Dual-Diagnosis Treatment for Trauma and Addiction
Post-traumatic stress disorder and addiction are both conditions that can completely take over a person’s life. They can prevent a person from achieving their life goals. They can destroy important relationships. They can lead to intense emotional distress that is difficult to eradicate. Moreover, both conditions can be life threatening.
What you may not know is that trauma and addiction are inextricably linked. Current research suggests that trauma is one of the most significant causal factors in addiction, with an estimated 50% of people with post-traumatic stress disorder developing comorbid substance use disorders. Not only does suffering from one condition increase a person’s likelihood of suffering from the other, but individuals who suffer from both often experience more disruptive symptoms. Understanding the relationship between those two conditions is essential for anyone hoping to recover.
What is Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder, often shortened to PTSD, is a mental health condition that can occur after a person experiences or witnesses a traumatic event. What constitutes a traumatic event can vary significantly from person to person, but a few common examples include warfare, sexual assault, traffic collisions, child abuse, and any experience of having one’s life threatened. Not everyone who experiences a terrifying or traumatic event develops PTSD.
Those who do, however, tend to experience ongoing symptoms for months or even years after the event. Post-traumatic stress disorder occurs when a person finds an event so overwhelming and difficult to process that they continually find themselves continually re-experiencing it.
People who go through traumatic events and develop PTSD experience a wide range of symptoms that can be painful and disruptive. Most symptoms begin within a month after a traumatic event, though sometimes symptoms occur much later.
Children often exhibit no symptoms of post-traumatic stress disorder, though they are likely to express their trauma through disturbing forms of play. The symptoms of PTSD are likely to cause issues in social situations, work situations, and important relationships. They also affect a person’s ability to complete daily tasks.
Common signs and symptoms of PTSD include but are not limited to:
- Avoidance. Because traumatic memories are so painful and have so much power, individuals with PTSD often go to great lengths to avoid remembering them. This may entail exercising a rigid control over one’s own mind, avoiding thinking or talking about the traumatic event. Many people also avoid activities, places, or even people that remind them of the traumatic event.
- Intrusive memories. Not everyone is able to avoid their memories, and sometimes the very act of avoiding them causes them to reappear when they are least wanted. Individuals with intrusive memories may experience flashbacks, during which they relive the traumatic event as if it were happening again. They may have upsetting dreams or nightmares that relate to the traumatic event. Many people simply experience unwanted recurrent memories of the traumatic event, or distressful emotional and physical reactions when a person, place, or activity reminds them of the event.
- Changes in thinking and mood. Negative changes in thinking and mood occur when a person has PTSD. They may have negative thoughts about themselves, other people, and even the world. It is common to have difficulties maintaining close relationships, with many sufferers reporting feeling detached from family and friends. They may feel hopelessness about the future, find it difficult to feel positive emotions, or simply feel emotionally numb. Individuals with PTSD tend to lose interest in activities they once enjoyed. Many also suffer from memory problems in general, often being unable to remember aspects of the very incident that traumatized them.
- Changes in physical and emotional reactions. These reactions, known as arousal symptoms, are likely to be different for individuals with PTSD. As a result, individuals with PTSD are often always on guard for danger and may be easily startled or frightened. They may have trouble sleeping or concentrating. A strong sense of guilt or shame often dominates their thoughts. Many engage in self-destructive behaviors, such as driving too fast or drinking too much alcohol.
Post-traumatic stress disorder causes people to experience considerable emotional distress, and many individuals with PTSD engage in forms of escapism. It is thus no surprise that people with post-traumatic stress disorder have a significantly increased likelihood of engaging in substance abuse.
For these individuals, alcohol or drug abuse can actually be a way of self-medicating and treating the symptoms of their mental illness. However, over the long term substance abuse is only likely to exacerbate these very symptoms. Once a person develops a substance use disorder, they will face significantly worse consequences, and they may find themselves facing triggering or distinct traumatic situations.
What is Substance Use Disorder?
The term “substance use disorder” is the clinical term of addiction. People can develop substance use disorders with a wide variety of substances, including opioids, alcohol, cocaine, methamphetamine, prescription stimulants, and cannabis. While all of these drugs have distinct and unique effects on users, the characteristics of substance use disorders are by and large the same no matter which substance a person habitually uses.
Individuals can be diagnosed with substance use disorders when their substance abuse leads to significant harmful consequences but they are unable to stop. The nature of these consequences can vary from person to person. TV shows and movies may depict addicted individuals as homeless and destitute, but the fact is that many people experience less dramatic consequences.
The consequences of addiction can range from simply feeling miserable and alone to suffering from a life-threatening overdose while living on the street. Ultimately, no matter which consequences an individual experiences, what they have in common is an inability to stop.
Individuals who have experienced the harmful consequences of substance abuse often recognize a need to stop or control their substance intake. However, once an individual has developed an addiction, they are unable to manage their substance use on their own. Some people are able to quit or control their usage for a day, a week, or even a few months, but few are able to remain abstinent for long.
Most are left facing a dilemma: either try to exercise self-control and be miserable, or engage in substance abuse without restraint and suffer the consequences. Individuals with substance use disorders often have plenty of self-control and discipline in other areas of their lives, but when it comes to drugs and alcohol they are powerless.
It is important to recognize that substance use disorders are legitimate mental health conditions. Unfortunately, people often believe that in order to recover from a substance use disorder all they need to do is try harder or exert more will power. The reality is that substance use disorders cannot be willed away, no more than a broken leg can be cured by going for a run.
Substance use disorders are caused by genetic, neurological, and psychosocial factors that have to be addressed. These causal factors affect the motivation and decision making parts of the brain, making it all but impossible for a person to control their substance use.
How Do Substance Use Disorders Develop?
It may seem obvious, but it bears repeating: most people use drugs and alcohol because these substances feel good. While drugs vary widely in their effects, one of the principal reasons that drugs and alcohol feel good is that they cause the brain to release dopamine. Dopamine is a neurotransmitter that plays an important role in the brain’s motivation centers.
When it is released during a delicious meal, while playing sports, or while having sex, it causes an individual to want to repeat that activity. The behavior-reinforcement function of dopamine is at its strongest when it comes to drugs and alcohol. Recreational substances not only make people feel good, the enormous quantities of dopamine they release make people want to use them again and again.
Over time, physical dependence develops. It doesn’t take long for a person’s brain, body, and central nervous system (CNS) to adapt to the effects of a substance — a phenomenon known as tolerance. When this happens, a person needs to take their substance of choice more frequently or at higher quantities in order to achieve their desired high. As a result, their intake of drugs or alcohol will gradually — or even rapidly — increase as time goes on.
At the same time, individuals may find themselves unable to stop using their substance of choice without experiencing agonizing symptoms of withdrawal. This state, known as physical dependence, is not the same as addiction, though it often paves the way for its development.
While some people are indeed able to extricate themselves from physical dependence, individuals who have developed substance use disorders will find that they continue to be obsessed with substance abuse even when physical cravings are absent. They may discover that their substance use is uncontrollable, and they may return again and again to drugs and alcohol long after they’ve recognized the insanity of doing so.
There is no single reason why some people develop addictions and others don’t. However, certain factors do make people more susceptible to substance use disorders. These factors include genetics (having a family history of addiction), mental health disorders, and trauma.
Understanding the Comorbidity of PTSD and Substance Use Disorder
A large percentage of people with substance use disorders suffer from post-traumatic stress disorder. Similarly, approximately 50% of individuals with PTSD end up developing addictions. Individuals who suffer from an addiction in addition to one or more additional mental health conditions, such as PTSD, are said to be “dual diagnosis.” Dual diagnosis individuals with comorbid conditions often suffer from more severe symptoms and face additional challenges while trying to recover.
Why are PTSD and substance use disorders so inextricably linked? The relationship between the two conditions stems from the fact that individuals with PTSD often go to great lengths to avoid or distract themselves from painful thoughts, moods, and memories. In fact, for people with PTSD, alcohol and drugs can sometimes appear to make them mentally healthier.
They may, for a period of time, find it easier to handle triggering situations, social interactions, and everyday tasks. Alcohol and other drugs are, in this sense, effective tools for numbing pain. With time, however, recreational drugs cease to be effective and ultimately bring their own set of painful consequences.
Is Drug Abuse an Obstacle to PTSD Treatment?
It can’t be denied that drugs and alcohol are effective tools for reducing anxiety, depression, and even the symptoms of post-traumatic stress disorder. It should come as no surprise that individuals with mental health disorders are frequently drawn to drugs and alcohol. However, even though these substances may temporarily relieve symptoms of mental illness, they always end up making symptoms worse in the long run.
Individuals who self-medicate by treating their symptoms with drugs and alcohol are less likely to seek actual treatments for their PTSD. Alcohol, opioids, cocaine, and other drugs may temporarily numb pain and help people forget their traumatic memories, but these substances are mere bandaids.
Ultimately, it is best not to avoid the pain. In fact, the most effective evidence-based PTSD treatments specifically involve a degree of emotional pain. Exposure therapy, for instance, involves learning to gradually accustom oneself to triggering experiences or situations. Unfortunately, the longer a person goes without seeking actual PTSD treatment, the worse their PTSD will get.
In some cases, people do engage in PTSD treatment but continue to abuse drugs and alcohol. For these individuals, their substance abuse is likely to nullify the potentially beneficial effects of PTSD treatment. Drugs and alcohol can make psychiatric medications less effective.
They disrupt sleep, reduce cognitive ability, and make it more difficult for people to manage their own moods. Even when people take part in therapeutic interventions for their PTSD, continual substance abuse is likely to impede any progress they might otherwise make.
How Does Substance Abuse Affect PTSD Symptoms?
Drugs and alcohol do not directly lead to the development of PTSD. However, the behaviors that people engage in while abusing drugs or suffering from addiction can lead to PTSD. Substance abuse causes people to engage in reckless and risk-taking behavior. It thereby exposes people to dangerous situations that can be potentially traumatic. For individuals with pre-existing PTSD, these upsetting situations can cause them to be re-traumatized.
Certain substances like alcohol and benzodiazepines can cause people to become less inhibited, which can result in them dealing with conflicts or other dangerous altercations. These substances are widely associated with various forms of assault, including sexual assault. Furthermore, disinhibiting substances can cause people to dissociate and feel disoriented.
As a result, they may find it difficult to assert themselves, defend themselves, or even understand what is happening to them. The fact that these drugs lead to black-outs and inhibit memory formation can make traumatic events even more difficult to process.
However, even when substance abuse does not directly lead to traumatic or triggering situations, drugs and alcohol make mental illness worse in the long run. Drug and alcohol abuse worsens depression, anxiety, and trauma-related symptoms. Furthermore, when people experience withdrawal effects, these symptoms tend to become even more severe.
Over the long term, substance abuse causes people to lose important components of their lives. Substance abuse can cause people to suffer from performance problems at work or school, which can cause them to lose their jobs or stagnate. Addiction can also wreck relationships with close friends and family members, either by creating the conditions for conflict or simply by fostering social isolation.
As other complications increase, like legal, financial, and health problems, an individual’s support system tends to decrease in size at the same rate. As a result, they tend to be ill-equipped to deal with the more severe PTSD symptoms that accompany substance abuse.
Trauma and Addiction Statistics
The link between trauma and addiction extends beyond PTSD. In fact, recent studies have shown that trauma can lead to substance use disorders even for individuals who do not meet the clinical criteria for a PTSD diagnosis. These studies showed that stress and trauma that accumulates over time has a severe impact on addictions later in life.
The researchers term this a “dose” or “building block” effect of stress load. They found that among adolescents receiving treatment for substance abuse, more than 70% of them had been exposed to stress and trauma over a considerable period of time.
The relationship between addiction and adverse childhood events (ACEs) is well-established. These experiences include abuse, poverty, traumatic experiences, neglect, and malnutrition. A large body of research has shown that children who suffer from one or more of these experiences are likely to suffer from a wide range of behavioral problems, physical health issues, mental health problems, and addictions later in life.
This is in part due to the fact that adverse childhood events impact brain development, causing structural and functional changes on the neuronal level that last throughout adulthood. Children who have been sexually abused have a particularly high risk for developing alcohol use disorder later in life.
Given the relationship between trauma and addiction, it should come as no surprise that veterans are particularly susceptible to addiction. 75% of veterans who suffer from post-traumatic stress disorder also suffer from a substance use disorder. 33% of veterans who are in treatment programs for addiction also meet the conditions for PTSD.
Certain substances are also more linked to PTSD than others. PTSD has a dramatic effect on alcohol consumption in particular, for instance. People with PTSD have double the likelihood of developing an alcohol use disorder compared to the rest of the general population. Individuals who use cocaine and opiates are also more likely to report having suffered from traumatic experiences compared to other drug users.
Find an Outpatient Treatment Center Near Me
For individuals who suffer from PTSD and a substance use disorder, outpatient treatment programs are often the best way of making a full recovery. Outpatient programs ensure that people receive treatment for their conditions every day, but they offer flexibility so that clients can return each day to their own homes and social support systems.
Outpatient programs are therefore ideal for individuals with commitments at school, at work, or to family members. Furthermore, outpatient programs work with clients to rebuild their lives in the outside world. They teach people new coping strategies and tools for managing their PTSD while ensuring their continued sobriety.
NuView Treatment Center, a treatment center located in Los Angeles’ Westside, provides outpatient treatment at all levels of care. The programs we offer include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
Dual Diagnosis Treatment For Trauma And Addiction At NuView Treatment Center
At NuView Treatment Center, we recognize that recovering from a substance use disorder is not the same thing as simply abstaining from drugs and alcohol. Physical sobriety is an important foundation, but we understand that most people with addictions engaged in substance abuse due to a wide range of underlying factors. Dealing with trauma, emotional distress, and relationship problems is just as important as withdrawing from drugs and alcohol.
At NuView Treatment Center, we offer individualized treatment plans that incorporate a comprehensive array of evidence-based treatment modalities. Our compassionate and highly trained staff make it their mission to ensure that everyone who walks through our doors is prepared to face the challenges ahead.
At holistic dual diagnosis treatment centers, clients learn to understand themselves better, develop a strong support system, learn new skills, and begin pursuing new life goals in sobriety.
A better life, free of substance abuse and trauma, is possible. You don’t need to suffer alone. And you don’t need to recover alone either. If you are ready to make a change, contact us today.