For many people living with post-traumatic stress disorder, substances become a way to quiet the symptoms — and over time, that substance use can become its own problem. PTSD is more common than many people realize. According to the VA National Center for PTSD, about 6% of U.S. adults will experience PTSD at some point in their lives, with higher rates among women.
The overlap with substance use is hard to ignore. According to a review in Alcohol Research: Current Reviews, a journal of the National Institute on Alcohol Abuse and Alcoholism, roughly a third of people with PTSD also meet the criteria for an alcohol use disorder at some point in their lives.
This article explains what PTSD is, why it so often appears alongside addiction, how the two feed each other, and what effective treatment looks like.
If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. If you’re in crisis or having thoughts of suicide, call or text 988 to reach the Suicide & Crisis Lifeline. The National Rehab Hotline at 866-210-1303 is for non-emergency information, support, and referrals.
Understanding PTSD
Post-traumatic stress disorder can develop after a person goes through or witnesses a traumatic event, such as combat, assault, a serious accident, abuse, or a disaster. Its symptoms generally fall into a few groups: re-experiencing the trauma through flashbacks or nightmares, avoiding reminders of it, changes in mood or thinking, and being constantly on edge or easily startled. PTSD is not a sign of weakness — it’s a recognized response to overwhelming stress, and it is treatable.
How PTSD and Addiction Are Connected
Using substances to manage PTSD symptoms is often described as self-medicating. Alcohol or drugs can briefly numb painful memories, calm a racing mind, or make sleep possible, but the relief is short-lived. Over time, substances tend to make PTSD symptoms worse while dependence builds.
The relationship can run in either direction: trauma can raise the risk of addiction, and heavy substance use can make trauma symptoms worse. When the two occur together, it’s known as a co-occurring disorder or dual diagnosis, and it’s far more common than many people expect.
PTSD and Addiction in Veterans
Veterans carry a particularly heavy burden. Combat and military trauma raise the risk of PTSD well above that of the general population. According to the VA National Center for PTSD, among the 5.8 million veterans who used VA health care in fiscal year 2024, about 14% of men and 24% of women were diagnosed with PTSD. Many also turn to alcohol or drugs to cope, which makes integrated care especially important. If you’re a service member or veteran, dedicated veteran addiction support is available.
Signs of Co-Occurring PTSD and Substance Use
Recognizing when trauma and substance use are intertwined can be difficult. Some signs to watch for include:
- Using substances to cope. Relying on alcohol or drugs to sleep, calm anxiety, or block out memories.
- Needing more over time. Requiring more of a substance to get the same relief.
- Symptoms that come back harder. Flashbacks, nightmares, or panic that worsen when not using, or when the substance wears off.
- Pulling away. Withdrawing from people and activities that once mattered.
- Feeling stuck. Feeling unable to function without a substance, yet no better with it.
Treatment for PTSD and Addiction
PTSD and addiction usually need to be treated at the same time. Integrated treatment may combine trauma-focused therapies — such as cognitive processing therapy, prolonged exposure, or EMDR — with evidence-based substance abuse treatment, which can include medication and counseling. Many people use alcohol to get through trauma symptoms, so treatment needs to address that directly. Recovery from both conditions is possible, and support is available for families, too.
Getting Help for PTSD and Addiction
Living with both PTSD and addiction can feel isolating, but you don’t have to face it alone. The National Rehab Hotline is a free, confidential, 24/7 line where you can be connected with information, guidance, and referrals to dual-diagnosis and treatment resources near you. It’s a non-emergency line. For a crisis or thoughts of suicide, call or text 988; for support and next steps, call 866-210-1303.
FAQ: PTSD and Addiction
- Can PTSD lead to addiction? Yes. Many people with PTSD use alcohol or drugs to cope with symptoms like anxiety, flashbacks, and insomnia. This self-medication can ease symptoms briefly but often leads to dependence and worsening PTSD over time.
- What is a dual diagnosis? A dual diagnosis, or co-occurring disorder, means a person has both a mental health condition (such as PTSD) and a substance use disorder at the same time. Treating both together leads to better outcomes than addressing them separately.
- Are veterans more likely to have PTSD and addiction? Yes. Combat and military trauma raise the risk of PTSD well above the general population, and many veterans also struggle with substance use. The VA reports that a significant share of the veterans it serves are diagnosed with PTSD.
- Can PTSD and addiction be treated at the same time? Yes, and they should be. Integrated treatment that combines trauma-focused therapy with substance use treatment is the most effective approach, rather than treating one condition and ignoring the other.
- Why do people use substances to cope with PTSD? Substances can temporarily dull painful memories, reduce anxiety, or help with sleep. The relief is short-lived, and over time substance use tends to intensify PTSD symptoms while creating a new dependence.
- How do I get help for PTSD and addiction? Call the National Rehab Hotline at 866-210-1303 to be connected with information, guidance, and referrals to dual-diagnosis treatment near you. It’s free, confidential, and available any time.
You Don’t Have to Carry This Alone
When you’re ready to take the next step, help is just a phone call away. Call the National Rehab Hotline at 866-210-1303, available 24/7. You deserve help that treats the trauma and the substance use together.
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