underlying causes of addiction and providing strategies to better manage PTSD symptoms.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a specialized therapy designed to process traumatic memories and reduce their impact. It has been studied to be particularly effective for individuals with PTSD.[9]
Holistic Approaches
Holistic, whole-person approaches can be especially beneficial in managing the stress and emotional turmoil that often accompany PTSD and addiction:
- Mindfulness and Meditation: These practices help individuals stay grounded in the present moment, helping to reduce anxiety and reactivity.
- Exercise: Physical activity can boost mood, reduce stress, and improve overall mental health.
- Nutrition and Sleep: A balanced, nutritious diet and sufficient sleep are two critical components of physical and emotional health.
Support Groups
Support groups provide individuals with a sense of community and understanding. Group therapy sessions allow participants to share their unique experiences, learn from others, and build a support network.
Inpatient or Residential Treatment
In some cases, where individuals require intensive support and structure, inpatient or residential treatment programs may be recommended. These programs offer a controlled environment that minimizes external triggers and provides 24/7 care and therapy for recovery.
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At Absolute Awakenings, we take information integrity seriously. We have dedicated our resources to ensure that all content published to our blog is medically sound. As such, all content on our blog has been thoroughly reviewed by a doctorate level clinician such as a Medical Doctor, or Psy.D, so that you can trust all of the data we publish.
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Frequently Asked Questions About PTSD, Addiction, and Dual Diagnosis Treatment
Can substance use cause PTSD or worsen its symptoms?
Substance use itself doesn’t necessarily cause PTSD, but it can exacerbate the symptoms of existing PTSD. Substance abuse may also lead to engaging in risky behaviors or exposure to new traumas, making PTSD symptoms more severe and complex or developing PTSD as a result.
Is it possible to treat both PTSD and addiction simultaneously?
Yes, integrated treatment plans that address both PTSD and addiction together tend to yield better outcomes. Treating one without the other can lead to poorer results compared to comprehensive dual diagnosis treatment.[10]
Are all types of substances equally linked to PTSD?
While substance use can be associated with various types of traumatic experiences, not all substances are equally linked to PTSD. Some individuals may turn to specific substances, like opioids or alcohol, more frequently as a way to cope with their PTSD symptoms. PTSD and alcohol abuse (along with complex PTSD and alcohol abuse) are commonly seen together, as alcohol is widely available in most parts of the country.
Can medications help with co-occurring PTSD and addiction?
Medications can play a role in managing symptoms of both PTSD and addiction, but they are typically used in conjunction with therapy and a comprehensive treatment plan. Medications may help alleviate anxiety, depression, cravings, or withdrawal symptoms.
Is recovery possible for individuals with co-occurring PTSD and addiction?
Yes, recovery is possible, but it requires dedication, time, and professional support. Many individuals have successfully managed and overcome the challenges of co-occurring PTSD and addiction and have gone on to lead fulfilling lives.
Sources
[1] Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent Treatment of Substance Use and PTSD. Current Psychiatry Reports, 18(8). https://doi.org/10.1007/s11920-016-0709-y on September 1st, 2023
[2] Post-Traumatic Stress Disorder (PTSD). (2023, February 8). Www.samhsa.gov. https://www.samhsa.gov/mental-health/post-traumatic-stress-disorder on September 1st, 2023
[3] post-traumatic stress disorder – psychiatry.org. (n.d.). https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-PTSD.pdf on September 1st, 2023
[4] NIMH. (2021). Substance use and co-occurring mental disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health on September 1st, 2023
[5] McNeely, J., & Adam, A. (2020, October 1). Table 3, DSM-5 Diagnostic Criteria for Diagnosing and Classifying Substance Use Disorders [abc]. Www.ncbi.nlm.nih.gov. https://www.ncbi.nlm.nih.gov/books/NBK565474/table/nycgsubuse.tab9/ on September 1st, 2023
[6] NIMH. (2021). Substance use and co-occurring mental disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health on September 1st, 2023
[7] Treatment of Co-Occurring PTSD and Substance Use Disorder in VA – PTSD: National Center for PTSD. (2014). Va.gov. https://www.ptsd.va.gov/professional/treat/cooccurring/tx_sud_va.asp on September 1st, 2023
[8] Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and post-traumatic Stress Disorder in an urban civilian population. Depression and Anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751 on September 1st, 2023
[9] VA.gov | Veterans Affairs. (2014). Va.gov. https://www.ptsd.va.gov/understand_tx/emdr.asp on September 1st, 2023
[10] Berenz, E. C., & Coffey, S. F. (2012). Treatment of Co-occurring post-traumatic Stress Disorder and Substance Use Disorders. Current Psychiatry Reports, 14(5), 469–477. https://doi.org/10.1007/s11920-012-0300-0 on September 1st, 2023
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