Veteran in therapy understanding the connection between PTSD and alcohol

The Connection Between PTSD and Alcohol

The relationship between Post-Traumatic Stress Disorder (PTSD) and alcohol abuse plays a significant role in how to treat the dual diagnosis. A person can have PTSD and later partake in alcohol abuse or first suffer from alcohol abuse and then PTSD. Either way, alcohol abuse can worsen PTSD. They are both debilitating to physical and mental health.

Is Alcohol Abuse Serious?

Alcohol abuse doesn’t necessarily mean addiction. Alcoholism is an alcohol addiction. It is both a physiological disease and a mental health issue, whereas alcohol abuse is a mental health disorder without the disease. 

Abusing alcohol can become an alcohol use disorder, but in and of itself, alcohol abuse signifies a person’s harmful use of alcohol. It is serious as alcohol abuse worsens PTSD symptoms.

What is PTSD Exactly?

PTSD develops after significant trauma or traumatic experience. The stress of living through or seeing a traumatic event like war, violent crime such as rape or murder, or ongoing physical and mental abuse can cause people to relive traumatic events. They may feel like they cannot get away from it, become edgy, and unable to get through their days. 

People with PTSD may develop sleep disorders or experience flashbacks. They may avoid anything or anyone related to the traumatic event they’ve experienced.

Anyone can develop PTSD, including children, and women are more likely to develop PTSD than men. PTSD symptoms may vary, so it is important to discuss any signs or concerns with a mental health professional.

Is There a Connection Between Alcohol and PTSD?

Many people turn to alcohol to numb their PTSD symptoms. They may feel alcohol helps them cope, so they continue to self-medicate. There is a physiological connection as well between mental health and substance abuse. 

When someone experiences a traumatic event, the brain releases endorphins. These neurotransmitters signal the brain to release hormones that provide a sedative or analgesic effect that reduces pain and stress. Our brain operates on a “fight or flight” response.

After the traumatic event, our brain stops releasing endorphins, and that sedative effect disappears. Many people turn to alcohol to replace that sedative effect that the brain withdrew. The problem is that the coping mechanism becomes alcohol consumption when the person finds that they must drink more to feel that analgesic effect. This can turn the diagnosis of PTSD into a dual diagnosis of alcoholism and PTSD.

What are Treatment Options for Dual Diagnosis?

Dual diagnosis treatment can be challenging. It takes an interdisciplinary team of physicians, nurses, and mental health professionals to create the patient care plan to treat PTSD and alcoholism. Through a holistic approach, addiction treatment professionals can address substance abuse and mental health conditions. 

The care plan must include both holistic and targeted medical care for co-occurring disorders. This includes detox and medications to treat the alcohol disorder and psychotherapy to treat PTSD. Both diagnoses, however, will be treated with medication and psychotherapy as warranted by the interdisciplinary care team.

  • Detoxification (detox)
  • Medication
  • CBT Therapy
  • Support groups


Before substance abuse treatment comes detox so that stabilization can occur. Stabilization entails withdrawal from alcohol and any other substance use. Alcohol detox is a serious and life-threatening health issue that must be immediately addressed so that PTSD can be treated. 

Withdrawal symptoms include delirium tremens (known as the DTs), restlessness, anxiety, seizures, and hallucinations. Severe depression is not uncommon, as are other physiological side effects such as sweating, high blood pressure, increased heart rate, chills, sleeplessness, and vomiting.

PTSD Medication

There are four medications recommended for PTSD (generic names in bold):

Sertraline: a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant. Brand name: Zoloft

Paroxetine: an SSRI antidepressant that raises serotonin in the brain. Brand name: Paxil

Fluoxetine: an SSRI antidepressant. Brand name: Prozac

Venlafaxine:  a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) antidepressant. Brand name: Effexor

Only sertraline and paroxetine are FDA-approved at this time. Note that many other brand names exist for the above-listed generic SSRI and SNRI medications. Both SSRI and SNRI medications work to raise serotonin levels in the brain. 

The main difference is that SNRIs also work on norepinephrine neurotransmitters. These medications help restore the brain’s hormonal balance to enhance mood, better sleep patterns, memory, and appetite.

Alcohol Detox Medication

There’s a wide range of alcohol detox medications used to reduce the side effects of detox, but just three of them are FDA-approved, each working on withdrawal symptoms differently.

  • Disulfiram: also called Antabuse. It works by changing how alcohol is broken down and processed in the body.
  • Naltrexone:  works by removing the euphoria felt after drinking.
  • Acamprosate: also called Campral. It helps control fear and anxiety after detox has started.

Detox medications balance a patient’s body chemistry to reduce the withdrawal symptoms and side effects of detoxification. After the detoxification process, other therapies, like behavioral therapy, begin.

Behavioral Therapy

The dual diagnosis of PTSD and alcohol abuse both benefit from behavioral or talk-therapy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, goal-oriented talk therapy that teaches patients how to use their beliefs, thoughts, and feelings to problem solve – taking negative, destructive behavior and learning to replace that behavior with positive, desirable behavior.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) goes further than CBT for those struggling with intense, harmful beliefs, thoughts, and feelings. By identifying those feelings that lead to self-harm, patients learn to better cope with their PTSD and alcohol abuse. 

Support Groups

Support groups provide peer-run programs for patients with dual diagnosis PTSD and alcohol abuse. Alcoholics Anonymous (AA) utilizes a 12-step support system for sharing hope and experiences – connecting people going through day-to-day living with alcoholism. Some steps include admitting that you’re powerless over alcohol and making amends for those you’ve hurt. 

PTSD peer-led support groups aren’t a direct PTSD treatment but provide the opportunity for those with PTSD to connect with others with the same diagnosis.

Support groups are essential to others so that patients suffering from PTSD and alcohol abuse don’t feel like they are facing the dual diagnosis alone.

Find Support with Inland Detox

Dual diagnosis can be treated successfully, so patients recover fully. Inland Detox treats PTSD and substance use disorders concurrently in a professional yet comfortable, quiet setting. After assessment and stabilization through the detox process, our interdisciplinary team will develop an effective treatment plan, including discharge decisions. Discharge is most often in an inpatient residential setting.

We accept referrals from treatment centers throughout Southern California that don’t offer inpatient detox. Many patients also self-refer for a myriad of reasons. Regardless of referral type, our compassionate care team respects and supports every patient’s unique dual diagnosis of PTSD and alcohol abuse. 

Contact us when you are ready for help.