Substance Abuse and PTSD

The use of addicting and illegal drugs is an ongoing problem for many people suffering from PTSD. It’s estimated that about half of the men and a quarter of the women qualify for a Substance Abuse diagnosis. Among Vietnam veterans, it’s closer to 80%, probably because there were fewer treatment options forty years back. Unfortunately, people with both PTSD and Substance Abuse have a more difficult time with recovery, suffer more PTSD symptoms, and are at higher risk of suicide.

Alcohol and Benzodiazepines:

The most commonly used drug is alcohol, probably since it’s legal. When you can’t sleep, it’s easy to pour yourself a drink. At first it works. This encourages you to have one every night, or maybe two, or three.

What most people don’t realize is that alcohol, and also the benzodiazepines like Valium, Xanax, Klonopin, and Ativan, lull you with calmness while dragging you down into a very deep hole. Problems arise because these drugs work by releasing a chemical called GABA. GABA is the primary calming chemical in the brain, the off switch on our neural TV screen, so releasing GABA turns worries off and calms you down.

What’s wrong with that?

The problem comes with the word “release”. Our brains can make GABA, but not quickly. So if we release some GABA once a week—no problem. If we release it once a day—probably okay. But if we start releasing quantities of GABA several times a day for weeks or months, we get in serious trouble because we don’t have enough GABA left.

Since GABA is the off switch in the brain, not having enough means our brain gets very hyper. We start to shake, get irritable and angry, can’t sleep, and can progress to hallucinations— even seizures. Delirium Tremens, commonly called DTs, can be lethal, and benzodiazepine withdrawals are equally dangerous. Even if you keep on drinking or taking pills, they no longer work because there’s less GABA to release.

Bottom line: Go easy on the alcohol and benzos. They may help in an emergency, but they can make serious trouble if you use them all the time.


Marijuana is now legal in some states. It’s reported to reduce both anxiety and flashbacks, and there is actually a scientific basis for this claim. Recent research shows a reduction in natural cannabinoids in the brains of people with PTSD and an increase in cannabinoid receptors (your brain is listening hard for a weak signal).

Now there is further evidence that cannabis can help with PTSD. Recent research suggests that using MJ right after a trauma may actually prevent PTSD. It also can be useful during exposure therapy as it helps to disconnect your triggers from your memories. Hopefully MJ will soon become available for medical use in all fifty states, but be very sure your state has approved it before using. Being arrested and incarcerated is a very serious side effect that creates continuing problems in your life.

Side effects from MJ include reduced short-term memory and reduced focus and motivation. There may be new strains that have reduced these problems, but both standard marijuana and cannabinoids synthesized by pharmaceutical companies. (Yes, they would love to make money off of you) can produce these side effects.

Finally, if you’re under twenty-five your brain is still maturing and MJ poses a more serious risk. Cannabinoids have been proven to increase both depression and psychosis in young brains, and the problem continues long after you stop use.

Bottom line: Cannabinoids found in marijuana can be helpful in PTSD, but they can impair your memory and focus. If you use, please evaluate for side effects and keep yourself safe.


Opiates are popular with PTSD clients for two reasons. First, opiates have an alpha-blocking component which helps calm down hyper-arousal symptoms. Second, they block pain. Many survivors have physical injuries, and emotions associated with traumatic memories can also cause significant distress, so a drug that reduces that discomfort is tempting.

But if you take opiates for any length of time, you develop tolerance, and they no longer work. That’s because the opiates replace your natural pain reducing chemicals—endorphins. The more opiates you use, the less natural pain chemicals you make.

Then you face a difficult decision. You can’t keep increasing your dose indefinitely. Using the same dose of opiate doesn’t work. And if you stop, you’re body reacts with serious discomfort and intestinal distress until it can remake it’s own endorphins. Luckily, opiate withdrawals aren’t lethal, but they’re painful.

Bottom line: Instead of narcotics, try alpha-blockers like Prazosin, or sedatives containing alpha blockers like Trazodone or Seroquel. Then work on letting go of your emotional pain using techniques in the blog: Treatment for Flashbacks, Nightmares, and Intrusive Memories.

Cocaine, Crack, Methamphetamine:

These drugs work by releasing dopamine, a chemical that activates the pleasure center in our brain. That makes them the most addicting drugs and the most dangerous. They release so much dopamine so fast they can burn out your dopamine receptors. After that nothing else can make you feel good for a long time.

Worse yet, these drugs can kill you with a heart attack or stroke. When a person under 30 shows up in the ER with symptoms of MI or stroke, the doctors always test them for cocaine and meth, and usually find it.

Bottom line: Just don’t. If antidepressants aren’t working for you, try X-sports. They’re safer than these drugs.


If you’re addicted to a drug, don’t give up hope. Call us Today866-671-5101

Research suggests that it’s best to find a treatment counselor who can work with both your addiction and PTSD problems. In most cases, your PTSD symptoms will drive the substance use, so you need to treat them simultaneously.