A New Standard in Treating PTSD and Addiction

People get addicted to drugs and alcohol for any number of reasons – sometimes there’s a family history, sometimes early experimentation turns into a lifelong problem. For as many as 30 to 60 percent of addicts, drug or alcohol problems coincide with a history of abuse, neglect or other traumas.

Study after study has shown that post-traumatic stress disorder (PTSD) and addiction often go hand in hand. One survey found that 34 percent of men and roughly 27 percent of women with PTSD also had a drug or alcohol problem. Some people develop PTSD after using drugs and alcohol, which puts them at greater risk for experiencing a traumatic event; others are exposed to trauma and then begin using drugs to self-medicate.

PTSD is an anxiety disorder that develops in response to a terrifying experience that threatened grave harm. While the obvious example is a soldier in combat, PTSD can result from any type of tragic event, whether the person was a victim or witness, including natural disasters, accidents and personal assaults. People with PTSD may struggle with insomnia, nightmares, flashbacks, an exaggerated startle response, avoidance of reminders of the trauma or emotional numbness.

Which therapies are most effective in treating PTSD and addiction? Typically treatment entails a combination of:

  • Medication
  • Cognitive-Behavioral Therapy
  • Group Therapy
  • Exposure Therapy (in which a trained therapist guides the patient through reliving traumatic memories under controlled conditions)

For decades, it was thought that people with both PTSD and addiction needed to get and stay sober before working through their traumas. The problem was two-sided: On one hand, PTSD treatment could bring up issues that would trigger a relapse to drugs; on the other hand, failing to treat the PTSD meant most people couldn’t stay sober for long.

As we learn more about these conditions, we’re discovering that people do better when both disorders are treated as the same time. Researchers from the National Drug and Alcohol Research Center at the University of New South Wales found that exposure therapy was effective in reducing PTSD symptoms even when participants continued using drugs. Even in the midst of all the difficult memories brought up in exposure therapy, the participants didn’t amplify their drug use or drop out of treatment more than those receiving traditional addiction treatment.

Co-occurring disorders are complex to treat. The good news for those with PTSD and addiction is that treatment for trauma doesn’t need to be delayed until the substance abuse problem is under control (which alone can be a lifetime process). Recovery for both disorders can start right away – and the sooner treatment starts, the better life can be.

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