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Post-Traumatic Stress Disorder (PTSD) and Addiction

Post-traumatic stress disorder, commonly referred to as PTSD, is a psychiatric condition that can develop after a person experiences or witnesses a significantly shocking, frightening, or dangerous traumatic event.1, 2 Post-traumatic stress disorder commonly co-occurs with substance use disorder (SUD).3 The presence of co-occurring PTSD and SUD predicts a worse outcome than either disorder alone.3 As a result, many may seek out evidence-based co-occurring disorder or dual diagnosis treatment that address both disorders simultaneously. Understanding the complex interactions between PTSD and SUDs, how treatment can help, and how to access treatment can be an important first step in finding help.

What Is PTSD?

PTSD is a mental health disorder that may develop as a result of a person’s exposure to a highly distressing, often dangerous, event. It can be described as an exaggerated fear response.4 While a person may experience a range of emotional reactions after a traumatic event, for many, those feelings tend to subside over time.2 However, for some people, their reactions continue to cause problems or disruptions in their lives, and they may be diagnosed with PTSD as a result.2 Many different types of trauma can lead to the development of PTSD. Being hurt or watching somebody else be hurt or killed, experiencing sexual violence, physical abuse, or violence, or living through a natural disaster or some type of other manmade disaster (ex: war) may lead to the development of PTSD.2

Approximately 6% (6 out of every 100 people) in the U.S. will experience PTSD in their lifetimes.1  Certain populations face an increased risk due to the nature of their work. First responders, military personnel, and military veterans are at a greater risk of developing PTSD than civilians.1 Additionally, women are more likely than men to be diagnosed with PTSD, with approximately 8% of women in the U.S. experiencing PTSD compared to 4% of men developing the condition at some point during their lifetime.1

PTSD may be experienced differently from one person to the next, depending on variables such as the seriousness of the traumatic event, whether multiple traumatic events were experienced, as well as the specific nature of the individual’s connection to the trauma. Symptoms of PTSD may include:5

  • Flashbacks, feeling like the event is happening again.
  • Insomnia.
  • Nightmares.
  • Feelings of isolation.
  • Angry outbursts or other extreme reactions.
  • Intense feelings of worry, sadness, or guilt.
  • Difficulty concentrating.
  • Headaches and/or stomach aches.
  • Hypervigilance.
  • Startling easily.

The Relationship Between PTSD and Addiction

The relationship between PTSD and substance use disorders is complex. While neither condition necessarily causes the other to develop, each condition can exacerbate the other.6 For people diagnosed with SUDs, the lifetime prevalence of PTSD is between 26% and 52%. Among those who have been diagnosed with PTSD, the lifetime prevalence of a SUD is between 36% and 52%.4

Some people may use alcohol or other substances to alleviate or otherwise manage certain symptoms of PTSD such as anxiety or intrusive memories.4 As another example, if someone has PTSD and tends to have insomnia or nightmares, a person may drink before bed, mistakingly thinking it will help them sleep better.6

PTSD and Alcohol Misuse and Addiction

As mentioned earlier, people who are diagnosed with PTSD have an increased risk of experiencing problems with alcohol. In fact, studies have shown that up to three-quarters of people who have survived a violent, traumatic event, or endured abuse, report problems with alcohol.6 Nearly one-third of those who survive traumatic accidents or disasters also report drinking problems.6

PTSD and Drug Misuse and Addiction

Alcohol is not the only issue; people with PTSD tend to misuse more serious drugs like cocaine, opioids, and prescription medications.5 Co-occurring PTSD and SUD are associated with a variety of health impacts. For instance, cognitive difficulties can impact memory, concentration, and a decline in one’s ability to function in social settings. A combination of emotional distress and substance use can result in a greater risk of depression and or suicidal thoughts or attempts, and increased mortality rates.4

Treatment for PTSD and Substance Use Disorder

Treatment for co-occurring PTSD and SUD may be most effective through a dual diagnosis or co-occurring disorders treatment approach. Integrated treatment for co-occurring disorders, with a combination of psychosocial and pharmacological interventions for PTSD and SUD has been increasingly considered the current standard of care.4 With this integrated approach, treatment teams can collaborate with one another to coordinate simultaneous care of both mental health and substance use disorders to provide the comprehensive support each person needs.

Does Insurance Cover Co-Occurring PTSD and Addiction Treatment?

The Affordable Care Act (ACA) mandates that all health insurance plans provide some degree of coverage for the medically-necessary treatment of mental health disorders, such as PTSD and addiction.7 This means that those with health insurance may be able to use their plans to cover some or all of the costs of PTSD and SUD treatment. However, it is possible that coverage may vary, and one may want to verify their insurance benefits before committing to treatment.

Veterans have higher rates of PTSD than civilians, however, it’s important to recognize that PTSD is a treatable condition. The Department of Veteran Affairs (VA) operates an annual enrollment system to ensure that Veterans who are eligible can receive services, and many places within the VA system offer PTSD treatment.6 VA medical centers, community-based outpatient clinics, and Vet Centers often provide mental health services.

Find Treatment for PTSD and Addiction

If you’d like to start the treatment process, learn more about rehab, or verify your insurance, call our free, confidential helpline at to speak with a caring admissions navigator any time–day or night. You can also find a rehab near you using our treatment directory or easily verify your insurance online.

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