PTSD and Alcohol: Why Veterans Self-Medicate and How to Break the Cycle

Disclaimer: This article is for informational purposes only and is not a replacement for expert medical or mental health advice. If you or a loved one is struggling with PTSD, alcohol use disorder, or related symptoms, please contact a licensed treatment provider. Call 9-8-8 or 9-1-1 in case of crises, emergencies, or other urgent needs.

Post-traumatic stress disorder (PTSD) is a mental health condition that typically occurs among those who have experienced or seen one or more traumatic events. The U.S. Department of Veterans Affairs says that 7 out of 100 U.S. veterans experience PTSD at some point in their lives, and this is slightly more common among veterans than civilians. PTSD often tends to co-occur with substance use disorders, like alcohol use disorder.

For many veterans living with PTSD, alcohol begins as a way to sleep, relax, or switch off. Understanding why it happens is the first step toward changing it.

PTSD keeps the body on high alert, and hypervigilance is one of its most common signs. Alcohol can dull that feeling for a few hours, which is why it feels like it makes you feel better. This is what is known as self-medication, and studies of veterans provide evidence for this - PTSD symptoms and drinking tend to rise and fall together.

However, the relief does not last. Alcohol cuts down sleep into small fragments, worsens anxiety and low mood, and can make nightmares more intense. As symptoms return, so does the urge to drink. This loop becomes a cycle.

Military drinking culture also has a role to play in this. Many veterans learn to drink in a setting where it was part of bonding, celebrating, and relaxing. Drinking with one’s unit builds trust, and heavy drinking was often glorified. After separation, that habit can go on without the unit.

Studies also show that veterans with unresolved PTSD are more likely to relapse after treatment for alcohol use, which is why treating only the drinking often falls short. Here is where trauma-informed dual diagnosis care becomes useful, as it treats both PTSD and alcohol use disorder together with psychotherapy, medication management, peer community, relapse prevention, and continued care.

Here are some alcohol use signs to watch out for:

• Drinking to fall asleep or to dull intrusive thoughts

• Needing more alcohol to get the same effect

• Drinking on your own or hiding how much you are drinking

• Missing work or pulling away from family

• Feeling worse, not rested, or not better the day after

• Treat Both Together: The National Center for PTSD recommends treating PTSD and substance use at the same time. Dual diagnosis care is built for this.

• Use Trauma-Informed Therapy: Individual therapy and group therapy can address the trauma driving the alcohol use.

• Get Medical Attention: Alcohol withdrawal can be dangerous. Speak with a licensed clinician before you cut back or stop alcohol use. Sometimes, you may need medically supervised detox before you quit drinking.

• Choose the Right Level of Care: Structured outpatient options range from partial hospitalization programs to intensive outpatient programs that fit around your routine and relationships you want to stay connected to. If you need residential care before outpatient care, then that can be suggested as well.

If you are in crisis, call or text 9-8-8 and press 1 to reach the Veterans Crisis Line.

Opioids and Chronic Pain

Many veterans live with both PTSD and chronic pain from injuries sustained in service. The two can feed each other, and pain can lead to longer-lasting opioid use. Opioids come with a risk of dependence, and combining them with alcohol is especially dangerous because both slow breathing. If you or someone you know takes opioids and drinks, speak with a medical provider. Do not stop prescribed medication suddenly without medical supervision.

Cannabis and PTSD

Some veterans turn to cannabis for sleep or relaxation. Studies have not shown this is particularly effective, and heavy use can worsen anxiety, sleep, and avoidance over time. If you or someone you know uses cannabis, be honest with your care team so they can personalize treatment to your needs.

NuView Treatment Center offers structured outpatient care for PTSD and alcohol use disorder that meets you where you are. We are also in-network with the VA Community Care Network through TriWest. Eligibility is determined by the VA, and authorization is required before treatment begins.

Call us at (323) 307-7997 to verify your insurance to see if VA Community Care may apply to you.

Alcohol use disorder (AUD) can be service-connected for Department of Veterans Affairs (VA) disability benefits, but only as a secondary condition rather than a primary (stand-alone) diagnosis.

VA acknowledges that AUD is a disability as it is common among veterans. However, it is not considered a VA-rated condition on its own. It can only be service-connected on a secondary basis. This means that if a veteran’s alcohol use comes from service-connected PTSD, then it can be considered secondary to, or a symptom of, a service-connected condition such as PTSD.

NuView is in-network with VA Community Care Network through TriWest. Behavioral health care for PTSD and alcohol use disorder (on a secondary basis) is a covered service when it is authorized.

The VA determines your eligibility, and you require pre-authorization before the treatment begins. Here are some steps you need to follow:

1. Speak with your VA primary care provider or your primary healthcare provider

2. Ask for a community care referral

3. VA approves your referral and directs it to TriWest

4. Request NuView Treatment Center as your behavioral healthcare provider

5. Begin your recovery with us once everything is confirmed

Our team can also verify your benefits free of cost. You are not obligated to commit to us right away. It is only an information-gathering step so you can make the right decisions in your care on your own time.