PTSD and addiction show up together all the time. According to the VA’s National Center for PTSD, more than 4 in 10 U.S. adults with PTSD also have problems with drug or alcohol use. The reason is usually painfully simple: drinking or using quiets the memories, the jumpiness and the sleepless nights, at least for a few hours.
Then it stops working, and now there are two problems. The upside is that both can be treated, and research shows treating them at the same time works.
What Is PTSD?
Post-traumatic stress disorder can develop after a frightening or life-threatening event: combat, assault, abuse, a car crash, a disaster, the sudden loss of someone you love. Most people have some symptoms right after a trauma. With PTSD, they don’t fade. MedlinePlus lists four groups of symptoms, lasting at least a month:
- Re-experiencing: flashbacks, nightmares, memories that crash in uninvited
- Avoidance: staying away from places, people or conversations that bring it back
- Arousal and reactivity: jumpiness, feeling on edge, angry outbursts, trouble sleeping
- Changes in thinking and mood: guilt, blame, numbness, losing interest in life
Symptoms often start soon after the event, but they can show up months or years later. Having been through earlier trauma, having little support afterward, and a history of substance use all raise the risk.
Why PTSD and Addiction Feed Each Other
Substances numb the symptoms
Picture a veteran who can’t sleep without the TV on and a six-pack. Or a woman who survived an assault and takes a pill before any situation that might remind her of it. Neither of them set out to become addicted. They found something that turned the volume down.
The VA reports that Veterans with PTSD were twice as likely to have alcohol problems, and about three times as likely to have drug problems, as Veterans without it.
Then the substances make PTSD worse
Alcohol and opioids slow down the nervous system. That feels like relief at first. Over time, heavy use wrecks sleep, deepens depression and anxiety, and makes the hangover or withdrawal feel a lot like the hypervigilance you were trying to escape. Avoiding the trauma with substances also keeps the brain from ever processing it.
Addiction raises the risk of new trauma
Heavy use puts people in dangerous situations: car accidents, violence, unsafe relationships, overdoses. Each new trauma piles onto the old one.
Signs Someone Is Using to Cope With Trauma
- Drinking or using mainly at night, to sleep or to stop nightmares
- Using before anything that might trigger a memory: a crowded store, an anniversary, a phone call with family
- Getting much more irritable or panicky when they can’t use
- Refusing to talk about what happened, and changing the subject with a drink in hand
- Swearing off the substance, then going back to it after a hard flashback
PTSD and Addiction Treatment
Treat both at the same time
For years, people were told to get sober first and deal with the trauma later. The VA’s National Center for PTSD says research now shows that treating PTSD and substance use at the same time works for both. Leave the trauma untreated, and the main reason for using is still sitting there on day one of sobriety.
Start with safety and detox if needed
Stopping alcohol or benzodiazepines suddenly after heavy use can cause seizures and other dangerous withdrawal symptoms. A supervised detox keeps you safe, and the team can watch for PTSD symptoms that often spike as the substance leaves.
Trauma-focused therapy
Once you’re stable, therapy aims at the trauma itself, carefully and at a pace you can handle. Approaches like cognitive processing therapy and prolonged exposure help people make sense of what happened and gradually stop avoiding it. Medication can help with depression, anxiety, nightmares and sleep. Group therapy lets you sit with people who actually get it.
Relapse prevention built around triggers
A good plan names your trauma triggers alongside your drug or drinking triggers, because they’re often the same: certain dates, smells, places, people. Our page on trauma and substance abuse explains how we approach this.
Faith and Healing After Trauma
Trauma can shake faith hard. People ask where God was. Others find that faith is what held them together. Either way, a faith-based program gives room for those questions alongside clinical care. “He healeth the broken in heart, and bindeth up their wounds” (Psalm 147:3, KJV). Our post on healing from PTSD in faith-based rehab goes deeper into that side of recovery.
PTSD is also closely tied to anxiety. If you’re trying to sort out what you’re dealing with, our overview of types of anxiety disorders may help.
Christian-Based Treatment for PTSD and Addiction at Covenant Hills
Covenant Hills uses a Whole Person Approach that looks at psychological, emotional, physical, nutritional and spiritual needs. Through our co-occurring disorders program, clients get psychiatric treatment, medication management and individual psychotherapy alongside addiction treatment, in gender-specific residential programs. You can choose a faith-based or traditional track.
If trauma and substance use have gotten tangled together for you or someone you love, call 800-662-2873 for a free, confidential assessment.
Frequently Asked Questions
How common are PTSD and addiction together?
Very common. The VA’s National Center for PTSD reports that more than 4 in 10 U.S. adults with PTSD also have problems with drug or alcohol use.
Why do people with PTSD drink?
Usually to sleep, to block out memories, or to calm the constant on-edge feeling. Alcohol does that briefly, but over time it tends to make sleep, mood and anxiety worse.
Should PTSD and addiction be treated separately?
No. Research shows treating them at the same time works for both. Waiting to address trauma until after sobriety often leaves the main trigger for relapse untouched.
Can you get treatment for PTSD in rehab?
Yes, at programs that treat co-occurring disorders. Look for one with mental health professionals who can provide trauma-focused therapy and psychiatric care, not just addiction counseling.
