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5 Signs Your Substance Use Disorder Is Linked To PTSD – PTSD Awareness Month

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

May 29, 2019

June is Post-Traumatic Stress Disorder (PTSD) Awareness month. In honor of PTSD awareness efforts, readers can explore the link between trauma and substance abuse, and the most effective treatment options.

Everyone experiences some form of stress in their life, from worrying about work, school, relationships, or dealing with other life stressors. This is different from trauma.

There are many different forms of trauma. Trauma can refer to a single traumatic event or experience, or chronic exposure to abuse or neglect.

Some common forms of trauma include:

  • childhood abuse or neglect
  • sexual violence
  • surviving an accident (e.g. car-crash)
  • wartime combat
  • domestic abuse
  • witnessing a traumatic event
  • serious injury

The majority of people that survive a dangerous event or form of trauma do not go on to develop Post-Traumatic Stress Disorder (PTSD). People that do develop PTSD following an experience of trauma likely have other risk factors, such as little or no support, stress in other areas of their lives, or history of mental illness or substance abuse.

PTSD can affect a person’s behavior, mood, and impact their ability to function in daily life. To relieve severe symptoms, people may turn to substances like drugs and alcohol to cope.

The relationship between substance use disorders (SUDs) and PTSD is complex and differs for each person. People will often experience and react to symptoms in ways different than others. This may include abusing substances, or finding other ways to cope.

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There are several signs that may indicate whether or not your substance abuse is linked to PTSD:

1. Using Alcohol Or Drugs To Numb Intense Emotions

Symptoms of PTSD are grouped into three categories: avoidant, intrusive, and arousal. The avoidant symptoms are what researchers have often linked back to substance abuse. This can involve avoiding situations that remind or bring someone back to their traumatic experience.

Many people with PTSD struggle with intense waves of anger, depression, or panic – sometimes without knowing why. People may often have nightmares, angry outbursts, or struggle with frequent panic attacks. This can be difficult for a person to manage.

Central nervous system (CNS) depressants like alcohol and sedatives can dull these intense emotions and slow down a person’s thoughts. This offers a ‘numbing’ sensation, which can feel helpful in instances of severe panic or a flashback.

This can be addictive and over time become a salve for a person’s emotional pain.

2. Using Alcohol Or Drugs To Get High

Avoidance symptoms of PTSD also include different means of distraction. Many people with PTSD turn to drugs and alcohol to avoid certain sensations, memories, or other experiences that remind them of their trauma.

Getting high, or intoxicated through alcohol, can become a welcome distraction for people who have suffered trauma, despite negative side effects.

Drugs and alcohol release endorphins the brain that provide a sense of well-being and pleasure. This can reinforce a person to keep using a drug to keep feeling that same sensation of calmness and pleasure.

3. Abusing Substances For Sleep

Nightmares and difficulty falling asleep is common among people with PTSD. This can result in mild to severe sleep deprivation, which can many harmful effects on a person’s health and well-being.

Depressants such as alcohol and other sedatives can have effects of drowsiness, and sleepiness with high doses. Using drugs, especially alcohol, for sleep is a common way people misuse drugs in the United States.

Abusing substances for sleep, however, is not a long-term fix. Chronic abuse of drugs and alcohol can eventually worsen sleep problems and have long-term effects on a healthy sleep-cycle. Talking to a doctor can help people with PTSD struggling to sleep find more suitable sleep aid alternatives.

4. Relying On Alcohol Or Drugs To Get Through The Day

Chronic abuse of drugs, or heavy drinking, can lead to dependence. This is when the body adapts to the presence of a substance in a person’s system. Becoming dependent on drugs or alcohol can cause withdrawal symptoms if a person doesn’t continue taking doses throughout the day.

People can also begin to feel dependent on a psychological level. Common withdrawal symptoms include effects on mood, such as irritability, anxiety, and depression. These overlap with symptoms of PTSD.

Experiencing withdrawal symptoms may be triggering for people with PTSD. Since many people use substances in order to manage these symptoms, experiencing them in withdrawal may trigger flashbacks or cause severe distress.

5. You Have Not Received Treatment For Your Trauma (Or Have Stopped)

People that have not received treatment for their PTSD, or have stopped, may be more likely to abuse substances. Treatments such as behavioral therapy and medications can help relieve the excruciating symptoms that often accompany serious trauma.

Not everyone will realize a connection right away between their PTSD symptoms and substance use. Denial is common, and it can be challenging to seek alternatives to drugs when someone is terrified of their PTSD symptoms resuming.

Seeking treatment that is able to treat both disorders at the same time is the most effective way for people to get the help they need.

How Often Do PTSD And Substance Abuse Co-occur?

As many as 50 percent of people who have a substance use disorder may meet the criteria for PTSD at some point in their lifetime.

Other statistics related to PTSD and substance abuse:

  • people with substance abuse problems are five times more likely to have co-occurring PTSD than the general U.S. population
  • nearly 1 in 3 veterans that seek help for a substance use disorder also have PTSD
  • men with PTSD are five times more likely to abuse drugs than men without PTSD
  • women with PTSD are 1.4 times more likely to struggle with drug abuse and dependence than those without PTSD

Many drugs share common effects. Therefore, they can often be used for the same purposes – to numb, distract, ease, or forget. Mind-altering substances can serve people in various ways, depending on their trauma and how it’s affected them.

Many people can often go misdiagnosed, receiving another mental disorder diagnosis such as depression instead. Yet still, cases of trauma can also undetected, leaving people without any diagnosis or plan for treatment.

People that receive a misdiagnosis, or none at all, do not show up in research statistics. Getting people the treatment they need is an important and necessary goal. Knowing the signs of substance use disorders (SUDs) and PTSD can help people understand their connection.

What Are The Signs Of Post-Traumatic Stress Disorder (PTSD)?

Mental health disorders like PTSD still carry heavy stigma. As a result, many people either feel ashamed about seeking help, or may even be unaware that they have an illness.

People with PTSD are affected deeply on an emotional and psychological level by their trauma. How and when symptoms of PTSD develop after a traumatic event can vary. To be diagnosed with PTSD, symptoms must persist for at least one month.

Signs and symptoms of post-traumatic stress disorder (PTSD) may include:

  • nightmares
  • insomnia
  • flashbacks
  • anxiety
  • depression
  • intrusive thoughts
  • easily startled
  • missing work, or getting fired from a job
  • dissociation
  • avoiding certain places or people related to the traumatic event
  • changes in appetite
  • feelings of guilt and shame

Many of these symptoms – such as depression, insomnia, and anxiety – can become worse with heavy use of drugs and alcohol. This creates a vicious cycle that can be challenging to get out of alone.

Treating PTSD And Substance Abuse

Getting treatment for one problem without addressing another fails to provide people with the full help they need. People with PTSD that become sober but aren’t treated for their trauma may be more likely to relapse.

It can also be very difficult to live with untreated trauma. This can lead to severe anxiety, isolating from others, being unable to work, and living in constant fear and hopelessness.

Dual-diagnosis treatment is the most effective way to treat co-occurring substance use disorders and PTSD. This type of treatment addresses both disorders together through an integrated approach. This typically involves the use of various therapies and medications, depending on the needs of the patient and their treatment history.

If you or someone you know is using drugs or alcohol to manage symptoms of their PTSD, contact us today. We’ll help you find suitable treatment options to meet you or your loved one’s needs.

Current Directions in Psychological Science - Substance Abuse and Posttraumatic Stress Disorder

National Institute on Mental Health (NIMH) - Post-Traumatic Stress Disorder

U.S Department of Veteran Affairs (VA) - Substance Abuse in Veterans

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