Trauma, PTSD, Substance Abuse and Treatment: An Overview

ptsd substance abuseTom Atonek is a licensed psychologist at The Refuge – A Healing Place and the President of Serenity Mission, a community based organization with a full range of psychiatric and substance abuse outpatient services.

Individuals who suffer from symptoms of PTSD have been exposed to actual or threatened death, serious injury, or sexual violence. Combat veterans definitely are a high risk group for developing PTSD. In addition, individuals who have witnessed such events as violence toward others can develop PTSD. For example, first responders such as law officers, fire fighters, and paramedics experience multiple repeated traumatic incidents that have a debilitating impact on their overall psychological functioning.

Subsequently, those who suffer from PTSD are subject to intrusive and distressing thoughts or images that recall the traumatic events. They may perceive that the event is reoccurring, as in illusions or flashbacks. When this does occur, the individual is besieged with overwhelming anxiety and feelings of powerlessness that increase the experience of unbearable fear. Therefore, a sense of detachment from others can occur and they may isolate from those that can and want to provide support.

Individuals who suffer from traumatic experiences are extremely vulnerable toward developing a substance use disorder as a means of coping with the devastating effects of PTSD. Most individuals who do not have a substance use disorder or trauma history consume alcohol responsibly and socially as a means of enhancing their overall social experience. In this regard, they drink to “Feel Good”. However, traumatized individuals who abuse mind altering substances tend do drink or drug in order to “NOT FEEL.”

Contemporary research supports this phenomenon. Reynolds, (2012), conducted a study on clients from community and inpatient treatment settings. Their study concluded:

“Substance use appears to have had the effect of dampening the memories for those with post-traumatic stress disorder (PTSD), and significantly more individuals reported that their memories were less vivid and less distressing before they ceased substance use…The findings suggest that continued substance use could in part be motivated by its capacity to dampen distressing memories within the PTSD group.”

This self-medicating co-morbidity is common among Refuge clients and the clinical staff directly treats this dynamic phenomenon.

Many of the clients at The Refuge present with complicated co-morbid clinical syndromes that include PTSD, Polysubstance Dependence, and Mood Disorders. In a random sample of 78 Refuge clients from 2012-2013; 75% of the clients had a diagnosis of PTSD and 98% of those with PTSD had a co-morbid substance use disorder. Since the typical client at The Refuge appears to support the contemporary research findings, the clinical staff is trained in the Spirit2Spirit (S2S) curriculum and trauma treatment leading to the Certified Trauma Therapist (CTT) professional credential. Part of that training includes an understanding of the dynamic impact of trauma on the development of substance use disorders in those who suffer from PTSD.

First and foremost, clients at The Refuge are stabilized medically from the effects of alcohol and drug dependence in the context of the safe and tranquil environment which is enveloped in a state forest. In this regard, western medical practices related to detox meet eastern practices of meditation, breath work, and mindfulness exercises as a means of rehabilitating the body, soul, and spirit of the early recovering addict. The trauma recovery work is conducted in individual assignments such as the “Trauma Egg, Body Map, and Time Line”. In essence, these exercises require in depth and honest self-exploration, followed by courageous disclosure to clinicians and peers, who provide support and affirmation for the audacious fearlessness that it takes to do the work of healing from the psychological devastation imposed on victims of traumatic experience.

It is impossible to actually quantify precise success rates for recovery from co-morbid substance use disorders and PTSD. However, the majority of the hundreds of alumni that remain connected with the “Refuge” and affectionately have labeled themselves as Refugee’s, are a living testimony to the transformative healing power that takes place in the lives of those who have participated in treatment at The Refuge. This is truly humbling to clinicians and staff that serve clients at The Refuge. We consider it a privilege and honor to be a part of the solution for those still suffering from the horrendous impact of trauma on the quality of life for those who have been violated and ravaged.

Reference: Intrusive memories of trauma in PTSD and addiction. Martina Reynolds, Sheena Nayak and Christos Kouimtsidis. The Psychiatrist (2012), 36, 284-289, doi: 10.1192/pb.bp.111.037937



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