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Behavioral Health FAQs
Table of Contents
- What Is PTSD?
- Why PTSD and Substance Abuse Occur Together
- Which Substances Are Most Commonly Used to Self-Medicate PTSD?
- Signs That PTSD and Substance Abuse Are Co-Occurring
- Why Standard Addiction Treatment Fails for PTSD
- Trauma-Informed Dual Diagnosis Treatment at iRely Recovery
- Recovery Is Possible With the Right Treatment
Key Points
- PTSD affects approximately 7-8% of the U.S. population over a lifetime, but among people in addiction treatment, rates range from 30% to as high as 60%.
- The self-medication pathway is central: alcohol numbs emotional flooding, opioids create distance from distressing memories, and benzodiazepines reduce panic — each provides short-term relief while worsening PTSD over time.
- PTSD symptoms emerging in early sobriety — nightmares, flashbacks, hyperarousal — are powerful relapse triggers; without trauma-informed care, returning to substances is a predictable survival response.
- Integrated, simultaneous treatment of PTSD and substance use produces better outcomes than treating either condition first; sequential approaches consistently underperform.
- iRely Recovery's clinical team is trained in Trauma-Focused CBT, Somatic Experiencing, and EMDR — three evidence-based modalities for PTSD that integrate with addiction treatment.
- Trauma processing therapy is introduced gradually with careful clinical judgment about timing — the priority in early recovery is stabilization, safety, and coping skill development first.
Trauma leaves marks that do not always fade with time. For many survivors of abuse, combat, accidents, or assault, those marks show up years later as post-traumatic stress disorder, and alongside it, a substance use disorder that developed as an attempt to survive unbearable symptoms.
The co-occurrence of PTSD and addiction is one of the most recognized patterns in addiction medicine. This guide explains why they occur together, how each condition worsens the other, and what effective dual diagnosis treatment looks like.
What Is PTSD?
Post-traumatic stress disorder is a psychiatric condition that develops after exposure to traumatic events. Core symptoms include intrusive re-experiencing (flashbacks, nightmares), avoidance behaviors, negative mood and cognitions, and hyperarousal (hypervigilance, insomnia, irritability).
PTSD affects approximately 7-8% of the U.S. population over a lifetime. Among people in addiction treatment, estimates range from 30% to as high as 60% depending on the population and substances involved.
Why PTSD and Substance Abuse Occur Together
The Self-Medication Pathway
Living with untreated PTSD is extraordinarily difficult. The intrusive memories, nightmares, emotional flooding, and hypervigilance create a constant state of internal crisis. For many trauma survivors, substances become the most available and fastest-acting form of relief.
Alcohol numbs the emotional flooding. Opioids create distance from distressing memories. Benzodiazepines reduce the panic underlying hypervigilance. In each case, the substance provides short-term relief while making the underlying condition worse over time.
This self-medication pattern is closely associated with alcohol use disorder, particularly among veterans and survivors of interpersonal trauma.
How Substance Abuse Increases PTSD Vulnerability
Substance use also increases exposure to traumatic events and reduces the emotional resources available to process trauma when it occurs.
Which Substances Are Most Commonly Used to Self-Medicate PTSD?
Alcohol is the most commonly used substance for PTSD self-medication, particularly among veterans. Opioids are used to create emotional distance and physical numbness and are strongly associated with trauma histories. Cannabis is used to manage hyperarousal and intrusive thoughts. Benzodiazepines are effective at reducing acute anxiety but are associated with dependence and worsened cognitive function.
Signs That PTSD and Substance Abuse Are Co-Occurring
Using substances specifically before sleep to manage nightmares or night terrors. Avoiding sober states because they bring unbearable emotional experiences. History of trauma that predates the onset of substance use. Relapse consistently triggered by trauma reminders or anniversaries. Previous addiction treatment attempts that did not address trauma history.
Why Standard Addiction Treatment Fails for PTSD
Many standard addiction treatment programs do not screen for or adequately treat PTSD. Symptoms emerging during early sobriety, such as nightmares and flashbacks, are powerful relapse triggers. Without clinical support for these symptoms, returning to substances is a predictable survival response.
Trauma-Informed Dual Diagnosis Treatment at iRely Recovery
At iRely Recovery in Los Angeles, trauma-informed care is integrated throughout every program. We understand that many clients have carried the weight of trauma for years and that their substance use has been, in many cases, the only thing that made that weight bearable.
Evidence-Based Trauma Therapies
Our clinical team is trained in Trauma-Focused CBT, which addresses the distorted thoughts and avoidance behaviors that perpetuate both PTSD and addiction.
We also offer Somatic Experiencing, a body-based approach that addresses the physiological components of trauma stored in the nervous system.
EMDR (Eye Movement Desensitization and Reprocessing) is available for appropriate clients and has strong evidence for PTSD treatment.
Integrated Psychiatric Support
Clients with significant PTSD symptoms may benefit from psychiatric medication support. Our consulting psychiatrist is experienced in trauma-specific medications and coordinates closely with the clinical team throughout medical detox and residential treatment.
Recovery Is Possible With the Right Treatment
PTSD and substance abuse are both treatable conditions. When treated together with integrated, evidence-based care, outcomes are significantly better than when either condition is treated alone.
If you or someone you love is dealing with both trauma and addiction, iRely Recovery in Los Angeles is here to help. Call us at (818) 262-3537 or visit our admissions page to learn about our program.
Frequently Asked Questions
Below are some of the most frequently asked questions regarding these two medications.
Sources
[1] National Institute on Drug Abuse. Common Comorbidities with Substance Use Disorders. NIDA Common Comorbidities
[2] Substance Abuse and Mental Health Services Administration. Co-Occurring Disorders. SAMHSA Co-Occurring Disorders
[3] American Society of Addiction Medicine. The ASAM Criteria. https://www.asam.org/asam-criteria
[4] National Institute on Drug Abuse. Treatment and Recovery. NIDA Treatment and Recovery
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