Post-Traumatic Stress Disorder and Addiction

Persons suffering from PTSD are in danger of turning to alcohol and drugs as a form of self-medication.

Post-traumatic stress disorder (PTSD) and addiction frequently occur together. For some people, alcohol or other drugs become a way of coping with overwhelming trauma symptoms – often before PTSD has been formally recognised or treated.

PTSD is a mental health condition that can develop after exposure to actual or threatened death, serious injury, or sexual violence. While many people experience distress following trauma, only a proportion go on to develop PTSD.

In Australia, around three in four people will experience at least one traumatic event during their lifetime, yet approximately one in four people exposed to trauma will develop PTSD.

What Is Post-Traumatic Stress Disorder (PTSD)?

PTSD may develop following either a single traumatic incident or prolonged, repeated trauma.

Traumatic experiences may include:

• Serious motor vehicle accidents
• Sexual assault or childhood abuse
• Domestic or family violence
• Natural disasters
• Military combat or emergency service work
• Ongoing emotional, physical or psychological abuse

Despite common misconceptions, PTSD is not limited to military personnel and frontline first responders. In Australia, severe motor vehicle accidents are among the most common causes of PTSD.

Common symptoms of PTSD

PTSD symptoms typically fall into four broad categories:

Intrusive symptoms

• Recurrent, distressing memories or “flashbacks”
• Nightmares related to the trauma
• Intense emotional or physical reactions to reminders

Avoidance

• Avoiding people, places or situations linked to the trauma
• Avoiding thoughts or conversations about the event

Negative changes in mood and thinking

• Emotional numbness or detachment
• Persistent feelings of guilt, shame or hopelessness
• Difficulty experiencing positive emotions

Hyperarousal

• Being constantly “on edge” or easily startled
• Irritability, anger or outbursts
• Sleep disturbance and concentration difficulties

Many people experience some of these symptoms immediately following trauma. For most, they resolve naturally over time. However, if symptoms persist for more than several weeks or significantly interfere with daily functioning, professional support is essential.

The Relationship Between PTSD and Addiction

People living with PTSD are at significantly increased risk of developing substance use disorders.

Alcohol and other drugs may initially appear to provide relief by:

• Dulling intrusive memories
• Reducing emotional distress
• Promoting sleep or emotional numbing

Alcohol, in particular, is commonly used because it is legal, accessible and socially accepted.

However, substance use typically worsens PTSD symptoms over time.

• Intoxication can heighten hyperarousal, impulsivity and aggression
• Withdrawal often intensifies anxiety, nightmares and sleep disturbance
• Risk-taking behaviours increase, including unsafe driving or confrontation
• Substance use can delay trauma recovery and reinforce avoidance

When PTSD and addiction occur together, individuals face increased risks of relationship breakdown, legal consequences, physical injury and suicide.

Why Dual-Diagnosis Treatment Is Essential

When PTSD and addiction co-occur, both conditions must be addressed together.

Treating addiction alone, without recognising unresolved trauma, leaves people vulnerable to relapse, as substance use may have been their primary coping strategy. Likewise, trauma therapy is unlikely to be effective while substance use remains unstable.

An integrated, trauma-informed treatment approach allows for:

• Stabilisation and safety
• Careful pacing of trauma work
• Development of healthy coping strategies
• Reduction in relapse risk
• Improved long-term recovery outcomes

With the right support, people can recover from both trauma and addiction and rebuild a sense of safety, connection and control.

Find out more

Mental Health and Addiction
Diagnosing Mental Health Disorders
Common Co-Occurring Disorders
Mental Health Effects of Ice
Are Mental Health and Addiction Connected?

References

1. Australian Institute of Health and Welfare (AIHW). Post-traumatic stress disorder in Australia. Canberra: AIHW; 2023. https://www.aihw.gov.au
2. Phoenix Australia – Centre for Posttraumatic Mental Health. Understanding PTSD and trauma recovery. https://www.phoenixaustralia.org
3. Beyond Blue. Trauma and PTSD. https://www.beyondblue.org.au
4. National Drug and Alcohol Research Centre (NDARC). Substance use and trauma-related mental health conditions. UNSW Sydney. https://ndarc.med.unsw.edu.au
5. Royal Australian and New Zealand College of Psychiatrists (RANZCP). Clinical guidance on PTSD and comorbid substance use. https://www.ranzcp.org