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Alcohol & drug addiction with ptsd

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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?
That what definitely an article I needed to read today. I don’t feel so alone in my struggle with this issue. Thank you.
I highly recommend cannabis. It’s NOT addictive and allows me to be my old ‘normal’ self again. I am down to using it only when needed as opposed to every day. The advantages of using is the ability to think and contemplate without the angst normally associated with the anxiety/depression.
Chewin tobacco like a fiend!!!!! I read the article and understand it won’t work to curb anxiety but it keeps me off the meds which is a positive in my book.
That what definitely an article I needed to read today. I don’t feel so alone in my struggle with thi...
I was diagnosed 5 yrs ago it gets better I assure you. It'll always be apart of us but definitely dies down.
My PTSD began at the tender age of 6. It was initially sexual abuse by my older brothers best friend. The first way I hid from the emotions it caused was complete and total dissociation. It was my own brain’s way of protecting itself from what it was too immature to handle. The abuse continued for years, as did the dissociation. At the age of 16, I began to realize that my memories were facts, and immediately began smoking pot. That quickly ceased to be enough and progressed to every drug I ever encountered. I’ve been treated like an immoral, anti-social, animalistic creature for as long as I can remember. Over the last 10 years, I’ve sought therapy, and have been given medications that were valid for me, yet not accepted by society as something that anyone truly needs. I want everyone who has judged me to have to be me for just one day. Just one. It’s a daily battle and I am doing my very best to live as well as I possibly can. I’m on less medications than I ever have been on before. It isn’t easy by any means, but it is better. I just get angry about the people that thought it was a good idea to kick me while I was down. I appreciate this article and I’m interested in the types of therapy it has introduced me to. Thank you
I am in complete agreement with Just Another Survivor. My parents were victims of WW2 and so had PTSD. As if being raised by them wasn’t traumatic enough, I was in a serious car accident at age 2 that involved head injury. 3 sibs have committed suicide which gives some indication of the tremendous unconscious stresses in the family. Marijuana is a wonderful comfort (though difficult to get hold of due to the current illegal status in so many countries) and, when I have a smoke (rare now), anger is damped down so that I can see more clearly through the clouds. I’m not even allowed to grow my own! Isn’t this abusive?!
I highly recommend cannabis. It’s NOT addictive and allows me to be my old ‘normal’ self again. I am...
Cannabis is addictive. I was addicted to it for 4 years. I smoked all day everyday and ensured I didn’t run out. I felt it helped me cope when in turn I realize now it numbed my emotions, got me out of my own head. It helped me ignore my traumas and prolong the start of my recovery.
I highly recommend cannabis. It’s NOT addictive and allows me to be my old ‘normal’ self again. I am...
“I highly recommend cannabis.”

I think that is a highly troublesome recommendation, to be honest, and maybe should be clarified whether grown or pharmaceutical grade is being recommended.

Grown has vast issues, pharmaceutical grade has removed the nasties, for the most part, just leaving the relaxation aspect.
I think drugs, and which drugs are a tricky subject when it comes to PTSD. I think there are a few considerations:

1. What behavior is the substance substituting for? For example, it might be better to use drugs to regulate emotions if the alternative is suicide. Likewise, one drug can substitute for a more life destroying drug (e.g. methodone in place of heroin)
2. Do the drugs have any positive effects? Even “drugs of abuse” show some potential in treating PTSD. For example, there are studies on Ecstasy (http://www.maps.org/research-archive/publications/Oehen_2012_MDMA_PTSD_Swisstudy.pdf) or Ketamine (Link Removed) Maybe if you’re treatment resistant, these could be something to try.

Personally, I found Kratom (https://en.wikipedia.org/wiki/Mitragyna_speciosa) helpful in my recovery. I’m an ex-addict as well as someone with the occasional tendency towards suicidal behavior. On the increasingly rare occasion I have intense suicidal urges or urges to relapse onto a more harmful drug, it can boost my mood enough to refocus on something more productive. And I haven’t found it to be habit forming. But everything affects everyone differently so I think it’s really an individual choice. I personally gravitated away from alcohol and marijuana because I found both to be severely judgment impairing, and caffeine because it disrupts sleep too much. Conventional psych meds caused me too many side effects for too little benefit, and many are easily used in suicide. But anyway, long story short, I think the problem is a lot more complicated than “don’t abuse drugs”.
MMJ saved me from complete and utter destruction caused by PtS and MDD. Mary Jane can be addictive to approximately 14% of users and happy to say I’m not one of them. However, alcohol is the Devils Beast in liquid form. I never responded to a call for service dealing with an out of control Marijuana users…it was either hard drugs or the Devils Water. I will agree whatever a persons drug of choice is, over time, we all need to confront our issues without relying upon any drug to live for a better day.
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