PTSD, Alcohol and Substance Abuse

Post-traumatic stress syndrome (PTSD) is a psychiatric disorder brought on by the extreme stress of traumatic events. Symptoms of PTSD include:

• Avoidance of people, places, situations and thoughts related to a traumatic experience, as well as emotional numbness
• Hyper-arousal, including anger, agitation, sleep problems and feeling constantly "on guard"
• Re-experiencing the trauma through flashbacks, nightmares and physical reactions such as sweating or racing heartbeat.

Scientists have long been aware of the relationship between stress and substance abuse. Not surprisingly, people with PTSD are also at risk of developing alcohol or drug abuse problems. However, the exact relationship between PTSD, alcohol and drug use is complex.

Understanding Stress

Stress is a very individualized response, and what is stressful for one person may not be for another. Some basics about the stress response and its possible connections to substance abuse include:

• Stress involves many parts of the body including the adrenal, cardiovascular, central nervous and immune systems.
• Stressful events are known to contribute to the initial use of drugs and alcohol, as well as contributing to relapse for those who have abstained for long periods of time.
• The purpose of stress is to help you adapt to danger. When you are stressed, your body releases norepinephrine, a neurotransmitter involved with memory. This may be a reason that stressful and traumatic events create such strong memories.
• When you experience stress, the body also releases the hormone corticotropin-releasing factor (CRF). Almost all drugs that people abuse also increase CRF levels in the brain, leading expects to speculate that this may be one reason for the correlation between substance abuse and PTSD.

PTSD, Alcohol and Drugs

Because the trauma that causes PTSD is an extreme stress, and stress is a known trigger for substance abuse, having PTSD increases a person's risk for substance abuse and addiction. One theory is that substance abuse may be an attempt to self-medicate and relieve the symptoms of PTSD, although this may make symptoms worse over time. Whatever the exact relationship, it is clear that there is a correlation between trauma, substance abuse and PTSD:

• After the 9/11 terrorist attacks, people living in Manhattan reported increased alcohol, marijuana and tobacco use, according to the results of a study published in the American Journal of Epidemiology (2002). Individuals who smoked cigarettes or used marijuana were also more likely to experience PTSD.
• Between 30 to 60 percent of people with substance abuse disorders also meet the criteria for PTSD, according to the National Institute of Drug Abuse (2006).
• Women who have been raped are more than 13 times more likely to have major alcohol problems, and are 26 times more likely to have serious drug abuse problems, according to the National Center for Victims of Crime (2009).

Getting Help

If you are going through the pain of PTSD symptoms and substance abuse, your doctor can help you to heal and get back to enjoying your life again. Effective treatments for PTSD and substance abuse may include:

• Antidepressants
• Cognitive behavioral therapy
• Exposure therapy
• Group therapy.

Resources

Addiction Technology Transfer Center National Office. (n.d.). Substance abuse and PTSD. Retrieved July 10, 2010, from: http://www.nattc.org/resPubs/trauma/saptsd.htm.

Mayo Clinic. (2009). Post-traumatic stress disorder.Retrieved July 14, 2010, from: http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246.

National Center for Victims of Crime. (2009). Rape-related post-traumatic stress disorder.Retrieved July 14, 2010, from: http://www.ncvc.org/ncvc/main.aspx?dbName=DocumentViewer