PTSD and Addiction: The Connection

It is estimated that almost 60 percent of people who are seeking treatment for a substance use disorder are also living with post-traumatic stress disorder (PTSD). This number does not account for those who were diagnosed previously with PTSD and overcame the disorder through treatment or those who developed PTSD after a traumatic experience but never received a formal diagnosis. This means that it is likely that the true number is higher.

What is the connection between PTSD and substance abuse and addiction? Why is it that so many people who are living with PTSD symptoms also struggle with drinking and alcohol abuse?


There is a lot we don’t know about why many people will experience a traumatic event and develop PTSD while others do not. There is also a lot we don’t know regarding why many will drink moderately or experiment with illicit substances and never develop a problem while others will. That being said, we do have some answers about the connections between PTSD and addiction.

What is post-traumatic stress disorder

Post-traumatic stress disorder is diagnosed in clients who experience intrusive symptoms after going through or bearing witness to trauma. These symptoms can be extremely disruptive to the person’s ability to interact positively with others, sleep, work, and otherwise function in the world.

They may be defined by:

  • Negative changes in personality and response to others
  • Avoidance (e.g., avoiding the subject of the trauma or any reminder of the event)
  • Uncontrollable memories (e.g., flashbacks, nightmares, etc.)
  • Intense emotional response to relatively small stimuli

It is also not uncommon for people who struggle with PTSD to experience suicidal thoughts and behaviors as well as symptoms of varying intensity that contribute to a sense of instability.

There is no one known cause for substance use disorders

Often, a combination of issues can contribute to the development of the problem including early first use, genetics, environment, and a co-occurring mental health disorder.

No matter what the drug of choice, chronic use and abuse can lead to physical and psychological dependence as well as an inability to quit without professional treatment. Though many turn to drugs and alcohol in an attempt to deal with high levels of stress or other uncomfortable emotions, the result is usually an even longer list of problems. Relationship difficulties, a hard time getting or maintaining employment, and health problems – as long as compulsive use of drugs and alcohol is a driving force, it is difficult to find balance.


Whether or not PTSD results, trauma is very often connected to substance use and abuse. Though no causal relationship has been shown, it is clear that the experience of trauma can be one of the issues underlying or related to drug and alcohol abuse.

Why? Consider the symptoms associated with PTSD – the emotions experienced after sexual or physical abuse, living through a natural disaster or a terrorist attack, seeing others succumb to the same, and living through war. The desire to escape these memories is understandable, and many mistakenly believe that they will be able to accomplish this feat by drinking or using drugs.


Healthfully managing triggers – both the triggers caused by PTSD and the triggers to drink or get high – is the primary challenge in recovery from both disorders.

For everyone, the best coping mechanisms may vary and depend upon:

  • The specifics of the traumatic event
  • The type and intensity of PTSD symptoms experienced
  • The drug of choice and the context in which it was used as well as withdrawal symptoms experienced, if any
  • Whether or not family members also struggle with substance abuse or co-occurring mental health disorders
  • Previous treatment efforts for either disorder

No matter what the specifics are, intensive treatment for both disorders that emphasizes healthy lifestyle choices and relapse prevention can be successful in helping the individual to build a balanced life in recovery.

Treatment for Co-occurring Disorders

When both PTSD and a substance use disorder are diagnosed, early intervention is recommended as is the comprehensive care mentioned above. Though each person’s experience is different and will require a unique treatment plan, in general, treatment for the co-occurring disorders of substance abuse or addiction and PTSD may include:

  • Stabilization: It is not uncommon for someone struggling with addiction to enter treatment via the emergency room. Overdose is a loud wakeup call for many who did not yet recognize the need for treatment. When PTSD is part of the puzzle, the emergency room visit may be precipitated by a mental health episode as well. In these cases, medical and/or psychiatric stabilization may be the first step in treatment.
  • Medical detox: For those who are addicted to substances that trigger withdrawal symptoms, the detox period may be focused on ensuring medical safety. Round-the-clock monitoring is recommended to address any complications swiftly and to prevent relapse in the first few days.
  • Therapeutic treatment: One-on-one therapy, family therapy, group therapy, alternative therapies, and holistic therapies will make up the bulk of the treatment schedule.
  • Relapse prevention: Identifying triggers for both PTSD and the substance abuse issue, and then creating an actionable plan to minimize or handle them positively, is key to long-term success in recovery.
  • Family support: Assisting the family in understanding the nature of both disorders and preparing them for what to expect through treatment and beyond, as well as connecting them with support services, can significantly improve the outcome for the client as well.
  • Aftercare: Long-term engagement with ongoing mental health treatment for PTSD and addiction, as well as continued connection with peers in recovery, can help clients to continue living without relapse as they build new lives for themselves.

How to Properly Address PTSD & Addiction

Learn About Treating Co-Occurring Disorders

About The Contributor

Editorial Staff
Editorial Staff

Editorial Staff, American Addiction Centers

The editorial staff of Sunrise House is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More

Have you lost control of your substance use?

Traveling for healthcare & essential services is permitted across the US. Addiction treatment is essential, and we are here for our patients in this difficult time.

Learn more