Substance Use Disorders and Co-Occurring PTSD

Substance Use Disorders and PTSD commonly co-occur. People with trauma may turn to substances in an attempt to forget or dull emotions. Additionally, during a traumatic event, the body is flooded with endorphins to help numb the emotional and/or physical pain. Once the event is over, people may experience endorphin withdrawal, which mirrors symptoms of withdrawal from alcohol and drugs. Some researchers think endorphin withdrawal may lead people to use substances in order to increase endorphin activity.

PTSD Facts

PTSD is a disorder that some people develop after witnessing or experiencing a dangerous, violent or traumatic event. People with PTSD experience intense and disturbing reminders of the experience long after it has ended. This may include flashbacks, nightmares, fear, and strong negative reactions to things that remind them of the event. Not everyone who experiences a trauma will develop PTSD. About 7 or 8 out of every 100 people will have PTSD at some point in their lives. Certain factors, such as genes and the type of trauma, influence whether or not a person develops PTSD.

PTSD Symptoms

When people experience a trauma, there is typically a “fight or flight” reaction meant to protect that person from harm. Most people will have a broad range of difficult emotions after experiencing a traumatic event. Those who continue to struggle for a longer period may be diagnosed with PTSD. Some of the symptoms of PTSD are: -Intrusive thoughts. People who have PTSD may experience involuntary flashbacks or memories, or disturbing dreams. Some of these phenomena may be so vivid as to feel like the event is taking place before the person’s eyes. -Avoiding reminders of the traumatic experience. People may avoid people, places and things that remind them of the event. They may also refuse to talk about the event to try to avoid stirring up upsetting feelings. -Persistent fear, anger, guilt or shame. -Reactivity. This may include being easily startled, quick to anger, prone to self-destructiveness or unable to focus.


A study between 2001 and 2003 found that the lifetime prevalence of PTSD in US adults was 6.8%. 30.2% of those with PTSD had mild symptoms, 33.1% moderate, and 36.6% serious. After accounting for exposure to a trauma, it’s been found that PTSD is 30% heritable.


Acute Stress Disorder (ASD)

Acute Stress Disorder is technically not PTSD, but a related condition. Acute Stress Disorder is when a person has many of the symptoms of PTSD shortly after experiencing a trauma. The diagnosis was created as a way to identify people who might not recover over time—people who had a higher risk of developing PTSD. A particular focus was on whether people had a dissociative response to the event. This could affect their ability to healthily process the emotions, putting them at higher risk of developing PTSD.

Uncomplicated PTSD

Uncomplicated PTSD is when a person experiences PTSD symptoms like flashbacks of the traumatic event, but with no symptoms of a co-morbid mental health disorder.

Co-Morbid PTSD 

80% of people who have PTSD have at least one co-occurring mental health disorder. The most common co-occurring disorders are Depression, Substance Use Disorders, and other Anxiety Disorders. 

Complex PTSD

While in some cases, a traumatic event is singular, things like abuse can last for months or years. Complex PTSD is a response to long-term or repeated trauma. People with Complex PTSD typically have some or all of the symptoms, with additional symptoms, including:  -Lack of emotional regulation, such as explosive anger  -Dissociation  -Low self-worth, guilt, or shame  -Distrust of others  -Loss of systems of meaning, such as religion or other beliefs about the world  -A strong sense of despair or hopelessness about the world


Nearly half of people seeking treatment for a Substance Use Disorder have symptoms of PTSD. One study found a genetic link between PTSD and Substance Use Disorders. However, this could be due to common genetic risk for exposure to a traumatic event. People with co-occurring PTSD report stronger cravings for drugs and alcohol.


Treatment for PTSD can be a combination of medication and therapy. The therapy used to treat PTSD is typically some type of Cognitive Behavioral Therapy. The idea is to work to change the disturbing thought patterns. People with PTSD may undergo Prolonged Exposure Therapy, where they will gradually confront the feelings they’ve been avoiding since the trauma. It is important to treat the Substance Use Disorder and PTSD together, as they greatly impact one another. Individuals with co-occurring PTSD are more likely to relapse after treatment, meaning their recovery program should include an aftercare and relapse prevention plan.

There is Help Available

If you are struggling with a Substance Use Disorder, co-occurring PTSD or another mental health disorder, Amatus Recovery Centers is here for you. We use trauma-informed therapy to help you heal wounds from your past and build a fulfilling future. We will also work with you on an intensive and individualized aftercare and relapse prevention plan. You can thrive in long-term recovery; we will help you get there. To find out more, call an admissions specialist at 410-593-0005.


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