The Link Between PTSD and Substance Abuse


An emerging body of research has documented a very strong association between Posttraumatic Stress Disorder (PTSD) and substance abuse. In most cases, substance use begins after the exposure to trauma and the development of PTSD, thus making PTSD a risk factor for drug abuse.

Early intervention to help children and adolescents who have suffered trauma from violence or a disaster is critical. Children who witness or are exposed to a traumatic event and are clinically diagnosed with PTSD have a greater likelihood for developing later drug and/or alcohol use disorders.

Of individuals with substance use disorders, 30 to 60 percent meet the criteria for comorbid PTSD. Patients with substance abuse disorders tend to suffer from more severe PTSD symptoms than do PTSD patients without substance use disorders.

What is PTSD?

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can develop in some people after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. PTSD can occur in people of any age, including children and adolescents.

In the past, PTSD had been associated with the violence of modern combat. However, it’s now understood that many people other than combat soldiers are susceptible. PTSD can result from many kinds of tragic incidents in which the individual was a witness, victim, or survivor, including violent or personal attacks, natural or human-caused disasters, or accidents.

Symptoms of PTSD can include re-experience of the trauma; emotional numbness; avoidance of people, places, and thoughts connected to the event; and arousal, which may include trouble sleeping, exaggerated startle response, and hyper-vigilance.

Helping Those Who Suffer from PTSD and Drug Abuse

Health care professionals must be alert to the fact that PTSD frequently co-occurs with depression, anxiety disorders, and alcohol or other substance abuse. Individuals who are experiencing the symptoms of PTSD need support from physicians and health care providers.
The likelihood of treatment success increases when these concurrent disorders are appropriately identified and treated as well.

In some cases, medications such as the antidepressant sertraline (Zoloft™), have been shown to be helpful in treating patients who suffer from PTSD and substance use disorders.

Some reports suggest that successful detoxification of these comorbid individuals will likely require inpatient admission to permit vigorous control of withdrawal and PTSD-related arousal symptoms.

Although there is no standardized, effective treatment developed for individuals with this disorder, studies show that those who suffer from PTSD can improve with cognitive behavioral therapy, group therapy, or exposure therapy, in which the individual gradually and repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma.

Exposure therapy is thought to be one of the most effective ways to manage PTSD when it is conducted by a trained therapist. It has not yet been widely used with comorbid disorders, but recent studies suggest that some individuals with PTSD and comorbid cocaine addiction can be successfully treated with exposure therapy. Individuals in a recent study who suffered from both disorders showed significant reductions in all PTSD symptoms and in overall cocaine use.

Finally, support from family and friends can play an important role in recovery.

Source: National Institute on Drug Abuse