Treating PTSD In Addiction Recovery: Treatment Options And Resources

Trauma is a loaded term that is not often well understood by the general public, although experiences of trauma are very common.

Trauma can occur to people across racial and ethnic lines, age, gender, income level, and educational background. Talking about trauma and its effects on physical and mental health can be difficult due to associated stigma.

People who experience trauma can be at risk for developing trauma-related conditions such as post-traumatic stress disorder (PTSD). This condition can be a risk factor for developing other mental illnesses as well as drug and alcohol use issues.

Here you’ll find:

• information about PTSD
• co-occurring substance abuse and PTSD
• treatment options for PTSD
• statistics about PTSD in the United States
• resources and support options

Defining Trauma: Emotional, Physical, Psychological

The word ‘trauma’ can be generally defined as an event, a series of events, or a set of circumstances that negatively affect a person’s mental, physical, or emotional wellbeing. 

This can have acute and long-lasting effects on a person’s mental health, physical health, ability to cope, and ability to live their life as normal.

Different Types Of Trauma

Trauma can be categorized in a few different ways. There is physical trauma, mental trauma, emotional trauma, and psychological trauma.  

A holistic approach to health and wellness recognizes that physical trauma can affect our mental and emotional health, and vice versa. 

Trauma can refer to incidents such as:

• verbal abuse
• neglect
• physical violence
• interpersonal violence
• childhood abuse
• sexual abuse, molestation, or sexual assault
• a serious accident/injury
• loss of a loved one
• living in poverty
• being attacked or beaten
• surviving a deadly incident (e.g. mass shooting, military combat)
• acts of discrimination or discriminatory violence
• racial and generational trauma
• imprisonment/incarceration

Experiences of trauma are common among adults, teenagers, and children in the United States. It is often associated with other mental illnesses, such as depression, anxiety, eating disorders, and mood disorders.

What Is Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is trauma and stress-related disorder that develops in people who have experienced or witnessed a traumatic event or series of events.

This disorder differs from trauma. While experiences of trauma are very common, not everyone who experiences trauma develops PTSD, which is characterized as a prolonged stress response. 

Signs and symptoms of PTSD include:

• changes in behavior or attitude (e.g. irritability, depressed, destructive behavior)
• nightmares
• flashbacks to the traumatic incident
• emotional distress after reminders of the trauma
• heightened sensitivity to touch, phrases, subject matter
• difficulty experiencing happiness or joy
• feelings of isolation
• changes in sleep (e.g. sleeping too much or too little)
• easily startled
• difficulty concentrating
• inability to recall key features of the trauma
• decreased interest in activities
• difficulty being physically or sexually intimate
• negative thoughts and assumptions about oneself or the world

PTSD can be a debilitating condition. This means it can significantly impact a person’s ability to function in their everyday life. They may have troubles at work, keeping a job, taking care of others, and taking care of their own basic needs.

People with PTSD may also have difficulty maintaining positive and healthy relationships. They may push others away and struggle to end relationships that are harmful to their physical or mental health. 

Substance Abuse And Co-Occurring Post Traumatic Stress Disorder

Living with PTSD can make it difficult to simply exist in the world. Just getting through the day can feel like a struggle.

The stress and life difficulties that can come from living with PTSD can place a person at greater risk for turning to drugs or alcohol to numb, repress, or cope. 

People who are diagnosed with PTSD are 25 to 49 percent more likely to have a substance use disorder compared to the general population. This includes drug and alcohol abuse, dependence, and addiction.

Signs Of Substance Abuse In People With PTSD

Substance abuse and PTSD share overlap in some of the symptoms experienced. Many people with both of these disorders experience dramatic changes in mood, thoughts, and behavior.

Signs of drug and alcohol abuse include

• frequent use of drugs or alcohol
• relying on drugs or alcohol to get through the day
• hiding or lying about your substance use
• using drugs or alcohol for their ability to heighten or numb emotions
• using drugs or alcohol to stay awake or sleep
• increasing how much drugs or alcohol you use over time
• constantly thinking about using or getting drugs
• continuing to drink or use drugs despite negative effects on health, ability to work, or relationships
• engaging in risky or reckless behavior
• drug or alcohol withdrawal symptoms
• feeling unable to control or stop your drug or alcohol use

Drugs and alcohol can be used to cope with experiences of trauma, and can also lead to situations that are traumatic, such as sexual assault, criminal activity, and car accidents. 

The reasons why a person turns to drugs or alcohol can be complex. Substance abuse commonly runs in families and can be influenced by biological, environmental, and sociocultural factors.

How Do You Treat Co-Occurring Trauma And Addiction?

Substance use disorders and PTSD are both chronic, debilitating conditions that can be best treated together through an integrated treatment approach.

Substance abuse and trauma can be treated together through behavioral, pharmacological, and holistic treatment services.

Treatment for trauma and addiction can include:

• inpatient rehabilitation 
• dual diagnosis treatment
• behavioral therapies
• trauma-specific therapies
• outpatient treatment programs
• support groups

Treatment programs are generally recommended based on factors such as current health status, treatment availability, co-occurring disorders, and other personal needs.

Inpatient Rehabilitation Programs

If one or more of your mental health conditions is severely limiting your ability to function in your daily life, inpatient treatment may be recommended.

Inpatient and residential treatment programs offer 24-hour supervision and care within a supportive rehab facility or hospital environment.

Inpatient rehabilitation involves living in a treatment facility for a predetermined amount of time. On average, inpatient treatment lasts 30 to 90 days. Upon admission, residents are typically assigned to a treatment team of medical and behavioral health professionals.

When you enter a rehab center, your treatment team will meet with you to assess your needs. From there, they can recommend a treatment plan that can address your physical and mental health needs, including treatments specifically designed for trauma and substance abuse.

Common inpatient treatment services include:

• detox
• behavioral therapy
• individual counseling
• group therapy
• medication
• mental health services
• holistic therapies
• relapse prevention

The United States is home to hundreds of rehab centers. Not all offer treatment programs specifically designed to treat PTSD, substance abuse, or both. 

If you have both conditions, it’s highly recommended that you search for a treatment center that is experienced in treating both PTSD and substance use disorders. This can improve your chance of achieving long-term recovery and finding the care you need.

Dual Diagnosis Treatment

Dual diagnosis is an integrated treatment for treating co-occurring disorders. This includes mental health and substance use disorders. Dual diagnosis is capable of addressing the many facets of living with more than one mental illness.

Dual diagnosis treatment programs may utilize medical, behavioral, and pharmacological treatments. Dual diagnosis treatment, or treatment for co-occurring disorders, may be offered within rehab centers, outpatient clinics, and by individual outpatient providers.

Behavioral And Trauma-Specific Therapies

Post-traumatic stress disorder and substance abuse are commonly treated through individual and group therapy sessions. 

There are several therapies designed specifically to treat trauma, while some others have been found to be useful for treating a range of mental health disorders.

Behavioral and trauma-specific therapies for PTSD include:

• trauma-focused cognitive behavioral therapy (CBT)
• cognitive processing therapy
• dialectical behavioral therapy (DBT)
• eye movement desensitization and reprocessing (EMDR)
• prolonged exposure therapy
• acceptance and commitment therapy (ACT)

The structure and goals of these different therapies can vary. Some therapeutic approaches follow a “talk therapy” format where you talk through what you’re thinking and how you’re feeling. 

Other therapies may involve physical contact, take-home assignments from a therapist, and working through memories associated with your trauma. 

Trauma Services For Certain Populations

There also exist treatment programs and services that are designed to meet the needs of certain populations. This can include LGBTQ populations, veterans, racial and ethnic minorities, and people who have experienced poverty, homeless, or disability.

Resources For Finding Treatment For Trauma And Substance Abuse

There are many state and federal agencies that offer resources to help people find treatment for themselves or a loved one living with PTSD and addiction.

Directories For Finding Treatment

• Substance Abuse and Mental Health Services Administration (SAMHSA)
  • National Helpline: 1-800-662-HELP (4357)
• Psychology Today: Find a Therapist, Psychiatrist, or Treatment Center
• National Center for PTSD
  • General line: 1-800-273-8255
  • PTSD Information Voicemail: (802) 296-6300

Trauma-Related Hotlines And Text Lines

If you need immediate support, there are many national hotlines for mental health and substance abuse support. 

If you are experiencing a medical or mental health crisis, you can also call 9-1-1 to be connected to your local emergency services center. 

• National Crisis Text Line: Text HELLO to 741741
• Veterans Crisis Line: 1-800-273-8255 and Press 1 or text to 838255
• National Suicide Prevention Hotline: 1-800-273-TALK (1-800-273-8255) 
• Disaster Distress Helpline
  • 1-800-985-5990 
  • Text “TalkWithUs” to 66746
• National Alliance on Mental Illness Helpline: 1-800-950-6264
• National Domestic Violence Hotline: 1-800-799-SAFE (7233)
• National Sexual Assault Telephone Hotline: 800-656-HOPE (4673)
• Trans Lifeline (for transgender teens and adults): (877) 565-8860
• National Teen Dating Abuse Hotline: 1 (866)-331-9474 or text 22522
• Mental Health America: 1-800-273-TALK (8255)
• Teen Line: 1-800-852-8336 or text “TEEN” to 839863

Coping Strategy And Resource Guides

Living with PTSD and addiction, or loving someone with these conditions, can be an everyday challenge. 

Here are some coping strategy guides and educational resources that may benefit you or a loved one affected by trauma:

• Racial Trauma—Mental Health America
• COVID-19 Resource and Information Guide—National Alliance on Mental Illness (NAMI)
• COVID-19 Mental Health Resource Page—Mental Health America
• Tips for College Students: After a Disaster or Other Trauma: R U A Survivor of a Disaster or Other Trauma?—SAMHSA
• Coronavirus (COVID-19): Resources for Managing Stress—U.S. Department of Veterans Affairs
• Coping with a Disaster or Traumatic Event—U.S. Centers for Disease Control and Prevention (CDC)
• How to Develop a Safety Plan for PTSD Symptoms—VeryWellMind

Post Traumatic Stress Disorder And Substance Abuse Statistics

Struggling with trauma-related flashbacks, nightmares, and substance use can be an isolating experience. If you or someone you know is experiencing these struggles: You’re not alone.

According to the National Alliance on Mental Illness (NAMI), PTSD affects an estimated 3.6 percent of the United States population. 

Gender

Women generally experience or report PTSD more often than men. Transgender and nonbinary individuals can also be at higher risk for PTSD, as a result of compounding factors such as higher rates of experiencing sexual assault, discrimination, and physical violence.

Veterans 

Veterans are at higher risk for PTSD compared to the general population, according to the American Psychological Association. The National Center for PTSD reported that an estimated 11 to 20 percent of veterans who served in Iraq and Afghanistan had PTSD.

Co-occurring disorders

About 80 percent of people with PTSD have one or more co-occurring mental health or substance use disorders. This can include disorders such as depression, eating disorders, bipolar disorder, anxiety disorders, and obsessive-compulsive disorder.

Racial and ethnic minorities

Some researchers suggest people of color, particularly Black Americans and indigenous populations, experience higher rates of PTSD than White Americans.

Generational trauma, racism, and trauma related to discrimination, violence, and poverty can be common causes of PTSD among Black and indigenous people of color (BIPOC).

Recovering From Addiction With A History Of Trauma

If you or someone you know is struggling with substance abuse or is struggling with mental health after experiencing trauma: You’re not alone. Help is available.

There are many supportive resources and treatment options that can help you, slowly, rebuild a life that feels meaningful and fulfilling. A better future is possible.