Co-occurring addiction and PTSD treatment
Many people suffering from PTSD are also suffering from addiction – which is why addiction and PTSD treatment are often done co-currently.
There are many factors which can pre-dispose people to substance abuse. One psychological condition frequently associated with alcoholism and drug abuse is post-traumatic stress disorder (PTSD).
What is PTSD?
PTSD is a condition of prolonged stress after an individual is involved with or witnesses a highly stressful event. Events which may lead to PTSD include:
- Military conflict
- Childhood Trauma
- Sexual assault
- Natural Disasters
- Other acute stressors
When such negative events occur, the individual is typically overwhelmed by fear, anxiety, powerlessness, and other negative emotions.
From a neurobiological perspective, the stressful event is not fully processed in the memory centres of the brain- the amygdala and hippocampus.
PTSD manifests in a range of symptoms which are divided into three categories:
1) Re-experiencing symptoms
- Negative thoughts and emotions related to the event
2) Avoidance Symptoms
- Avoiding people, places and situations which trigger memories of the event
- Emotional numbness
- Emotions such as worry, guilt, and depression
- Loss of interest in former activities
- Loss of memory about the event
3) Hyper-arousal symptoms
- Easily startled
- Agitation or “on edge”
- Angry or emotional outbursts
- Difficulty sleeping
Symptoms may occur for a short time, or for more longer, chronic periods. When these symptoms persist for just a few weeks, the condition is labelled Acute Stress Disorder. When a number of symptoms are present from each category for a longer period of time, along with other criteria, an individual is diagnosed with PTSD.
The good news? Post traumatic stress disorder treatment understanding and success has grown significantly in recent years.
Why do PTSD and Addiction Often Co-occur
The symptoms of PTSD have a significant negative effect on an individual’s ability to cope with life and its challenges. To compound these effects, those diagnosed with PTSD have an increased risk of substance abuse. In a literature review published in the American Journal of Psychiatry, it was found that 21-43% of those suffering from PTSD, were also suffering from the abuse of substances, compared to only 8-25% of the general population who also suffers from substance abuse disorder.
Why is this? Symptoms of PTSD make life challenging, as can be seen in research reporting increased risk of major depression and suicide in those who have PTSD. In order to manage the symptoms of PTSD, many turn to alcohol and drugs. Substance abuse provides a temporary numbing of painful symptoms, but unfortunately, substance abuse carries many harmful effects and is not an effective PTSD treatment.
Negative Effects of Substance Abuse for Individuals with PTSD
For those with PTSD, using drugs and alcohol does not resolve the traumatic symptoms. It merely numbs them. The symptoms remain present even though they may be masked by intoxication. In addition, as the PTSD-sufferer continues to use substances, his or her tolerance will grow, and will likely require more to keep negative symptoms at bay.
In addition, all types of substance abuse makes treating PTSD more challenging. Part of treatment is learning new ways to cope with stress, understanding how the past influences the present, and making conscious, healthy choices. Addiction interferes with the ability to implement these life changes.
Finally, substance abuse increases the risk of further trauma. When people are under the influence of various drugs and alcohol, they have an increased likelihood in engaging in risky behaviours that can result in accidents and violence.
Why is Addiction and PTSD Treatment Done Together?
When a person has PTSD and also suffers from addiction, quality of life, happiness, and health are significantly impacted. Given the high rate of co-occurrence of PTSD and alcoholism or other substance abuse, it is important to understand why addiction and PTSD treatment are often given simultaneously.
In the past, it was thought that addiction should be treated before PTSD. The logic was that the use of substances during PTSD treatment would make it harder to focus. As a result, clinicians used a sequential approach to treatment, first focusing on resolution of substance use.
However, it was found that treatment for substance abuse disorder was significantly less successful when patients were still suffering from PTSD. Patients treated for substance abuse had a high likelihood of relapsing before PTSD treatment could successfully be accomplished. As a result, clinicians shifted their focus to simultaneous treatment of both conditions.
Research is on-going concerning PTSD treatment of patients who are also dealing with addiction. Some clinicians continue to focus on first resolving substance abuse issues. Others focus on treatment of both disorders concurrently, while others have shifted to focus on PTSD treatment first, focusing on resolution of the condition which underlies addiction.
How is PTSD Treated with Addiction?
High-quality treatment programmes integrate several key components for effective addiction and PTSD treatment. These include cognitive-behavioural therapies, which focus on managing negative thoughts and emotions; mindfulness techniques, which focus on in-the-moment awareness of and management of stress, and modified “12-steps” programmes which focus on distinct stages and ways of thinking about recovery. These psychotherapeutic interventions are supported by group therapy, exercise programs, behavioural planning, and other healthy lifestyle choices.
The preceding programme components have been shown to successfully support recovery of both PTSD and addiction. In addition to these, innovative, research-based treatments have been developed to help resolve the symptoms and causes of PTSD. These include trauma focused CBT, and Eye Movement Desensitization and Reprocessing (EMDR).
In every case, a thorough assessment is critical in the successful treatment of PTSD and addiction. Many drug rehab centres will miss the symptoms of PTSD if they are not experienced with PTSD treatment alongside addiction. Therefore, it is important that when choosing an addiction treatment centre, one must ensure that the clinical staff has experience with both disorders. An intake by a qualified clinician is conducted to ensure that all factors which may affect treatment are taken into consideration.
Successful addiction and PTSD treatment requires skilled clinicians with experience and knowledge and a proven track record of success. Here at The Cabin Chiang Mai, we have successfully treated PTSD and addiction co-currently. If you or a loved one is showing signs of PTSD or addiction, contact us for more information on getting a proper diagnosis, and how to get help.