Post-traumatic stress disorder (PTSD) and addiction often occur together, creating a difficult cycle to break without proper treatment. After traumatic experiences, some individuals turn to substances for relief, which may offer temporary comfort but often lead to dependency, making integrated treatment essential for lasting recovery.
At Peak Path Health, we recognize the deep connection between trauma and substance use. Our evidence-based, compassionate approach treats both conditions simultaneously, focusing on healing the whole person for long-term wellness.
According to the National Institute on Drug Abuse, people with PTSD are 2–4 times more likely to develop a substance use disorder. This link highlights how trauma can change brain function and coping mechanisms. Understanding this connection and accessing dual diagnosis residential treatment is the first step toward genuine healing and recovery.
According to the National Center for PTSD, about 6% of the U.S. population will experience PTSD at some point in their lives. However, this rate increases dramatically among those with substance use disorders, with some studies showing co-occurrence rates as high as 50%.
PTSD affects the brain’s stress response system, altering how we process fear and threats. The condition manifests through four main symptom categories:
- Intrusion: Unwanted memories of the traumatic event that intrude into daily life. These may include flashbacks (feeling as if the event is happening again), nightmares, or distressing thoughts.
- Avoidance: Efforts to avoid reminders of the trauma, including people, places, activities, objects, or situations that might trigger upsetting memories or feelings.
- Negative Changes in Thinking and Mood: Persistent negative thoughts about oneself or the world, feelings of detachment from others, difficulty experiencing positive emotions, or inability to remember important aspects of the traumatic event.
- Alterations in Arousal and Reactivity: Being easily startled, feeling tense or “on edge,” having difficulty sleeping, experiencing angry outbursts, or engaging in reckless behavior.
These symptoms can be overwhelming, leading many individuals to turn to alcohol or drugs in an attempt to manage their distress. This self-medication may temporarily reduce symptoms, but ultimately creates additional problems.
PTSD and Substance Abuse: Why Do They Co-Occur?
Many individuals with PTSD use substances to cope with distressing symptoms. According to research from the Substance Abuse and Mental Health Services Administration (SAMHSA), this self-medication often targets specific symptoms:
- Alcohol may be used to induce sleep or reduce anxiety
- Benzodiazepines might temporarily relieve panic or hypervigilance, but benzo addiction treatment is often necessary if reliance develops.
- Opioids can numb both emotional and physical pain
- Cannabis may be used to manage nightmares or intrusive thoughts
- Stimulants might counteract depression or emotional numbness
A 2022 study published in the Journal of Traumatic Stress found that approximately 46% of individuals with PTSD reported using substances specifically to manage their trauma symptoms.
PTSD and substance use disorders share several risk factors that increase vulnerability to both conditions:
- Genetic predisposition affecting stress response systems
- Early life trauma or adverse childhood experiences
- Environmental stressors like poverty or community violence
- Neurobiological changes in brain regions that regulate emotions
These shared factors help explain why these conditions so frequently appear together, creating what clinicians call a “dual diagnosis” or “co-occurring disorders.”
When trauma remains unaddressed, it often undermines addiction recovery efforts. Trauma triggers can prompt intense emotional responses that lead to substance use as a coping mechanism. Without addressing the underlying trauma, the cycle continues.
Research from the National Institute on Drug Abuse indicates that individuals with untreated PTSD have significantly higher relapse rates following addiction treatment compared to those who receive trauma-focused care.
Why PTSD and Drug Use Exacerbate Each Other
Trauma alters the brain’s stress and reward systems, the same systems affected by addiction. When trauma occurs, it can create lasting changes in how the brain responds to stress, making individuals more vulnerable to substance use disorders. The amygdala (fear center) becomes hyperactive while the prefrontal cortex (decision-making area) shows reduced function. Substances may initially provide relief from PTSD symptoms through:
- Numbing emotional pain
- Reducing anxiety or hyperarousal
- Helping with sleep difficulties
- Blocking intrusive memories
Research from the National Center for PTSD shows that substance use interferes with the brain’s natural recovery from trauma. Normally, the brain processes traumatic memories over time, gradually reducing their emotional impact. Substances disrupt this process, preventing healing and potentially making PTSD symptoms worse in the long run.
Additionally, withdrawal symptoms often mimic or intensify PTSD symptoms. Increased anxiety, irritability, sleep disturbances, and heightened startle responses can occur during withdrawal, making it difficult to distinguish between withdrawal and PTSD symptoms.
Signs of PTSD and Addiction and When to Seek Help
- Increased isolation or social withdrawal
- Neglecting responsibilities at work, school, or home
- Engaging in risky behaviors while under the influence
- Spending significant time obtaining, using, or recovering from substances
- Avoiding situations that might trigger trauma memories
- Changes in appearance or a decline in personal hygiene
- Unexplained physical injuries or health problems
- Sleep disturbances, including insomnia or nightmares
- Physical symptoms of withdrawal when attempting to stop substance use
- Tolerance (needing more of the substance for the same effect)
- Mood swings, irritability, or emotional outbursts
- Withdrawal from previously enjoyed activities or relationships
- Difficulty trusting others or feeling safe
- Hypervigilance (being constantly on alert)
- Feelings of guilt, shame, or worthlessness
Casual substance use crosses into problematic territory when it becomes a primary coping mechanism for trauma symptoms or begins interfering with daily functioning. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), substance use disorder is diagnosed when substance use causes significant impairment or distress.
At Peak Path Health, we conduct comprehensive assessments to identify both PTSD and substance use disorders. This dual diagnosis approach ensures that treatment addresses all aspects of a person’s experience rather than focusing on just one condition.
PTSD and Addiction Treatment
Several therapeutic approaches have proven effective for treating co-occurring PTSD and substance use disorders:
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) helps individuals understand how trauma affects thoughts, emotions, and behaviors. It teaches skills to identify and change unhelpful thinking patterns while developing healthier coping strategies.
- Eye Movement Desensitization and Reprocessing (EMDR) uses bilateral stimulation (usually guided eye movements) while recalling traumatic memories. This helps the brain process traumatic experiences in a way that reduces their emotional impact without requiring detailed discussion of the trauma.
- Dialectical Behavior Therapy (DBT) combines acceptance and change strategies to help individuals regulate emotions, tolerate distress, improve relationships, and develop mindfulness skills. These tools are particularly helpful for managing trauma responses and reducing substance use.
Medications can play an important role in managing symptoms and supporting recovery:
- Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline and paroxetine are FDA-approved for PTSD treatment and can help reduce symptoms of anxiety, depression, and intrusive thoughts.
- Medication-Assisted Treatment (MAT) for substance use disorders may include medications that reduce cravings and withdrawal symptoms. For example, naltrexone can help with alcohol dependence, while buprenorphine can assist with opioid use disorder. Many individuals also benefit from an opioid rehab center for comprehensive recovery.
When prescribed and monitored by medical professionals, these medications can be used safely together as part of a comprehensive treatment plan.
Effective therapy for co-occurring PTSD and addiction focuses on processing trauma while developing healthy coping skills to replace substance use. These approaches recognize that both conditions must be addressed for lasting recovery.
Many individuals benefit from approaches that address overall wellness:
- Mindfulness and meditation practices help increase awareness of triggers without automatically reacting to them
- Nutrition counseling supports physical recovery and helps stabilize mood
- Exercise and physical wellness programs improve sleep, reduce stress, and create healthy routines
- Yoga and tai chi combine movement with mindfulness to help regulate the nervous system
At Peak Path Health, we incorporate holistic therapy approaches alongside evidence-based therapies to support whole-person healing.
Cognitive Behavioral Therapy (CBT) helps individuals identify and change unhelpful thoughts and behaviors related to both trauma and substance use. Key components include:
- Cognitive restructuring: Identifying and challenging negative thought patterns that maintain PTSD symptoms or trigger substance use
- Exposure therapy: Gradually facing trauma memories in a safe environment to reduce their emotional power
- Skills training: Learning healthy coping strategies, stress management, and relapse prevention techniques
CBT typically involves weekly sessions over 3-6 months, with homework assignments to practice skills between sessions. Research from the National Institute on Drug Abuse shows cognitive behavioral therapy can reduce both PTSD symptoms and substance use when used in an integrated approach.
EMDR therapy helps the brain process traumatic memories without requiring a detailed discussion of the trauma. During EMDR sessions:
- The therapist guides bilateral stimulation (usually eye movements) while the person briefly focuses on trauma memories
- This process helps the brain store these memories differently, reducing their emotional impact
- Over time, the traumatic memories become less distressing and lose their power to trigger substance use
DBT combines acceptance and change strategies, teaching four main skill sets:
- Mindfulness: Being present in the moment without judgment
- Distress tolerance: Managing difficult emotions without turning to substances
- Emotion regulation: Understanding and managing emotional responses
- Interpersonal effectiveness: Communicating needs and setting boundaries in relationships
These skills help individuals manage trauma responses and develop alternatives to substance use. DBT typically combines individual therapy with group skills training sessions.
Relapse prevention strategies for trauma survivors include:
- Continuing therapy or counseling as needed
- Maintaining medication regimens when prescribed
- Regular check-ins with treatment providers
- Practicing stress management and emotional regulation skills
At Peak Path Health, we provide comprehensive aftercare planning that connects individuals with resources for ongoing support. This might include outpatient therapy, support groups, alumni programs, or community services.
Recovery from PTSD and addiction is not just about stopping substance use; it’s about creating a life where substances are no longer needed to cope with trauma. With the right treatment and support, healing is possible.
PTSD and Addiction FAQs
Treatment duration varies based on individual needs and symptom severity. Most residential programs range from 30 to 90 days, while outpatient treatment may continue for several months or longer.
Many private insurance plans and some government programs cover treatment for co-occurring disorders. Coverage varies by provider and plan type, so it’s helpful to verify benefits before beginning treatment.
Family members can help by learning about both conditions, participating in family therapy for addiction when appropriate, maintaining healthy boundaries, and encouraging their loved one to continue treatment.
Integrated treatment addresses the complex interaction between trauma and substance use, preventing the cycle where symptoms of one condition trigger or worsen the other.
Noticing patterns where substance use increases after trauma reminders, or using substances specifically to manage symptoms like nightmares or anxiety, may indicate a connection between trauma and substance use.
Moving Forward With Lasting Support
If you’re struggling with PTSD and addiction, know that recovery is possible with the right support. At Peak Path Health in Los Angeles, CA, we specialize in treating these co-occurring conditions through evidence-based, compassionate care tailored to your unique needs.
Our integrated approach addresses both trauma and substance use to create lasting healing and improved quality of life. Contact us today to learn more about how we can support your recovery journey.
Vana Agopian is a Licensed Clinical Social Worker with a unique background bridging entrepreneurship, advocacy, and clinical care. Drawn to a service-driven path, she developed therapeutic services in schools and supported children with autism through ABA therapy. She went on to serve seven years with Los Angeles County, specializing in child safety assessments, crisis intervention, and multidisciplinary collaboration. In the private sector, she has provided individual therapy, clinical assessments, and treatment center support.
Vana specializes in attachment theory, trauma-informed care, holistic healing, and family engagement. She holds a Master of Social Work and a Bachelor’s in Political Science and Law, and is bilingual in English and Armenian.
Her leadership ensures clients at Peak Path Health receive culturally competent, compassionate, and recovery-focused care.
