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About 10 percent of people ages 12 and older in the US struggle with some kind of substance abuse or addiction problem.
However, people who suffer from post-traumatic stress disorder are much more likely to also struggle with substance abuse.
Post-traumatic stress disorder can be caused by multiple sources of trauma. Potential sources include fighting in a warzone, witnessing a terrorist attack, experiencing or witnessing sexual or physical assault, or being in a severe car accident. For people who have concurrent PTSD and substance abuse problems, the addiction could have started after the post-traumatic stress disorder took hold, or the PTSD could be the result of violence or an accident suffered while the individual was intoxicated.
Past theories have suggested that individuals who suffer these concurrent conditions should be first treated for their addiction, and once they have ended their substance abuse, they can then be successfully treated for PTSD. However, modern studies suggest that treating the two conditions at the same time gives better outcomes. As a result, integrated treatment is recommended, which addresses both disorders concurrently.
Prevalence of Co-occurring PTSD and Substance AbuseAlthough it is statistically clear that PTSD and substance abuse or addiction often go hand in hand, the relationship between the two disorders is complex and sometimes difficult to define.
Trauma could induce an addiction to a substance. For example, suffering abuse as a child could lead an individual to struggle with alcohol addiction as an adult. This theory suggests that PTSD leads to self-medicating behaviors, so that the person suffering from PTSD does not feel as much emotional pain or is able to dissociate from their mental state. Among teens with substance use disorders, 25-76 percent of those with PTSD abused substances after the onset of trauma, and 14-59 percent developed a substance abuse problem at the onset of PTSD.
Substance abuse could put people at a higher risk of suffering trauma as well. Drinking alcohol or using illegal substances like marijuana lowers inhibitions and makes people more likely to engage in risky behavior, such as walking through unsafe neighborhoods or driving a vehicle while under the influence. These individuals are at a higher risk of accidentally harming themselves or witnessing traumatic events. Additionally, emotional and cognitive impairment as the result of an addiction could lower a person’s ability to cope with trauma, leading to PTSD.
- Needing the substance to feel “normal”
- Inability to stop taking the substance, even when quitting is desired
- Suffering from withdrawal symptoms like muscle pain, nausea, anxiety, and lethargy when attempting to stop taking the substance
- Failing to meet work, school, and social obligations, specifically to take the substance
- Feeling extreme anxiety when unable to obtain more of the substance
- Lying about taking the substance and/or performing risky activities to obtain more of the substance
- Needing larger quantities of the substance to achieve the “high” associated with use
- Reliving the traumatic event
- Avoiding activities or geographic areas that remind a person of the trauma-inducing event
- Difficulty expressing feelings
- Difficulty feeling emotions, especially pleasure
- Feeling constantly alert or on edge
- Feeling hopelessness or despair
- Self-destructive or impulsive behaviors
Causes of PTSD and Substance Abuse or Addiction
Although any traumatic event can lead to PTSD, even years down the line, and substance abuse is a frequently concurrent condition with PTSD, there are some situations that put individuals at higher risk of suffering from both PTSD and substance abuse or addiction problems.
One of the highest risk groups for both PTSD and substance addiction is the veteran population. According to the National Center for PTSD, about a third of combat veterans who seek out treatment for a substance use disorder also suffer from PTSD. Due to the severe emotional, physical, and mental strain of combat, veterans often deal with the aftereffects of trauma, and this leads many to substance abuse.
Those who are victims of domestic violence or sexual abuse are more likely to suffer from addiction disorders. These individuals are at a high risk of developing PTSD due to their past or ongoing abusive situations.
Individuals often develop PTSD after repeated exposure to violence. However, anyone can develop PTSD after a single traumatic event, such as in cases of rape or physical attacks. Experiencing a natural disaster, such as an earthquake, hurricane, or flood, could also trigger PTSD in certain individuals.
Regardless of the original cause, medical professionals believe it is important for people who suffer from both PTSD and addiction to get treatment for both conditions at the same time.
Treatment for Both PTSD and Substance Abuse or Addiction
People who suffer from both PTSD and substance abuse issues are more likely to turn to substances when they feel worthless or out of control. If the underlying trauma isn’t addressed, it will always cause problems that result in substance abuse or other self-harming behaviors, even if the individual attempts sobriety with professional help. In order for sustained recovery to take hold, the issues related to PTSD must be adequately addressed.People with these co-occurring disorders are more likely to suffer other psychological conditions, like major depression or anxiety, which can lead to even further social isolation. Without social support, people who struggle with either PTSD or substance addiction generally get worse. In recovery from both conditions, ongoing social support is necessary. This can be found in inpatient treatment programs and then through 12-Step meetings and other peer support groups on a long-term basis. Exposure therapy has shown great promise for helping individuals who struggle with both PTSD and addiction. This type of therapy exposes the individual to “triggers” or memories of the traumatic event in some way, but this exposure occurs in a safe setting where the client has control. The client is guided by a psychologist or therapist, and can always stop the experience at any time. A medical professional, like a psychologist, monitors the sessions to ensure the exposure is gradual and doesn’t overwhelm the individual.
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People who suffer from PTSD are likely to deal with substance abuse issues, and vice versa.
If individuals with these co-occurring disorders get professional help at an integrated treatment program, both disorders can be addressed concurrently, ensuring the best chances of sustained recovery in all areas of life.