Alcohol and Substance Abuse in PTSD
Some people try to cope with their posttraumatic stress disorder (PTSD) symptoms by drinking heavily, using drugs, or smoking too much. People with PTSD have more problems with drugs and alcohol both before and after developing PTSD. Even if you do not have a problem with alcohol before a traumatic event, if you have PTSD you are at increased risk for developing a drinking or drug problem.
Eventually, the overuse of drugs or alcohol can develop into substance use disorder (SUD). Treatment should be given for both PTSD and SUD to lead to successful recovery. The good news is that treatment works if you have PTSD and SUD happening at the same time (co-occurring).
PTSD and SUD in Veterans
There is a strong link between co-occurring PTSD and SUD. This is true in both civilian and military populations, as well as for both men and women.
The following is true for Veterans:
Almost a quarter of Veterans with PTSD also have SUD.
War Veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to bad memories of combat trauma.
Almost 1 out of every 3 Veterans getting treatment for SUD also has PTSD.
The number of Veterans who smoke is almost double for those with PTSD versus those without a PTSD diagnosis.
In the wars in Iraq and Afghanistan, about 1 in 10 returning soldiers seen in VA have a problem with drinking or other drugs.
Those who have both PTSD and SUD likely also have the following:
Health problems, such as physical pain
Relationship problems with family and friends
Problems with daily functioning, such as keeping a job or staying in school
Using drugs and alcohol can make PTSD symptoms worse. For example, you may experience the following:
Sleep problems. PTSD may make you have trouble falling asleep or waking up during the night. You might "medicate" yourself with alcohol or drugs because you think it helps your sleep. But drugs and alcohol change the quality of your sleep and make you feel less refreshed.
Feeling numb. PTSD makes you feel "numb," like being cut off from others, angry and irritable, or depressed. It also makes you feel like you are always on guard. All of these feelings can get worse when you use drugs and alcohol.
Avoidance. Drug and alcohol use allows you to continue the cycle of “avoidance” found in PTSD. Avoiding bad memories and dreams or people and places can actually make PTSD last longer. You can’t get better in treatment if you avoid your problems.
Distraction. You may drink or use drugs because it distracts you from your problems for a short time, but drugs and alcohol make it harder to concentrate, be productive, and enjoy all parts of your life.
VA has made it easier to get help. It is important to know that treatment can help and you are not alone.
Treating both PTSD and SUD
In general, your symptoms of PTSD and SUD can get better when the treatment addresses both conditions. This can involve any of the following either alone or together:
Talk with your healthcare provider about treatment for specific symptoms like pain, anger, or sleep problems.
When to seek treatment
The first step is to talk with a healthcare provider and ask for more information about treatment options. Each VA Medical Center has an SUD-PTSD Specialist trained in treating both conditions to reach the best health outcomes. If there are signs you are at risk for both conditions, you will be encouraged to talk with a healthcare provider about how to best support your recovery. VA wants you to have the best possible care for co-occurring PTSD and SUD.
If you continue to be troubled or distracted by your experiences for more than 3 months or have questions about your drinking or drug use, learn more about treatment options. Life can be better. Talk to a VA or other healthcare provider to discuss choices for getting started.
For more information
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