Mental health

PTSD and addiction: The trauma-substance use connection

Published March 1, 2025 · 8 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

The connection

Up to 50% of people seeking treatment for PTSD also have a substance use disorder. Substances numb traumatic memories, reduce hypervigilance, and provide temporary relief from intrusive thoughts.

The vicious cycle

Substances provide short-term relief but worsen PTSD long-term by preventing trauma processing, disrupting sleep (where consolidation occurs), and creating additional traumatic experiences during active addiction.

Integrated treatment

Trauma-focused therapy (CPT, PE, EMDR) delivered alongside addiction treatment. Both conditions must be addressed simultaneously. Treating only one leaves the other to drive relapse.

Key point

You do not need to choose between treating your trauma and treating your addiction. Modern integrated programs address both. Medication may help both conditions (prazosin for PTSD nightmares, naltrexone for alcohol cravings).

Authoritative sources

This article references guidelines from: NIH · NAMI · APA

Frequently asked questions

Should I treat both conditions at once?

Yes. Integrated treatment addressing both simultaneously produces significantly better outcomes than treating either alone.

How do I find a dual diagnosis program?

Search our directory or call SAMHSA at 1-800-662-4357 and specify you need dual diagnosis treatment.

Does insurance cover dual diagnosis treatment?

Yes. Under mental health parity laws, insurance covers both substance use and mental health treatment.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.