PTSD and Substance Use Disorder

It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally.  Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger, which can make them seek escape from these symptoms through substances. Therefore, people who have PTSD and substance use disorder need to have both disorders treated at the same time for the best results.

What Is Post Traumatic Stress Disorder?

PTSD is a mental health disorder that develops after exposure to a traumatic event. The traumatic event may be experienced directly, witnessed, or happen to someone close to you. Some examples of traumatic events are:

  • Serious accidents
  • Military combat
  • Natural disasters
  • Personal assaults
  • Abuse
A man and a woman talking to a therapist about PTSD and substance use disorder
PTSD is a common mental health issue.

Although anyone can technically develop PTSD through traumatic scenarios, some people are more at risk. Those with repeated trauma, a history of mental illness, childhood abuse victims, and those who experience further stress after the traumatic event are more at risk of developing PTSD. Additionally, more women develop PTSD in response to trauma than men. In general, between 3% and 4% of adults in the US have PTSD. The rate becomes higher when you look at groups like military veterans as well as first responders and law enforcement.

PTSD Symptoms and Diagnosis

After a traumatic event, a number of symptoms must surface for the person to meet the criteria for a diagnosis of PTSD. There are four different types of PTSD symptoms:

  • Intrusion symptoms. At least 1 intrusion symptom must be present.
  • Avoidance symptoms. At least 1 avoidance symptom must be present.
  • Cognitions and mood symptoms. At least 2 negative changes in cognition and mood must be present.
  • Arousal and reactivity symptoms. At least 2 noticeable changes must be present.

The symptoms include:

  • Flashbacks or nightmares
  • Severe anxiety
  • Attitude and behavioral changes, such as being easily irritated and angered
  • Difficulty sleeping and concentrating
  • Feeling numb and avoiding people, places, or activities
  • Reliving the trauma, experiencing flashbacks, and having nightmares
  • Avoiding thinking or talking about the event
  • Avoiding places, activities, or people that remind you of the event
  • Negative thoughts about oneself or the world
  • Hopelessness about the future
  • Memory problems
  • Difficulty with relationships
  • Feeling emotionally numb
  • Being easily startled or frightened
  • Always being on guard
  • Self-destructive behavior
  • Difficulty concentrating or sleeping
  • Irritability or anger outbursts
  • Overwhelming guilt or shame
A stressed man sitting at a table
PTSD can manifest in various ways.

Some combination of the above symptoms must be present for at least 1 month for the person to meet the criteria for PTSD. Also, the symptoms must affect important areas of functioning, such as school, work, the ability to maintain relationships with others, or the ability to take care of oneself. Lastly, the symptoms must not be due to other factors, such as another medical condition or substance use.

The Link Between PTSD and Substance Use Disorder

Diving deeper into the connection between PTSD and substance use disorder, it’s important to understand the underlying mechanisms and reasons why individuals with PTSD may be more prone to developing substance use disorders. The relationship between these two conditions is complex and influenced by several factors.

Self-Medication Theory

PTSD and substance abuse often go hand in hand because some people with PTSD might turn to alcohol, drugs, or other substances as a way to cope with their feelings and symptoms. Think of it like this: someone with PTSD is dealing with a lot of difficult emotions and memories that can feel overwhelming. They might start using substances because, at first, these can seem to offer a temporary escape or a way to numb the pain. However, over time, this can turn into a substance abuse problem. The reason is that the relief substances provide is only short-lived. As the body gets used to these substances, it needs more to achieve the same effect, leading to a cycle of dependency.

Biological Factors

Research has also shown that there may be biological factors at play that link PTSD and substance abuse. Both conditions involve similar brain regions and neurotransmitter systems. People with PTSD, for instance, may have altered reward systems in their brains, which makes them more vulnerable to substance use disorders. Additionally, chronic exposure to stress can lead to changes in brain chemistry that predispose individuals to both PTSD and substance abuse.

Social and Environmental Factors

Environmental factors also play a crucial role in the connection between PTSD and substance abuse. Individuals with PTSD may find themselves in environments or social circles where substance use is more common, particularly if they are trying to avoid reminders of their trauma or seeking out others who have had similar experiences. This can create a social context in which substance use is normalized or even encouraged.

A young man talking to a therapist about PTSD and substance use disorder
The relationship between PTSD and substance abuse is complicated

The Cycle of Worsening Symptoms

Substance abuse can worsen PTSD symptoms over time. While substances may provide a temporary escape, their effects wear off, often leaving the individual feeling worse than before due to the physical and psychological consequences of substance use, including increased anxiety, depression, and physical withdrawal symptoms. This may lead to a vicious cycle where the person uses more drugs to deal with their worsening PTSD symptoms, which in turn makes their condition worse.

Statistics on PTSD and Substance Abuse

PTSD and substance abuse statistics show significant relationships between these conditions:

  • Around 33 percent of veterans seeking substance abuse treatment in WV and other est of the country have comorbid PTSD.
  • About 50 percent of people in inpatient substance abuse treatment also have PTSD.
  • Nearly 80 percent of women seeking substance abuse treatment have lifetime histories of sexual or physical assault.
  • People who abuse opiates and cocaine report higher rates of exposure to trauma than users of other substances.
  • People with PTSD are at least two times more likely than the general population to have an alcohol use disorder.
  • 75 percent of veterans with PTSD have a co-occurring substance use disorder.
  • Most people with PTSD—about 80%—have one or more additional mental health diagnoses. They are also at risk for functional impairments, reduced quality of life, and relationship problems.

Due to the strong link between PTSD and addiction, it is important to screen for and treat PTSD and substance use disorder together. 

How to Treat Co-Occurring PTSD and Substance Use Disorder

Years ago, the common procedure was that, in order to treat PTSD, one had to first treat the substance use problems. It was also suggested that to successfully treat a substance problem, one has to treat PTSD first. Unfortunately, these myths continue in some places. However, research has shown clearly that the best treatment addresses PTSD and SUD simultaneously.

At Harmony Ridge, we understand that patients undergoing dual diagnosis treatment in West Virginia require special care and attention. Having two disorders at the same time is not easy to handle, but you can put your faith in us. We offer a comprehensive approach to dual diagnosis treatment, and we know that there is no one right solution for everybody. Each program we design is tailored to our patients.

If you have co-occurring disorders, they must be treated simultaneously. An inpatient drug rehab in WV will be your best option since you’re suffering from two major health conditions. When you’re in an inpatient program, you’ll receive intense, round-the-clock care. When a dual diagnosis is treated as one, doctors will be better able to determine the causes of both your addiction and your mental illness.

Men in military uniforms talking in group therapy
Harmony Ridge can help you get the right personalized treatment.

While there is no single best treatment for co-occurring PTSD and substance use disorders, research has shown that successful dual-diagnosis treatment uses an integrated approach. Individuals with co-occurring SUD and PTSD suffer a more complicated course of treatment and less favorable treatment outcomes than individuals with either disorder alone.

Common therapeutic approaches include:

Besides residential treatment, people struggling with addiction and PTSD who don’t require the intensity of inpatient treatment have two more options:

  1. Partial Hospitalization Program
  2. Intensive Outpatient Program (IOP)

Pharmacotherapy can also be helpful in reducing PTSD symptoms and preventing people who are in treatment for PTSD and substance use disorder. In many cases, treatment will include a combination of therapy for addiction and medication in order to get the best results. 

What Is a Dual Diagnosis?

Many people diagnosed with substance use disorder (SUD) also suffer from a co-occurring mental health or behavioral disorder. This is known as a dual diagnosis. Individuals with a dual diagnosis require an integrated treatment plan that addresses both disorders as interconnected mental health issues. According to the National Survey on Drug Use and Health (NSDUH), 45 percent of people with addiction have a co-occurring mental health disorder.

Benefits of Dual Diagnosis Treatment

Dual diagnosis treatment, which addresses both mental health disorders and substance use disorders together, offers several significant benefits for individuals facing these challenges:

  • Holistic Approach: Dual diagnosis treatment provides holistic therapy for addiction that addresses the entire spectrum of an individual’s needs, including psychological, physical, social, and sometimes legal issues.
  • Reduced Relapse Rates: Integrated treatment can help lower the risk of relapse. When mental health issues are adequately managed, individuals are less likely to turn to substance use.
  • Support Networks: These programs often include building support networks that can offer encouragement and understanding from others who are facing similar struggles.
  • Better Physical Health: Substance abuse can take a toll on one’s physical health. Dual diagnosis treatment also focuses on physical health, leading to better overall health outcomes.
  • Education: Dual diagnosis treatment programs often include educational components that help individuals understand the nature of their conditions, the risks associated with substance use, and the importance of ongoing mental health care.
  • Coping Strategies: These treatments equip individuals with coping strategies to manage stress, avoid triggers, and deal with the challenges of life without resorting to substance use.
  • Resource Connection: Treatment programs can connect individuals with various resources, including psychiatric care, medical treatment, counseling, and group therapy for addiction.

Why Does SUD Hinder PTSD Treatment?

PTSD changes brain chemistry in much the same way substance abuse and addiction do. PTSD and substance use disorder (SUD) are a dangerous combination. Often, these disorders form at the same time and feed off one another. The same trauma that caused PTSD can also trigger a substance use disorder. Substance abuse hinders the treatment and recovery process for any mental health condition. Because recovering from PTSD necessitates reconnection with memories, thoughts, and feelings that they have suppressed or avoided, substance use can make the condition particularly difficult.

Two women hugging
Individuals need to receive treatment for PTSD and substance use disorder simultaneously.

Drugs can numb emotions and disrupt thinking and memory, making it difficult for people with PTSD to process trauma while actively using substances. Substance use can also worsen PTSD symptoms through the ways it disrupts sleep and can make prescription psychiatric medications less effective. One thing is certain: PTSD and substance use disorder should be treated together.

PTSD and Substance Use Disorder: Where to Go for Help?

When examining someone with a dual diagnosis, it isn’t always easy to tell whether the substance abuse or mental health disorder came first. However, with the right treatment and recovery plan, people with co-occurring disorders can live healthy, sober lives. They can also gain the confidence to face their mental illness head-on and use coping skills to manage it daily. Are you suffering from drug addiction and a mental health disorder? It’s not too late for you to seek help. Harmony Ridge Recovery Center can bring light to the dark path you’ve been on for so long. Don’t give up hope now!

For more information about the symptoms of PTSD and substance use disorder, contact Harmony Ridge Recovery Center today.

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