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  • Alcohol Use Disorder & PTSD | Dual Diagnosis Risks & Treatment

    Alcohol Use Disorder & PTSD | Dual Diagnosis Risks & Treatment

    Post-traumatic stress disorder (PTSD) can affect someone who has gone through or witnessed a traumatic experience, such as violence or an accident. 

    Many people who go through trauma suffer for a time and then overcome it. PTSD is a condition in which someone cannot work through the issues and continues to suffer, sometimes for years. 

    People who have PTSD are twice as likely to abuse alcohol as people who don’t have PTSD. And the type of people who develop PTSD are also more prone to alcohol abuse.

    Alcohol Use Disorder (AUD) & PTSD Dual Diagnosis Prevalence

    The US Department of Veterans Affairs (VA) estimates that seven to eight percent of Americans will have post-traumatic stress disorder (PTSD) at some point in their lives. More than 40 percent of people in the US with PTSD also have an alcohol use disorder (AUD).

    The two disorders often co-occur because alcohol takes the edge off PTSD symptoms, at least at first. Over time, alcohol abuse impairs your ability to function without alcohol, which can cause more anxiety and worsen the symptoms of PTSD.

    Alcohol abuse also increases the chance that you’ll be involved in a traumatic event that causes PTSD, such as a drunk driving accident that takes someone else’s life. 

    People with PTSD are more likely to develop other mental health conditions too, such as anxiety disorders or depression. Anxiety and depression are risk factors for alcohol and drug abuse.

    Because these two mental disorders can be so interconnected, it’s essential to address both through dual diagnosis treatment

    Risk Factors For AUD & PTSD Dual Diagnosis

    Trauma is the primary risk factor for post-traumatic stress disorder (PTSD). Many people who’ve gone through trauma drink alcohol to self-medicate or avoid bad memories when they arise. An inability to cope with stress is a common reason that people turn to alcohol abuse.

    Risk factors for alcohol use disorder (AUD) and PTSD include:

    • witnessing traumatic events
    • sexual abuse or a sexual assault
    • childhood trauma (such as abuse, neglect, or an accident)
    • being involved in trauma through a job (such as first response or military)
    • mental health issues, like depression or anxiety
    • not having a strong support network
    • family members with mental health disorders
    • the way your brain responds to stress

    About 30 percent of Vietnam veterans suffer from PTSD. The VA reports that 60 to 80 percent of these veterans who seek treatment for PTSD also have problems with alcohol abuse.

    Symptoms Of PTSD & AUD

    PTSD symptoms can appear a month after trauma occurs, but may not show up for years. Some of the symptoms of PTSD can result from comorbid alcohol abuse as well, such as irritability and numbness.

    There are four types of PTSD symptoms:

    • Intrusive memories: having nightmares, flashbacks, reliving the trauma, feeling an emotional or physical response to things that trigger painful memories
    • Avoidance: staying away from people, places, or things that remind you of trauma and not thinking or talking about it
    • Physical and emotional responses: insomnia, irritability, guilt or shame, being guarded, hyperarousal
    • Negative thoughts and mood: hopelessness, detachment, numbness, pessimism

    PTSD can get in the way of your daily life, straining relationships and making it hard to focus at work. Alcohol use disorder can do the same. Both disorders may cause legal problems or self-destructive behavior, such as drinking so much you develop health problems or harm others.

    Other symptoms of alcohol use disorder are:

    • hiding alcohol bottles and drinking in secret
    • being intoxicated all the time
    • smelling like alcohol but denying that you’ve been drinking
    • drinking all day or at inappropriate times, such as before work
    • turning to alcohol for self-medication every time you feel a little stress
    • spending a lot of time drinking alcohol and recovering from it
    • spending excessive money on alcohol
    • alcohol withdrawal symptoms

    Symptoms of either disorder can impede treatment progress for the other. It can be a challenge to overcome alcohol addiction if you continue to suffer from PTSD, and alcohol abuse doesn’t help you work through traumatic memories. 

    Dual Diagnosis Treatment For AUD & PTSD

    To effectively treat a person with AUD and PTSD, a treatment program must address both issues. Dual diagnosis treatment gets at the root cause of PTSD and alcohol abuse to resolve the problem and prevent relapse.


    Psychotherapy is a common treatment option for both disorders. Many therapists use cognitive-behavioral therapy (CBT) or exposure therapy for PTSD, and CBT is helpful in addiction treatment, too.

    CBT addresses negative thinking patterns that lead to unhealthy behaviors. It also teaches you positive coping strategies to replace substance abuse. Exposure therapy brings you in contact with things that trigger PTSD to lessen their effect.


    Medication may be paired with therapy for both PTSD and AUD. Antidepressants, anti-anxiety medications, and prazosin (Minipress—a drug that decreases nightmares) can help with PTSD. 

    For AUD, medication-assisted treatment (MAT) may include naltrexone (Vivitrol), acamprosate (Campral), and disulfiram (Antabuse)

    It can be challenging to incorporate medication in treatment if you struggle with substance use disorder. The best treatment centers will likely tailor a treatment plan to your needs that consider co-occurring disorders.

    To learn more about dual diagnosis treatment for alcohol use disorder and PTSD, speak with an Ark Behavioral Health specialist today.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Medically Reviewed by
    Manish Mishra, MBBS
    on August 12, 2022
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