PTSD & Substance Abuse
PTSD tends to be more common in women. In fact, 10% of American women will
be diagnosed with PTSD in their lifetimes. Approximately 4% of American
men will receive a diagnosis of PTSD during their lives.
PTSD often occurs in conjunction with other conditions. In fact, between
50% to 66% of individuals with PTSD also have substance use disorders
involving drugs or alcohol. Having PTSD can more than double the risk
of developing a substance use disorder, such as alcoholism or drug addiction.
Even with treatment, patients with substance use disorders have a relapse
rate of up to 60%. In addition, patients with PTSD have a higher risk
eating disorders, suicidal thoughts or actions,
This guide will help you understand the causes, symptoms, and complications
associated with PTSD. It will provide information on diagnosis and treatment
options, including dual-diagnosis and treatment for patients who have
PTSD and addiction. If you would like to learn more, or if you are interested
in speaking directly to a member of our professional addiction treatment
team, please contact Grace Land Recovery today. We answer our phones 24/7.
What Causes PTSD?
PTSD may develop after the patient learns about, witnesses, or directly
experiences a traumatic event, such as assault, sexual assault, rape,
bodily injury, or death. The exact cause of PTSD is unknown, but clinicians
believe that it may arise in certain individuals due to a combination
of inherited mental health risk factors and personality traits (temperament).
The amount and severity of witnessed or experienced trauma and the regulation
of stress-related chemicals and hormones in the brain may also play a role.
Individuals who experience trauma at a young age are more likely to develop
PTSD. Military personnel and emergency responders are also at an increased
risk of developing PTSD.
Anxiety, depression, and substance use disorders all increase the likelihood
of developing PTSD, as well. Patients who have a family history of mental
health conditions and/or a lack of support system at home have an elevated
risk of PTSD.
What Type of Trauma Can Lead to PTSD?
The most common types of traumas that are associated with the development
of PTSD include:
- Accidents, such as car accidents
- Sexual violence
- Childhood physical abuse
- Physical assault
- Exposure to combat
- Being threatened with a weapon
However, it is possible to develop PTSD after many different types of traumas.
Examples of other traumatic events that could potentially result in PTSD include:
- Natural disasters
- Plane crashes
- Terrorist attacks
Categories of PTSD Symptoms
Currently, doctors group PTSD symptoms into four major categories. Symptoms
in each category tend to begin around one month after the traumatic event,
but some individuals with PTSD may not show symptoms until several years
The four categories of PTSD symptoms include:
Intrusive Memories Category: In the “intrusive memories” category of PTSD symptoms, patients
may experience nightmares about a past traumatic event. Individuals with
this category of PTSD symptoms may also experience flashbacks that feel
as though they are reliving their past trauma. When exposed to something
that reminds individuals of intrusive memories, individuals with PTSD
may display severe emotional distress or severe physical reactions. Intrusive
memories could also take the form of unwanted, recurrent memories of the event.
Avoidance: The next category of symptoms, avoidance, causes individuals with PTSD
to avoid people, places, and activities that remind them of the type of
trauma that they experienced. Individuals who experience these symptoms
might try to avoid thinking of past traumatic events. They may also go
to great lengths to avoid talking about past trauma.
Negative Thinking and Mood: Potential negative thinking and mood PTSD symptoms include negative thoughts
about oneself and others, difficulty remembering details of past traumatic
events, and a feeling of hopelessness about the future. Patients that
experience negative thinking and mood may also feel emotionally numb and
detached from family and friends.It might be difficult for individuals
with these PTSD symptoms to maintain close relationships. Individuals
who experience negative thinking and mood PTSD symptoms also struggle
to maintain interest in activities they once enjoyed.
Alterations in a Person’s Physical and Emotional Reactions: The last of the four major categories involves alterations in the patient’s
physical and emotional reactions. For example, individuals with PTSD who
experience changes in the way they physically respond to situations may
struggle sleeping and concentrating.Emotionally, such individuals might
be easily frightened or display irritability, aggression, or feelings
of anger. Feelings of overwhelming guilt or shame may be present, and
patients could engage in self-destructive behavior. This includes excessive
alcohol consumption, substance use, or reckless driving.
What Symptoms Occur in Individuals with PTSD & Addiction?
Individuals who struggle with PTSD and addiction may display additional
symptoms associated with substance use issues. For example, some people
with PTSD and addiction experience intense cravings for substances. Often,
these cravings are so intense that they block out all other thoughts.
Individuals with PTSD and addiction will also spend more money than they
can afford to maintain a steady supply of substances. These individuals
may even engage in risky activities to obtain more substances. Such individuals
will often have conflicts at work and in relationships.
Withdrawal symptoms will occur in individuals with PTSD and addiction if
they try to minimize or discontinue their use of substances. Withdrawal
occurs whenever a person who is dependent on a substance stops using or
decreases their use of the substance.
How Are PTSD & Substance Use Conditions Diagnosed?
To diagnose PTSD, patients may need to have a medical exam to rule out
all other physical health issues that could be causing similar symptoms.
Psychological evaluations are necessary to diagnose both PTSD and substance
use disorders. These evaluations are completed by a psychiatrist, a psychologist,
or a licensed alcohol and drug counselor.
First, clinicians will perform blood and urine tests to monitor a patient’s
Dual-Diagnosis Treatment for Individuals with PTSD & Addiction
Dual diagnosis treats both PTSD and substance addictions. Until the 1990s,
clinicians treated PTSD and addiction separately. Patients were sometimes
required to successfully recover from their substance use disorder before
they could be offered treatment for PTSD. This approach resulted in delayed
care, and the treatment was often less effective.
Dual-diagnosis treatment approaches the treatment of PTSD and addiction
simultaneously. At dual-diagnosis treatment centers, the patient receives
holistic evaluation and treatment. Other substance use specialists can
then identify any overlooked issues and contributing factors.
For example, substance use specialists and therapists at dual-diagnosis
treatment programs are often able to identify instability in the patients’
living situations. This includes anxiety, depression, chronic pain, underlying
health issues, and other concerns that may be contributing to the patient’s
conditions. Dual-diagnosis treatment provides integrated care to individuals
with PTSD and addiction so that they can successfully recover from their
Types of PTSD & Addiction Treatments
In general, treatment for PTSD and addiction involves a combination of
medication and counseling. Treatment for severe co-occurring disorders,
such as PTSD and addiction, usually occurs at residential treatment centers.
Dual-diagnosis treatment patients who experience withdrawal symptoms associated
with substance use cam receive medications to ease anxiety, nausea, and
other symptoms that occur during the
detox process. The exact medications the patient receives will vary depending on the
substance they are using.
While undergoing withdrawal, patients are closely monitored by medical
staff. Anti-addiction medicines can also be administered to help prevent
patients from returning to substance use. Anti-anxiety medicines and antidepressants
may also be used to help treat PTSD at this time.
Several different types of
therapy are used to treat substance use disorders and co-occurring PTSD. Typically,
individuals in treatment for PTSD and addiction receive intensive
individual therapy and regular
group therapy sessions with other patients. Couples therapy and
family therapy help to build or rebuild relationships. In addition, some patients might
opt to participate in a 12-step program to enhance their support system.
What Therapies Are Used to Treat Different Types of Traumas?
Cognitive-behavioral therapy (CBT) is a major psychotherapy method that can be beneficial for PTSD and addiction.
This type of therapy helps patients learn healthy coping mechanisms. CBT
patients also learn to identify limiting beliefs and thought distortions
so that they can replace them with positive thoughts that are more optimistic
For the treatment of PTSD, patients may experience exposure therapy. This
type of therapy gradually exposes patients to images and sensations associated
with the types of traumas they witnessed. The therapy takes place in a
safe, medically supervised environment so that patients are able to learn
to confront their triggers. Exposure therapy for some types of traumas
may use virtual reality to allow the patient to safely re-enter the environment
where the trauma took place. Exposure therapy is particularly helpful
for individuals who have experienced combat exposure, accidents, and other
types of traumas that cause nightmares and flashbacks.
Therapists may use
eye movement desensitization and reprocessing (EMDR) therapy when assisting patients who have experienced trauma that has been
particularly severe or prolonged. EMDR therapy uses guided eye movements
to help with processing traumatic events. The therapy helps the patient
change how he or she reacts to memories of the events.