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  • Post-Traumatic Stress Disorder (PTSD) & Addiction | Dual Diagnosis Prevalence, Risk Factors, Symptoms, & Treatment

    Post-Traumatic Stress Disorder (PTSD) & Addiction | Dual Diagnosis

    Our experiences, accomplishments, and even our failures help make us who we are. But some experiences can be so deeply disturbing and harmful that they disrupt your day-to-day life and cause real and lasting pain for months or even years into the future.

    This condition is known as post-traumatic stress disorder or PTSD, and unfortunately, many who experience it ultimately turn to substance abuse, including alcohol abuse, to help blunt its effects.

    A dual diagnosis of PTSD and substance use disorder (SUD) is best managed by professional clinicians inside a formal treatment program setting.

    Prevalence Of PTSD & Substance Use Disorder

    According to the 2018 National Survey on Drug Use and Health, approximately 20.3 million Americans experienced a substance use disorder in 2018, or about 7.4% of the population.

    At the same time, it is estimated that the lifetime prevalence of PTSD among adult Americans is 6.8% (22 million), with 3.5% of Americans experiencing PTSD each year. The condition is estimated to be experienced more commonly among women (9.7% lifetime, 5.2% per year) than men (3.6% lifetime, 1.8% per year). 

    It is believed that between one in five and more than two in five individuals with PTSD engage in substance abuse.

    Symptoms Of PTSD

    Whenever you have a new experience, your mind is busy recording it in your memory, building pathways and connections that generally fade away over time unless the memory is significant enough to be re-remembered and converted into a long-term memory. 

    But when you experience a traumatic event, the resulting memory pattern can cut deep through your mind, triggering unwanted symptoms that can include:

    • flashbacks
    • nightmares
    • sweating
    • behavioral changes and avoidance symptoms (including substance abuse)
    • emotional numbness
    • anxiety and hyperarousal
    • aggression or heightened fight-or-flight responses

    These symptoms can appear suddenly at any time, but are most common when you are reminded of the traumatic experience in some way.

    Keep in mind that PTSD is a mental health disorder and a natural reaction to severe trauma. There is no shame in experiencing these symptoms or in seeking professional help to better manage them and help your mind recover.

    Symptoms Of Substance Use Disorder

    Addiction, be it alcohol use or drug addiction, is often characterized by three distinct signs and symptoms:

    • loss of control over the amount and frequency of use
    • craving and compulsive use
    • continued drug abuse despite all physical or social consequences

    Addiction also often involves some level of physical dependency as the body becomes reliant on drugs or alcohol for normal feeling and function. 

    This can lead to increasing tolerance to the substance being abused as well as distressing withdrawal symptoms if you cut your dosage or stop taking the drug. 


    In the event of co-occurring PTSD, substance misuse often begins when those with PTSD self-medicate, using drugs or alcohol to achieve temporary relief from intrusive thoughts, depression, and anxiety. 

    But these substances only provide a fleeting escape, and the longer addiction continues to develop unchecked the more physical and mental harm will result. 

    Risk Factors

    PTSD can strike anyone who experiences trauma, but it is most strongly associated with several specific circumstances, some of which also increase the likelihood of PTSD symptoms being more severe. 

    Risk factors for PTSD may include:

    • military combat
    • sexual assault
    • loss of a loved one
    • repeated or prolonged exposure to disturbing situations
    • experiencing physical harm
    • seeing another individual harmed, or a dead body
    • past childhood traumas
    • having a lack of social or emotional support
    • high levels of stress, pain, or uncertainty following the event
    • having a prior history of mental illness or substance abuse

    Co-Occurring PTSD & Addiction Treatment

    Because these co-occurring disorders often feed off of one another, creating a cycle of fear, guilt, and shame, recovering from a dual diagnosis of PTSD and substance use disorder requires professional support and support from family members and other loved ones. 

    Potential dual diagnosis treatments include:

    Cognitive Behavioral Therapy (CBT)

    CBT is a type of psychotherapy used in the treatment of PTSD as well as in the treatment of substance abuse disorders. In CBT, negative patterns of thought about the self and the world you inhabit are examined and challenged, changing harmful patterns of behavior.

    Prolonged Exposure Therapy (PET)

    After a traumatic event, it’s natural to avoid thinking about what happened and to try to steer away from anything that might bring that event back to mind. PET challenges this neurosis, helping you face the triggers you’ve been avoiding to bring your life back to normal.

    Eye Movement Desensitization & Reprocessing (EMDR)

    In EMDR, you work to process your traumatic memory while focusing your eyes on some external stimuli like a moving light. While this happens, you also focus on a positive thought. This process helps the brain access the traumatic memory, process it, and ultimately heal from it.

    Stress Inoculation Training (SIT)

    SIT is designed to ready your body and mind to respond to PTSD-related fear and anxiety when they appear, arming you with a range of coping strategies and relaxation techniques.


    A range of medications might be prescribed during integrated treatments, including:

    • Selective Serotonin Reuptake Inhibitors (SSRIs), a type of antidepressant
    • naltrexone, which decreases the pleasure from opioid or alcohol use
    • disulfiram, which causes nausea and flushed skin if alcohol is consumed
    • methadone, which reduces the intensity of opioid cravings and other opioid withdrawal symptoms
    • buprenorphine, which is used to manage opioid withdrawal symptoms and cravings

    To learn more about available mental health programs and substance abuse treatment options, including both inpatient and outpatient care, please contact Ark Behavioral Health today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Anxiety and Depression Association of America, ADAA - Symptoms of PTSD
    Substance Abuse and Mental Health Services Administration (SAMHSA) - Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health
    U.S. Department of Veterans Affairs - Substance Use Disorder and PTSD: two diagnoses, one underlying cause
    U.S. Department of Veterans Affairs: National Center for PTSD - Epidemiology of PTSD

    Medically Reviewed by
    Davis Sugar, M.D.
    on June 26, 2022
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