Substance abuse is always almost preceded by an underlying, deeper problem within individuals. Post traumatic stress disorder contributes immensely as such an underlying problem, pushing sufferers to turn to substances–whether legal or illegal–as a means to escape from themselves and lessen the intensity of symptoms.

Let’s call it what it is: self-medication.

Alcohol is an excellent example of a popular substance among PTSD sufferers, and endorphins are a major culprit in this trend. Endorphins are released upon enduring a traumatic event, and their function is to assist in numbing physical and mental pain. As endorphin levels decrease to normal, drinking alcohol increases endorphins, so the pain is once again muted.

Drugs come in three primary categories–pharmaceutical, psychoactive (alcohol, nicotine and caffeine) and recreational drugs (hallucinogens, opiates and amphetamines). Some are the lesser evil; most will do considerable damage, especially when abused. You may feel good in the short term, but the long term consequences have proven statistical problems, often worsening your own situation and health.

The majority of those diagnosed with PTSD will have a Substance Use Disorder (SUD) or lesser addiction (coffee or nicotine).

This isn’t anything new for those who have PTSD. Chances are that at some point prior to diagnosis or after, you became addicted to something within the three primary categories.

The National Center for PTSD states: “Women who go through trauma have more risk for drinking problems. They are at risk for drinking problems even if they do not have PTSD. Both men and women who have been sexually abused have higher rates of alcohol and drug use problems than others.”

Up to three quarters of those who have survived abusive or violent trauma report drinking problems. Up to a third of those who survive traumatic accidents, illness, or disasters report drinking problems. 60-80% of Vietnam Veterans seeking PTSD treatment have alcohol abuse problems. Alcohol problems are more common for survivors who have ongoing health problems or pain.

A significant problem with all three categories of addiction is that they contain uppers and downers. In other words, some make you feel great while others cause outright depressive episodes. The majority of those diagnosed PTSD are also diagnosed with a depressive disorder.

Think about it simply–whether you’re addicted to uppers or downers, they all lead downwards for you. You may feel good from a drug; you then have withdrawal from that drug. That leads to continued use. Your body progressively becomes more tolerant of the drug. You either increase the dose or increase the intensity of drug choice to maintain the desired effect, self-titrating your use to continue the efficacy of the substance.

With every dose, your body strives further towards a withdrawal problem. You feel good (upper) and then feel bad (downer). It becomes a vicious cycle. You’re an addict who added another problem. Don’t feel bad. Again, the majority of those diagnosed with PTSD have some level of addiction at some point to help them cope with trauma symptoms.

Alcohol makes you depressed and can increase anger and potential for violence. Hallucinogens increase paranoia symptoms. Coffee and other drugs increase anxiety. All the while, a sufferer believes these drugs are helping them cope with their PTSD, and they may be doing that as a short-term goal to lessen symptom severity, but overall, every type of addiction is leading towards early health disease and conditions and likely death.

The simple truth is that addiction makes PTSD symptoms worse in the long-term.

Treatment for alcohol and drug abuse can vary significantly depending on the individual and addiction severity. It is common to treat the addiction first or in combination with PTSD treatment. There are residential facilities such as Serenity at Summit who offer detox and residential care services, therapies such as Cognitive Behavioural Therapy (CBT) and prolonged exposure (PE), which are geared towards dual treatment of PTSD and SUD.

Acceptance & Commitment Therapy (ACT) is a precise treatment for PTSD plus addiction, in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches to “just notice,” accept, and embrace private feelings and thoughts, especially previously unwanted ones.

A prominent treatment for treating PTSD with alcoholism is MDMA assisted psychotherapy. MAPS, the Multidiscipinary Association for Psychedelic Studies, have extensive research demonstrating approximately an 80% success rate, even for dual treatment–not the obvious treatment where hallucinogens are the addiction.

Lastly, there are pharmacological treatments to aid drug and alcohol withdrawal symptoms during detoxification, which can be dangerous for those hoping to quit powerful drugs ‘cold turkey.’ Obviously these require strict guidelines and dosage when treating an addict.

There is an example article for further reading: “The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction.” If alcohol is your primary concern, I highly recommend reading this scholarly article.

What’s your addiction? What are the positives and negatives of your addiction for yourself?