Post-traumatic stress disorder, or PTSD for short, is a serious mental health disorder that can develop after a person experiences or witnesses a traumatic event. While living with PTSD alone can be challenging, it is also a major contributor to substance use disorders (SUD), as many people turn to drugs or alcohol to manage the distress and emotional pain brought on by PTSD. This combination can complicate both disorders, requiring an integrated treatment approach.
Co-occurring PTSD and substance use disorders often reinforce each other in increasingly harmful ways. That’s why understanding the nature of PTSD, including its causes and symptoms, is an important first step toward treatment and recovery.
If you or a loved one is struggling with PTSD and addiction, Empowered Recovery Center can help. Our Atlanta drug and alcohol rehab provides specialized treatment to address co-occurring PTSD and substance abuse together.
What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health disorder that sometimes develops after a person experiences or witnesses a traumatic event. These events include natural disasters, serious accidents, acts of violence, and personal assaults.
People living with PTSD experience symptoms such as flashbacks, nightmares, negative changes in mood, and intrusive thoughts about the traumatic event. These symptoms can start soon after the event or they may not occur for months or even years after. Fortunately, PTSD is a treatable mental health disorder.1,2
PTSD is not limited to just one type of trauma, and what is traumatic for one person may not be traumatic for another. While it is common to feel anxious or sad following a stressful experience, PTSD symptoms do not fade with time but rather persist and sometimes worsen.1
Types of PTSD
Different types of PTSD are based on specific symptoms as well as the timing and intensity of symptoms. They can often require different treatment methods. Types of PTSD include:
- Acute stress disorder. Acute stress disorder is a short-term mental health disorder that can occur within the first month after experiencing a traumatic event. If symptoms persist for more than a month, a PTSD diagnosis can follow.3
- Uncomplicated PTSD. This type of PTSD is linked to a single traumatic event rather than multiple events. Uncomplicated PTSD is characterized by the avoidance of trauma “triggers,” nightmares, flashbacks, and mood changes.4
- Complex PTSD (CPTSD). Separate from PTSD, complex PTSD usually has some of the symptoms of PTSD but also includes personality changes experienced following the traumatic event. Feelings of worthlessness and hopelessness, difficulty controlling emotions, and suicidal thoughts can all occur with complex PTSD.3
- Comorbid PTSD. Comorbid PTSD is PTSD plus a co-occurring mental health disorder, such as a mood disorder or anxiety disorder. Unfortunately, comorbid PTSD is common, particularly comorbid PTSD and addiction.3
- Delayed-onset PTSD. While PTSD tends to develop within the first six months after experiencing trauma, symptoms of delayed-onset PTSD can occur well past the six-month mark. Delayed-onset PTSD makes up fewer than one in five cases.5
- Secondary trauma. Secondary trauma occurs when someone is supporting or living with a person who has experienced trauma. While the event may have happened to another person, the impact of the event becomes traumatic for that second person. This mental health disorder can occur with the witnessing or learning of traumatic events as part of a job, such as those in the medical profession.6
Symptoms of PTSD
PTSD symptoms generally fall into four specific types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Of course, these symptoms vary over time and from person to person. PTSD symptoms include:2
Intrusive memories
- Distressing memories of the traumatic event occur over and over
- Reliving the traumatic event as if it were happening anew, also known as a “flashback”
- Nightmares about the traumatic event
- Severe emotional distress or physical reactions to something that reminds one of the traumatic event or events
Avoidance
- Not wanting to think or talk about the traumatic event
- Staying away from places, activities, or people that remind one of the traumatic event or events
Negative changes in thinking and mood
- Negative thoughts about oneself, other people, or the world
- Ongoing negative emotions of fear, blame, guilt, or shame
- Memory problems, including not remembering the important aspects of a traumatic event
- Detachment from family or friends
- Lack of interest in activities once considered enjoyable
- Difficulty or inability to feel positive emotions
- Feeling emotionally “numb”
Changes in physical and emotional reactions
- Being easily startled
- Always feeling on guard against danger
- Self-destructive behavior, such as binge drinking or driving too fast
- Lack of sleep
- Difficulty concentrating
- Irritability, angry outbursts, or aggressive behavior
- Physical reactions (sweating, rapid breathing, fast heartbeat, shaking)
Is There a Connection Between PTSD & Substance Use?
Is There a Connection Between PTSD & Substance Use?
SUDs, including alcohol use disorder (AUD), are a common comorbidity of PTSD.3 Epidemiological data indicates that approximately 30 percent of the U.S. population will experience SUD and 8 percent will experience PTSD during their lifetime, and that PTSD co-occurs with SUD among roughly 40 percent of civilians and veterans. People with co-occurring SUD and PTSD incur greater risk for other mental health problems like depression, anxiety, suicidality, neuropsychological impairment, increased morbidity and mortality, and unemployment.7
One of the more common explanations for the prevalence of co-occurring PTSD and SUD involves self-medication, that is, people living with PTSD will turn to drugs and alcohol as a way of finding relief from the more distressing symptoms of their PTSD. While substance use may provide temporary relief, PTSD symptoms always return, inciting more frequent substance use, leading eventually to tolerance and addiction.7
Does Substance Use Affect PTSD Treatment?
Yes, substance use affects the treatment of PTSD. People with co-occurring PTSD and SUD typically have a more complicated course of treatment compared to people with either disorder by itself.3 The main reason for this is the overlap of PTSD and SUD symptoms, such as:2,8
- Detachment from family and friends
- Lack of interest in activities that were once enjoyed
- Difficulty concentrating
- Memory problems
- Issues fulfilling duties at work or school
- Irritability or aggressive behavior
Treating PTSD & Addiction Simultaneously
It is possible to receive treatment for PTSD and addiction simultaneously. In fact, many addiction treatment programs specialize in what’s called dual diagnosis treatment, which addresses both the PTSD and the co-occurring SUD together. Dual diagnosis treatment recognizes and prepares for how these two disorders can feed into and influence each other.9
Dual diagnosis treatment is recommended for people with the co-occurring disorders of PTSD and SUD. This is because treating only one condition while neglecting the other can increase the risk of relapse or lead to a decline in the patient’s overall mental health.9
One popular treatment approach for PTSD is exposure therapy, which helps break the patient’s cycle of avoidance and anxiety and fosters emotional resilience, rendering their need to self-medicate with drugs and alcohol ineffective.10
How is PTSD & Addiction Treated?
Treating both PTSD and addiction can happen in several different settings, but it traditionally begins with medically supervised detox. Detox is the process of getting rid of harmful substances from the body while managing any symptoms that come with substance withdrawal. It is best done in a safe and controlled environment. Prescription medications are sometimes issued to help ease the patient’s more uncomfortable symptoms of withdrawal. This approach is called medication-assisted treatment, or MAT for short.
Once detox is complete, the patient continues with a dual-diagnosis treatment plan to help them stay sober and address their PTSD symptoms. This treatment can take place in a residential setting or outpatient setting, depending on the severity of the patient’s disorders. Partial hospitalization (PHP), intensive outpatient programs (IOP), outpatient care (OP), and ongoing aftercare are all viable options for those living with both PTSD and addiction. The most effective treatment path depends on the patient’s needs, their health background, and their personal situation.
No matter the level of care, most programs involve some combination of addiction therapies, counseling, and group support. These services help people learn coping skills and strategies to manage the triggers that could lead them back to substance use. In recovery, a trigger is anything that sparks the urge to use again, such as an event, feeling, or memory.
In addition to traditional treatments, Empowered Recovery Center in Atlanta incorporates holistic practices to support and enhance recovery.
Medication Used to Treat PTSD
PTSD treatment usually involves regular psychotherapy and the issuance of prescription medications. These medications play a pivotal role in stabilizing the patient and managing their symptoms. Of course, each patient varies in their response and ability to tolerate a certain dosage, so medications must be tailored to meet the patient’s individual needs. Medications used to treat PTSD include:11
- Sertraline, also known by the brand name Zoloft, is a type of antidepressant called a Selective Serotonin Reuptake Inhibitor (SSRI). It works by increasing serotonin levels in the brain, which regulate mood. It has been approved by the U.S. Food and Drug Administration for the treatment of PTSD.
- Paroxetine, also known by its brand name Paxil, is another SSRI that has been FDA-approved for treating PTSD symptoms.
- Fluoxetine, also known as Prozac, is an SSRI that can be prescribed as a first-line medication for the treatment of PTSD symptoms, though it has not been specifically approved by the FDA for this purpose.
- Anti-anxiety medicines can ease severe anxiety and related problems that come with PTSD. Generally, anti-anxiety medicines are prescribed only for a short time, as they can be misused.12
- Anticonvulsant medication Topiramate has undergone investigation recently as a potential treatment for PTSD. It has yet to be approved by the FDA for this use, however. Recent studies of Topiramate have shown promise in reducing specific PTSD symptoms like avoidance, but other recent studies have shown mixed results.13
Treating Co-Occurring PTSD & Addiction in Atlanta
If you are struggling with PTSD or addiction, you don’t have to face it alone. Empowered Recovery Center in Atlanta can help. At Empowered Recovery Center, we can help you take back control and build a life free of substance abuse and negative coping. Our rehab programs are designed to support you every step of the way.
If you are concerned about paying for rehab or have questions about using insurance to pay for rehab, we’re here to help. Our rehab admissions team can work with you over the phone or online to verify your insurance. And we accept most major health plans and can even work with out-of-network providers to ensure you get the treatment you need.
We know that one size does not necessarily fit all when it comes to recovery, which is why we offer flexible treatment options. Plus, when you complete a program with us, you’ll receive one year of free recovery coaching to help keep you on track.
If you’re ready to start working toward positive change in your life, reach out to us today.
References
- National Institute of Mental Health (2024). Traumatic Events and Post-Traumatic Stress Disorder (PTSD). National Institutes of Health. Retrieved June 16, 2025, from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
- Mayo Clinic (2024). Post-Traumatic stress disorder (PTSD). Mayo Foundation for Medical Education and Research. Retrieved June 16, 2025, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
- Cleveland Clinic (2023). PTSD (Post-Traumatic Stress Disorder). Cleveland Clinic’s Health Library. Retrieved June 16, 2025, from https://my.clevelandclinic.org/health/diseases/9545-post-traumatic-stress-disorder-ptsd
- U.S. National Library of Medicine (1998). Comorbidity and course of psychiatric disorders in a community sample of former prisoners of war. National Institutes of Health. Retrieved June 16, 2025, from https://pubmed.ncbi.nlm.nih.gov/9842785/
- U.S. National Library of Medicine (2021). Neurobiological mechanisms underlying delayed expression of posttraumatic stress disorder: A scoping review. National Institutes of Health. Retrieved June 16, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC8783158/
- National Child Traumatic Stress Network (n.d.) Secondary Traumatic Stress. Substance Abuse and Mental Health Services Administration (SAMHSA) and the UCLA-Duke University National Center for Child Traumatic Stress (NCCTS). Retrieved June 17, 2025, from https://www.nctsn.org/trauma-informed-care/secondary-traumatic-stress
- U.S. National Library of Medicine (2017). Concurrent Treatment of Substance Use and PTSD. National Institutes of Health. Retrieved June 17, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC4928573/
- Cleveland Clinic (2024). Substance Use Disorder (SUD). Cleveland Clinic’s Health Library. Retrieved June 17, 2025, from https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud
- Cleveland Clinic (2022). Dual Diagnosis. Cleveland Clinic’s Health Library. Retrieved June 17, 2025, from https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis
- Harvard Health Publishing (2024). Exposure therapy: What is it and how can it help? Harvard Medical School. Retrieved June 17, 2025, from https://www.health.harvard.edu/mind-and-mood/exposure-therapy-what-is-it-and-how-can-it-help
- American Psychological Association (2017). Medications for PTSD. American Psychological Association. Retrieved June 18, 2025, from https://www.apa.org/ptsd-guideline/treatments/medications
- Mayo Clinic (2024). Post-traumatic stress disorder (PTSD). Mayo Foundation for Medical Education and Research. Retrieved June 18, 2025, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973
- U.S. National Library of Medicine (2006). Topiramate as a Therapy for Chronic Posttraumatic Stress Disorder. National Institutes of Health. Retrieved June 18, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC2990556/
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