Is PTSD Contributing to Your Substance Abuse?

The Recovery Village RidgefieldCo-Occurring Disorders

There is little doubt that there is a correlation between Post Traumatic Stress Disorder (PSTD) and alcohol abuse. The chart below puts the relationship into perspective. More than twice as many men with PTSD also reportedly dealt with alcohol abuse problems that men without PTSD. For women, those with PTSD reported alcohol abuse or dependence nearly three times that of women without PTSD. Alcohol abuse Similarly, nearly 35 percent of men and 27 percent of women with PTSD also experienced drug abuse or dependency problems.

What Is the Relationship?

This is a much more difficult question to answer than whether or not a relationship exists. Researchers disagree as much as philosophers debate “Which came first, the chicken of the egg?” Does one precede the other? Does one contribute to the other? It does not take a rocket scientist to understand that the likelihood that the onset of PTSD and substance abuse occur simultaneously is infinitesimal. There are four major working theories. They are:
  • High-Risk Theory
    • The high-risk theory states that drug and alcohol problems occur before PTSD develops.
    • Proponents of this model believe that the use of alcohol and drugs puts people at greater risk for experiencing traumatic events, and therefore, at greater risk for developing PTSD.
  • Self-Medication Theory
    • The self-medication theory states that people with PTSD use substances as a way of reducing distress tied to particular PTSD symptoms.
  • Susceptibility Theory
    • The susceptibility theory suggests that there is something about alcohol and drug use that may increase a person’s risk for developing PTSD symptoms after experiencing a traumatic event.
  • Shared Vulnerability Theory
    • This theory states that some people may have a genetic vulnerability that increases the likelihood that they will develop both PTSD and substance abuse problems following a traumatic event.
Regardless of which, if any, of these theories proves to be true, the bottom line is that research indicates a link between addiction and PTSD. Substance abuse

What Does Therapy Reveal?

The traditional approach to treating PTSD and substance abuse or dependency has been to treat the addiction problem first, then move on to dealing with the PTSD. This method approaches the situation with the assumption that it is not possible to deal with the trauma problem while the client is under the influence of alcohol or drugs. While that makes sense to some extent, it fails to recognize that the issues are intertwined or to determine the order in which the issues occurred. Medical science constantly deals with cause and effect. Medications that diminish symptoms (the effects), such as pain, do not treat the underlying problem that is causing the pain. Healing does not occur until the underlying problem is corrected or removed. In the case of physical illness, for example, the general rule of thumb is that physicians will do what they can to relieve symptoms while working to diagnose and treat the actual problem. This is known as integrated treatment, and it works for mental as well as physical illnesses. Substance abuse

Dual-Diagnosis Integrated Treatment

The International Society for Traumatic Stress Studies (ISTSS) recommends integrative treatment for the dual diagnosis of PSTD and substance use disorders. The recommendation is based, in part, on a study by the National Institute of Health (NIH), as well as other studies that have generated similar data. In the NIH study, more than 350 women with PTSD and substance abuse problems were divided into two treatment groups. One group received substance abuse therapy. The other received integrated therapy. After the year-long study, the first group showed progress with substance abuse, but little to none with PTSD. The integrated treatment group saw a significant decrease in both their trauma symptoms and their substance abuse symptoms. The report concluded that “We contend that the most effective treatment models are those that address PTSD before substance use or simultaneously. We propose this course of treatment, in contrast to treatment commonly offered in substance abuse treatment settings that lack a trauma-focus, especially because of the high prevalence rates of trauma histories and PTSD among such patients.”

The Evidence-Based Conclusion

The conclusion of the NIH report indicates that the answer to the title question is, “Yes.” If you have both PTSD and a substance abuse problem, the PTSD is probably contributing to the substance abuse problem. If you are one of the many mired in trauma and substance abuse, contact us now. We are able to provide the integrated treatment that can free you at last.
Is PTSD Contributing to Your Substance Abuse?
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