Healing After Sexual Assault: Understanding Trauma, Substance Use, and Recovery

Sexual assault is becoming increasingly common - the Centers for Disease Control and Prevention (CDC) recently reported that nearly half of women and 1 in 6 men have experienced some kind of sexual violence in their lifetime.

The point is that this is not just a faraway statistic we can think of in numerical terms. Many of us or someone we know may have gone through this, too. Regardless of gender and background, sexual assault can leave behind trauma that is not visible. Many survivors find that trauma shows up in their daily functioning, nutrition, sleep, their relationships, and sometimes in their relationship with alcohol or drugs.

In this article, we will explore how trauma and substance use can become intertwined, why that connection is so common, and what recovery can look like.

Trauma after a sexual assault is a common reaction to the event or circumstances. It is not a sign of weakness, but your mind and body's attempts to cope with an overwhelming experience.

Survivors may notice post-traumatic stress disorder (PTSD), including intrusive memories, nightmares, and constant vigilance. Anxiety and depressive symptoms are also common, sometimes with panic attacks.

Many survivors also struggle with shame, guilt, or self-blame, even though none of it belongs to the survivor. Others feel emotionally disconnected and detached from themselves and their surroundings. It can be difficult to trust others or feel safe in interpersonal relationships. Sleep troubles and physical symptoms, such as headaches or chronic pain, are common as well.

Some feel the effects of a sexual assault immediately, while others notice them months or years later.

As per the Bureau of Justice Statistics data summarized by Rape, Abuse, & Incest National Network (RAINN), nearly 2 in 3 survivors report severe emotional distress when the person who harmed them was an intimate partner or relative, which is a reminder of how deeply betrayal of trust can wound. Nearly 1 in 3 survivors report distress when the person who harmed them was a stranger or otherwise known to the victim, which indicates how difficult it is to develop trust again.

In the U.S., an estimated 301,580 people age 12 and older experience rape or sexual assault each year, which is nearly 826 people every day. Most perpetrators are not strangers. 76% of reported rapes involve someone the victim knew.

California law enforcement agencies reported 13,081 rapes in 2025, down from 13,874 in 2024, and about 26% of reported rapes were cleared by law enforcement. These figures reflect only crimes that were reported.

The Los Angeles County Sheriff's Department reported rapes rose countywide in the first eight months of 2025 compared with the previous year. However, the Department described a “slight rise” for the full year. This covers areas the Sheriff's Department serves, not the City of Los Angeles, and increases may partly reflect more survivors coming forward.

Trauma and Substance Use

As per the U.S. Department of Veterans Affairs (VA), over 40% (nearly 45%) of adults with a lifetime history of PTSD also experience alcohol or drug use problems.

Trauma and substance use disorders frequently occur together. A review in “Current Directions in Psychological Science” found that nearly 36% to 50% of people seeking treatment for substance use disorders meet criteria for lifetime PTSD.

Researchers point out several reasons for this. The most common one is self-medicating, where substances are used to numb the pain within. But this is only like having a pair of temporary arms around you, as substances can also make trauma symptoms harder to manage. On the other hand, some survivors were already living with substance use concerns before a sexual assault.

Substances can offer fast relief, albeit temporary.

For instance, alcohol may relax the racing thoughts at night. Other substances may suppress flashbacks, numb overwhelming emotions, or make it easier to be around others in social circumstances. For someone in pain who has not been believed, or has not had access to care, this kind of relief can feel like the only option available.

Over time, however, tolerance develops, trauma symptoms often return stronger, and use can become dependence. As both sexual assault and substance use can be stigmatized in our society, the shame, guilt, and self-blame only worsen.

But please remember - survivors deserve empathy, not judgment, for finding ways to get through the hardest moments. Noticing the pattern is not a reason to judge or criticize. For many, identifying this pattern is the first step to seeking the care they need and deserve.

Trauma-informed care begins with a question - “What happened to you, and what do you need to feel safe?” Its core principles include safety, choice, collaboration, transparency, and comfort. Survivors decide what to share and when, and healing does not require retelling every detail.

When trauma and substance use occur together, treating only one often leaves the other unaddressed. Integrated care, often called dual-diagnosis treatment, addresses both at the same time. Depending on the person, a plan may include:

• Cognitive behavioral therapy (CBT) to understand and shift painful thought patterns
• Dialectical behavior therapy (DBT) for managing intense emotions and distress
• Internal Family Systems (IFS) therapy to empathetically reach out to the different parts of ourselves that trauma affects
• Mindfulness and grounding skills, plus medical evaluation when appropriate

You do not have to decide anything right now to reach out. These services are free and confidential:

• Peace Over Violence: 24/7 hotlines at 213-626-3393 for Central Los Angeles, 310-392-8381 for South Los Angeles, and 626-793-3385 for West San Gabriel Valley.
• UCLA Rape Treatment Center: Based in Santa Monica, open 24/7 at 424-259-7208. Services provided will involve emergency medical care, forensic exams, advocacy, and free individual and group counseling in English and Spanish.
• RAINN National Sexual Assault Hotline: 800-656-HOPE (4673), online chat at RAINN.org/hotline, or text HOPE to 64673, 24/7.
• In Crisis or Thinking About Suicide: Call or text 9-8-8.
• For Urgent Help or Emergencies: Call 9-1-1 immediately.

Support from a rape crisis center and ongoing clinical care can happen side by side. NuView Treatment Center is an outpatient behavioral healthcare provider in Los Angeles offering trauma-focused therapy, along with care for mental health conditions and substance use.

Our programs range from partial hospitalization programs to intensive outpatient programs, with telehealth options available across California. Care is personalized, so your story can be the focus of your recovery.

Please Note: NuView is not a crisis service or rape crisis center. If you need immediate medical care, safety, or emergency services, please use the resources mentioned above or call 9-1-1 immediately.

Healing is not a linear journey, but reaching out is the first step to healing. If trauma and substance use have become tangled together in your life, you deserve care that treats both with respect.

Call NuView at (323) 307-7997 to speak confidentially with our licensed clinicians, who will sit with you in confidential settings to understand your experiences, needs, and goals, and recommend a personalized care program that meets you where you are.