Dual Diagnosis: Post-Traumatic Stress and Substance Use Disorders
- Post-traumatic stress disorder (PTSD) is a specific anxiety disorder that occurs after someone has experienced or witnessed a traumatic event.
- Symptoms of PTSD include flashbacks, intrusive thoughts, physical symptoms of stress, avoiding people, places, or ideas connected to the trauma, irritability, being on edge, recurring nightmares, difficulty sleeping, risky behavior, loss of interest, and persistent negative feelings.
- Around 13 million Americans report having a PTSD diagnosis in any given year.
- Studies have demonstrated a significant connection between experiencing trauma and addiction.
Substance use disorders (SUD) and post-traumatic stress disorder (PTSD) are chronic, debilitating conditions that frequently co-occur. A person struggling with a dual diagnosis needs individualized care, as neglecting one piece of the puzzle can intensify the other. If you can take action with appropriate and personalized treatment, recovery is possible.
Common Symptoms of PTSD
Post-traumatic stress disorder, or PTSD, is a specific anxiety disorder that occurs after an individual has experienced or witnessed a traumatic event. A traumatic event or experience could include natural disasters, ongoing emotional or physical abuse, or witnessing a tragic death.
A key characteristic of PTSD is a persistent “fight or flight” feeling that continues for weeks, months, or even years beyond the traumatic experience.
There are a variety of signs and symptoms of PTSD. Each person with a PTSD diagnosis has endured unique trauma, which creates a need for an individualized treatment approach.
Symptoms of PTSD may include the following:
- Flashbacks or reliving the traumatic event
- Distressing and intrusive thoughts that occur randomly
- Experiencing physical symptoms of stress, such as excessive sweating or nausea
- Avoiding people, places, or ideas connected to the traumatic experience
- Feeling irritable and easily angered, leading to aggressive behaviors
- Being on guard and easily startled by noise or movements
- Having recurring dreams or nightmares about the traumatic experience
- Having difficulty falling or staying asleep
- Engaging in risky or destructive behavior
- Loss of interest in previous social connections and activities
- Persistent negative feelings and pessimism about the world
Based on recent data, an estimated 1 in 4 adults in the United States reports suffering from any diagnosable mental disorder in any given year. PTSD diagnoses occur in a smaller number of people; however, around 13 million Americans report having a PTSD diagnosis in any year.
- Approximately 5% of adults report having a PTSD diagnosis in an average year
- About 6% of adults will have PTSD at some point in their lives
- Women receive a PTSD diagnosis twice as frequently as men due to the increased likelihood of women experiencing certain types of trauma
PTSD and Addiction
Studies have demonstrated a significant connection between experiencing trauma and addiction. Many individuals who have endured trauma, such as surviving an armed robbery, a natural disaster, or abuse turn to drugs and alcohol to cope with the emotional pain connected with their trauma.
The co-occurrence of SUD and PTSD is common. This co-occurrence is believed to be a result of the fact that a person with PTSD is seeking an accessible coping skill to mitigate the extreme symptoms they experience with PTSD.
PTSD and Substance Abuse Treatment
It is essential to treat a substance use disorder alongside PTSD in an integrative manner. From detox and partial hospitalization programs (PHP) to intensive outpatient (IOP) and standard outpatient programming (OP), achieving long-term healing is possible. Treatment modalities utilized frequently to reduce symptoms of SUD co-occurring with PTSD may safely include the following:
- Psychoeducation and psychosocial support groups
- Teaching about the relationship between SUD and PTSD
- Developing healthy coping skills to reduce the impact of symptoms
- Learning how to manage negative emotions that arise
- Healing from the effects of trauma symptoms
Cost of Dual Diagnosis Treatment for PTSD
The cost of dual diagnosis treatment depends on several factors:
- Location of a treatment facility
- Types of services offered (inpatient, residential, or outpatient)
- Health insurance coverage for substance abuse treatment
Your health insurance will often cover some, and possibly all, of the services administered. Most major insurance carriers consider addiction treatment to be an essential service. However, out-of-pocket or private pay will vary depending on the type of treatment needed and the duration required. To verify your insurance, call now.
Frequently Asked Questions about PTSD
Trauma can be a collection of symptoms that occur either immediately following a traumatic event. Some examples of traumatic events or experiences are:
- Surviving an armed robbery
- Living through a natural disaster
- Experiencing one-time or ongoing physical or emotional abuse
- Witnessing a death (murder, suicide, accidental death)
- Being hospitalized long term
- Experiencing an auto accident
- Any other impactful and life-changing event or experience that causes an individual to meet criteria for PTSD
Trauma impacts each person differently; not everyone who experiences it will meet the criteria for PTSD. Experiencing emotional numbness or difficulty regulating emotions after a triggering situation could indicate that trauma has impacted you. Trauma can appear subtly or in obvious and potentially destructive ways to yourself or others.
A person may experience signs and symptoms of PTSD but attribute them to something else or want to avoid sharing so they are not a burden to others. A person struggling with PTSD may be more easily overwhelmed and choose to withdraw from social interactions because spending time with people can feel too stressful. They may have panic attacks or other heightened reactions to stimuli that remind them of the traumatic event.
They could feel like the trauma they endured was “not as bad as” other trauma, and they downplay their experience. Additionally, someone with PTSD may appear exhausted or unable to focus from lack of sleep due to frequent nightmares and feeling unable to settle enough to fall asleep.
A mental health professional, such as a clinical therapist or psychologist, can diagnose PTSD. You may already feel that you meet the criteria for diagnosis; however, a licensed clinician will need to assess you to review the diagnostic criteria with you and conduct a clinical interview.
The clinician will ask questions to determine if you meet the cognitive, physical, and emotional criteria for a PTSD diagnosis. A mental health professional may also administer an assessment to determine the extent of your symptoms and to understand better how to proceed with individualized treatment.
The assessment process will provide a better idea of your mental health symptoms, and you can be referred to appropriate mental health treatment at that time.
Are you or a loved one struggling with PTSD?
 The National Institute of Mental Health. (2020). Post-Traumatic Stress Disorder. Nih.gov. Retrieved from https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd on 2023, July 24
 National Center for PTSD. (2014). How Common Is PTSD in Adults? – PTSD: National Center for PTSD. U.S. Department of Veteran Affairs. Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp on 2023, July 23
 Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent Treatment of Substance Use and PTSD. Current Psychiatry Reports, 18(8). Retrieved from https://link.springer.com/article/10.1007/s11920-016-0709-y on 2023, July 23
 Average Cost of Drug Rehab : by Type, State & More. (2022). NCDAS. Retrieved from https://drugabusestatistics.org/cost-of-rehab/ on 2023, July 25
 How Can You Tell if Someone You Know May Have PTSD? | Mount Sinai Today. (2021, June 18). Health.mountsinai.org. Retrieved from https://health.mountsinai.org/blog/how-can-you-tell-if-someone-you-know-may-have-ptsd/ on 2023, July 25
 How is PTSD Measured? – PTSD: National Center for PTSD. (2014). Va.gov. Retrieved from https://www.ptsd.va.gov/understand/isitptsd/measured_how.asp on 2023, July 25