Mental health
PTSD and substance abuse: The trauma-addiction connection
Published November 4, 2024 · 8 min read · Updated April 2026
Reviewed for accuracy by licensed clinical professionals.
PTSD and substance use disorders co-occur at extremely high rates. Up to 50% of people seeking addiction treatment have co-occurring PTSD.
Why they co-occur
Substances temporarily manage PTSD symptoms: hyperarousal, intrusive memories, nightmares, and emotional numbing. The relief is immediate but temporary, driving repeated use.
Treatment
Integrated treatment addressing both simultaneously. Phase-based approach: stabilization, then trauma processing. EMDR and CPT are gold-standard trauma therapies. Seeking Safety curriculum for early recovery. MAT where appropriate.
Frequently asked questions
How common is PTSD in addiction?
Up to 50% of people seeking addiction treatment have co-occurring PTSD.
Should trauma be addressed during addiction treatment?
Yes. After initial stabilization, trauma processing should begin. Treating only addiction without addressing trauma leads to relapse.
What therapy works for PTSD and addiction?
EMDR, CPT, and Seeking Safety curriculum in an integrated treatment approach.
Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.