Self-Medicating - A Risky Form of Self-Treatment for PTSD

Why Drugs and Alcohol Won't Make Things Better for You

Teenage alcoholic
Peter Dazeley/Photographer's Choice/Getty Images

People with PTSD commonly use or abuse drugs and alcohol, and self-treatment with substances, known as self-medicating, may help to explain their high rates of substance use.

Consider the statistics:

  • Among people who have had PTSD, approximately 31% have also abused drugs or have been dependent on them at some point in their lifetime.
  • Approximately 40% of people who have had PTSD have also abused or been dependent on alcohol.

    The high rate of co-occurrence between PTSD and substance use has led researchers to try and better understand this relationship so that treatments can be targeted more effectively.

    Substance Use as Self-Treatment

    Substance use problems are more likely to follow the development of PTSD, suggesting that there is something about having PTSD that may increase risk for substance use problems.

    One major theory of the relationship between PTSD and substance use is that a person's use of drugs or alcohol is motivated by their desire to escape or alleviate the distressing symptoms of PTSD. This is known as self-medicating. 

    One study of cocaine users with PTSD found that the majority of people studied believed that their PTSD and substance use were related. And as their PTSD symptoms got worse, their drug use increased as well. Conversely, as their PTSD symptoms got better, their drug use also decreased.

    Other researchers have found specific relationships between certain PTSD symptoms and the types of substances used. For example, the severity of hyperarousal symptoms of PTSD is strongly connected with the use of substances that have a depressant or anti-anxiety effect, such as alcohol.

    It's important to note, however, that self-medication is not the only theory as to why PTSD and substance use are related.

    Other possible connections aside from self-treatment:

    • Using substances may put a person at risk to experience traumatic events, and thus, PTSD.
    • Some people may have an underlying genetic vulnerability for developing both substance use problems and PTSD.

    Consequences of Self-Treating PTSD with Substances

    If you turn to drugs or alcohol (or both) when you're dealing with PTSD, it may initially help you feel less distressed. But in the long-run self-medicating can cause many serious problems.

    Substance use is a short-term fix. Your PTSD symptoms may come back even stronger, resulting in stronger desires to use substances. Plus, people with PTSD and substance use problems are at increased risk for experiencing a number of negative consequences, such as:

    Getting Help Instead of Self-Treating PTSD with Drugs or Alcohol

    It makes sense that people with PTSD would want to alleviate distress that results from their PTSD symptoms, but substance use is definitely not the answer.

    Specialized treatments for people with PTSD and substance use problems have been developed. One such popular and well-established treatment is Seeking Safety. This treatment can help you understand the relationship between PTSD and your substance use. It can also provide you with additional skills for managing your distressing PTSD symptoms, so you're less reliant on drugs and alcohol.


    Back, S., Brady, K.T., Jaanimagi, U., & Jackson, J.L. (2006). Cocaine dependence and PTSD: A pilot study of symptom interplay and treatment preferences. Addictive Behaviors, 31, 351-354.

    Back, S., Dansky, B.S., Coffey, S.F., Saladin, M.E., Sonne, S., & Brady, K.T. (2000). Cocaine dependence with and without post-traumatic stress disorder: A comparison of substance use, trauma history, and psychiatric comorbidity. The American Journal on Addictions, 9, 51-62.

    Brady, K.T., Killeen, T., Saladin, M.E., Dansky, B., & Becker, S. (1994). Comorbid substance abuse and post-traumatic stress disorder: Characteristics of women in treatment. American Journal on Addictions, 3, 160-164.

    Brown, P.J., Stout, R.L., & Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 13, 115-122.

    Chilcoat, H.D., & Breslau, N. (1998). Investigations of causal pathways between PTSD and drug use disorders. Addictive Behaviors, 23, 827-840.

    Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.

    McFall, M.E., Mackay, P.W., & Donovan, D.M. (1992). Combat-related posttraumatic stress disorder and severity of substance abuse in Vietnam veterans. Journal of Studies on Alcohol, 53, 357-363.

    Najavits, L.M., Weiss, R.D., & Shaw, S.R. (1999). A clinical profile of women with posttraumatic stress disorder and substance dependence. Psychology of Addictive Behaviors, 13, 98-104.

    Najavits, L.M., Weiss, R.D., Shaw, S.R., & Muenz, L.R. (1998). “Seeking Safety”: Outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence. Journal of Traumatic Stress, 11, 437-456.

    Stewart, S.H., Conrod, P.J., Pihl, R.O., & Dongier, M. (1999). Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women. Psychology of Addictive Behaviors, 13, 78-88.

    Tull, M.T., Baruch, D., Duplinsky, M., & Lejuez, C.W. (in press). Illicit drug use across the anxiety disorders: Prevalence, underlying mechanisms, and treatment. In M.J. Zvolensky & J.A.J. Smits (Eds.), Health behaviors and physical illness in anxiety and its disorders: Contemporary theory and research. New York, NY: Springer.

    Continue Reading