Treatment Solutions for People Struggling with PTSD and Substance Abuse

According to the U.S. Department of Veterans Affairs, studies have found that 46.4% of individuals with post-traumatic stress disorder (PTSD) also met the criteria for substance use disorder (SUD).[1] Addiction, even by itself, is a devastating condition characterized by compulsive substance abuse and loss of control. When PTSD and addiction co-occur, individuals can suffer immensely from a vicious cycle of trying to self-medicate their trauma symptoms and control their substance use. PTSD increases the risk of addiction, and substance abuse exacerbates symptoms of PTSD.

Patients who are affected by PTSD and substance abuse can benefit from trauma-informed care and trauma-focused treatment. Treatment for people struggling with PTSD and substance abuse is most effective when therapists use a patient-centered and collaborative approach that targets the patient’s individual needs.[1]

Treatment Approaches for People With Co-Occurring PTSD and Substance Abuse Issues

Co-occurring PTSD and drug or alcohol use disorder can be difficult to treat, and many individuals with PTSD have poorer treatment outcomes than those who do not have PTSD.[2] However, a trauma-focused approach can help these individuals recover from substance abuse, cope with their trauma, and live fulfilling healthy lives. Here are the top treatment methods used when addressing patients with PTSD and substance abuse problems.

Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is at the foundation of nearly all addiction treatment programs. CBT is a form of talk therapy that helps patients identify, challenge, and change negative thinking patterns or behaviors that are causing problems. When it comes to treating PTSD, CBT can help individuals reframe their thoughts about their trauma, let go of guilt and shame, and reduce feelings of anxiety.

Cognitive Processing Therapy (CPT)

Cognitive processing therapy (CPT) is a trauma-focused approach that addresses self-defeating thoughts and beliefs regarding one’s trauma. It is a form of CBT that follows a series of steps where a person retells their trauma, identifies problematic thinking, and begins to challenge those thoughts, replacing them with healthy affirmations. The goal of CPT is to change the way a person thinks and feels about their traumatic experience.[3]

Prolonged Exposure Therapy (PET)

Prolonged exposure therapy (PET) is thought to be one of the most effective treatments for PTSD.[2] This approach combines psycho-education, breathing retraining, in vivo exposure (thinking about events that trigger symptoms), and imaginal exposure (recalling a traumatic event).

During PET, the therapist helps the patient practice breathing and relaxation skills to try and regulate their response to distress both during and after exposure sessions. When combined with treatments targeted for substance abuse, PET can significantly reduce a person’s PTSD symptoms and risk of relapse.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

Another treatment that is often used for people struggling with PTSD and substance abuse is Eye Movement Desensitization and Reprocessing Therapy (EMDR). EMDR is a newer therapy that was developed in 1987 for the treatment of PTSD.[4]

During EMDR sessions, a therapist facilitates bilateral stimulation to induce eye movements while the patient recalls a traumatic event. The bilateral stimulation is thought to reduce the vividness of traumatic memories and associated emotions. While other therapies for PTSD focus on thoughts, feelings, and behaviors that result from trauma, EMDR solely focuses on memories and how they are stored in the brain.

Holistic and Alternative Therapies

Holistic therapies, such as art, yoga, meditation, massage, and music can also be used in the treatment of individuals with PTSD and substance abuse issues. All of these therapies can be tailored to meet a patient’s individual needs. Holistic therapies are meant to help individuals become more mindful, learn relaxation techniques, and find healthy outlets to express their emotions. Studies have found that practices like deep breathing, yoga, and meditation can benefit patients who struggle with PTSD.[5]

Pharmacological Therapy

Some patients who struggle with PTSD and substance abuse can benefit from pharmacological treatment.[1] Medications used to treat opioid or alcohol use disorders, such as naltrexone or buprenorphine, may help these individuals cope with drug/alcohol cravings. Additionally, certain medications have been found helpful in treating PTSD and other co-occurring disorders.

Medications that may be used to treat symptoms of PTSD include:

• Selective serotonin reuptake inhibitors (SSRIs)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
• Other antidepressants like Venlafaxine (Effexor)
• Beta-blocker medications used for anxiety-like propranolol

These medications do not cure PTSD or addiction. They are intended to be used in combination with a comprehensive addiction treatment program.

Find Treatment for Co-Occurring PTSD And Substance Abuse Today

It is important for people who are struggling with PTSD and addiction to seek help that addresses not only their substance abuse but also their trauma. During treatment, patients should learn how to manage cravings, prevent relapse, and change the way they think and feel about traumatic events.

Here at Woburn Wellness Addiction Treatment, we’re dedicated to helping all patients overcome their past struggles and live healthy, sober lives. If you or someone you love is seeking treatment for PTSD and addiction in the Boston area, please give us a call today. We can’t wait to be a part of your recovery journey.

References:

1.  https://www.ptsd.va.gov/professional/treat/cooccurring/tx_sud_va.asp
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466083/
3. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy
4. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939561/