Welcome to Engage Wellness Acton’ page on dual diagnosis: post-traumatic stress disorder (PTSD) and substance use disorders.

The term dual diagnosis refers to the concept of living with a mental health and substance abuse disorder at the same time. Unfortunately, each condition often feeds into the other, and while they are unique disorders, treating them together encourages greater success.

To overcome a dual diagnosis of substance abuse and PTSD, individuals require professional, ongoing treatment and support. Although the initial step can be daunting, your ability to live a happy, healthy life is possible when you receive tailored treatment.

This page explores everything you need to know to take that first step, focusing on the relationship between these disorders and the PTSD and addiction treatment options available to you.

Does One Disorder Cause the Other?

Many people who experience a traumatic event will develop PTSD, with around 6% of the American population having PTSD at some point in their lives. Some populations face a higher risk, including women (based on a higher rate of sexual assault), veterans, and first responders.

To be diagnosed with PTSD, you must display all of the following for at least one month:

• At least one re-experiencing symptom, such as flashbacks, distressing thoughts, or recurring memories.
• At least one avoidance symptom, including avoiding thoughts or feelings related to the event or staying away from places, objects, or events that trigger traumatic memories.
• At least two arousal and reactivity symptoms are present, which include poor concentration, being easily startled, feeling tense, angry, or irritable, and difficulty sleeping.
• At least two cognition and mood symptoms, such as ongoing negative emotions (sadness, fear, guilt), loss of interest in activities, feeling socially isolated, and trouble remembering certain aspects of the traumatic event.

However, there is a silver lining. Of these individuals, many recover and no longer meet the diagnostic criteria for PTSD after they receive treatment.

In contrast, addiction is the most severe phase of substance use disorder, and when combined with symptoms of PTSD, the effects can be highly distressing. While one condition doesn’t cause the other, there can be a distinct link. For example, the same trauma that causes PTSD to develop can also trigger substance abuse. Drugs and alcohol can quickly become a form of self-medication. While this approach can make people feel more relaxed temporarily, substance abuse can worsen PTSD over time.

After prolonged periods of substance abuse, users may become dependent on drugs or alcohol to “relieve” symptoms of PTSD — although this is more of a band-aid solution. Depending on the substance being abused, physical dependency can also become a significant issue.

People can become so numb and dependent that they do not seek the treatment they need to live a fulfilling, happy life. Unfortunately, many individuals with PTSD and addiction feel disconnected from their friends and loved ones — even though those closest to them often want to help.

Fast Facts: The Link Between PTSD and Addiction

So, while one of these disorders does not “cause” the other, there is a close link between the two.

When examining veterans:

• Over 20% of veterans with PTSD also have substance use disorder.
• Nearly one-third of veterans seeking treatment for substance use disorder also have PTSD.
• Those who have PTSD and a drinking problem tend to binge drink.

A similar connection was made concerning substance use, childhood traumatic experiences, and PTSD. A study on traumatic life experiences found that physical or sexual abuse and neglect, especially in childhood, are known to increase the risk of psychiatric disorders in adulthood, particularly PTSD — which is highly comorbid with substance use disorder.

After examining 587 participants who experienced childhood trauma, it was found that:

• 39% showcased a lifetime dependence on alcohol
• 1% showcased a lifetime dependence on cocaine
• 8% showcased a lifetime dependence on marijuana
• 2% showcased a lifetime dependence on heroin/opiates

This study also reported that up to 59% of young people with PTSD subsequently develop substance abuse problems. However, this dynamic is incredibly complex, and individual variables must be considered, which is why holistic, personalized treatment is so important.

Signs and Symptoms of Dual Diagnosis

The symptoms of PTSD are discussed above. However, when a dual diagnosis is present, you may experience or notice the following:

• Worsening symptoms of both disorders
• Alcohol or drug use that is excessive (losing control over substance use)
• Struggling to complete everyday tasks because of both disorder’s symptoms
• Not maintaining personal hygiene
• Worsening or enhanced depression and anxiety
• An inability to enjoy life
• Needing substances to feel normal
• Isolating oneself from loved ones to hide substance use or PTSD symptoms
• Using substances to cope with distressing memories
• A compulsion to abuse substances when thinking about past traumatic events

Speaking with a professional is the first step in understanding whether one condition is present or two. That diagnosis will help guide your substance use and mental health treatment plan.

How Is Addiction and Co-Occurring PTSD Diagnosed?

Diagnosing an addiction alongside PTSD can be challenging because these disorders often have overlapping symptoms. To receive a diagnosis, licensed professionals leverage comprehensive assessment tools, taking several variables into account, including:

• Family history
• Medical history
• Mental health history
• History of substance abuse

There is also the possibility of polysubstance use, which refers to using more than one substance, which is relatively common among individuals with a dual diagnosis. Research shows that a subset of people with severe polysubstance use experience PTSD and major depression symptoms. The diagnostic process can be complex in these cases, and these individuals often require increased care.

PTSD and Addiction Treatment

Depending on the substances you use, PTSD and addiction treatment typically begins with a detoxification period. Mental health treatment, such as behavioral or combined therapy, will typically follow, and in some cases, medication-assisted treatment.

Each client is unique and will require a tailored treatment plan. However, here’s what you can typically expect from PTSD and addiction treatment.

Step One: Detoxification

When you enter a dual-diagnosis treatment plan, there will be an initial detox period. This process lasts days for some and weeks for others — although symptoms will gradually improve. Many will detox at home before entering an addiction and mental health treatment plan — but others may require medical support.

Withdrawal symptoms will vary depending on which substances you’re detoxing from, as some are more dangerous than others. For example, alcohol withdrawal can lead to seizures. The withdrawal symptoms from benzodiazepines and barbiturates can also be severe.

This step is something you can discuss with your healthcare provider, especially if you have pre-existing health concerns that withdrawal symptoms may complicate.

Step Two: Choose Your Program

When entering PTSD and mental health treatment for a dual diagnosis, you’ll have several options, depending on where you seek treatment.

In most cases, clients suffering from PTSD and addiction will enter an inpatient treatment program. This program offers 24-hour, on-site support and access to comprehensive treatment options, ranging from psychiatric services to experiential therapy.

Some clients will stay for 30 days, and others will remain for months. For this reason, you must seek a treatment facility that offers customized therapy and support.

Partial hospitalization programs (PHP) and outpatient programs are also available. These options are more flexible and are often offered to those with responsibilities outside of rehab or those seeking ongoing support after an inpatient program.

Discover Engage Wellness Acton’ Dual Diagnosis Program

The Engage Wellness Acton’ dual diagnosis program offers a professional, safe, and supportive environment for those living with PTSD and substance use disorder. Clients receive evidence-based treatment to help them overcome their addictions and address the trauma they have experienced. The result is a healthier, more fulfilling future.

If you’re ready to take the first step, we’re here to help. Contact us to begin your road to recovery today!