Treatments for Substance Abuse and PTSD

Seeking Safety

There is a definite need for treatments for substance abuse and PTSD. This is because it is common for individuals with PTSD to also develop problems with alcohol and drug use. In fact, these problems co-occur quite frequently. Alcohol and drug use can interfere with standard treatments for PTSD. Therefore, people have developed specialized cognitive-behavioral treatments for substance abuse and PTSD.

One such treatment is called Seeking Safety.

If you are unfamiliar with what is meant by the term "cognitive-behavioral," it may be important for you to first read about this form of treatment here.

Seeking Safety: An Overview

Seeking Safety was developed to specifically target the unique problems that result from having difficulties with both drug/alcohol use and PTSD.

It is a 24-session cognitive behavioral group therapy that teaches people with PTSD and substance use problems a number of different coping skills.

Some of these coping skills include learning how to ask others for help, recognizing warning signs or high risk situations for drug/alcohol use, self-care, and coping with PTSD symptoms.

This treatment recognizes that the individual with both PTSD and drug/alcohol use problems is at risk for a number of negative outcomes, such as bad relationships, the experience of another traumatic event, or even death.

Therefore, its top priority is improving the person's safety, and all skills are geared towards this focus.

Support for Seeking Safety as a Treatment for PTSD and Drug/Alcohol Use

Several studies have examined the success of Seeking Safety in helping people with PTSD and drug/alcohol use problems. This treatment has strong support.

In general, this treatment has been found to:

  • reduce drug/alcohol use

  • reduce PTSD symptoms

  • reduce risk for suicide

  • reduce thoughts about suicide

  • reduce depression

  • improve social skills

  • improve family life

  • improve problem-solving

Want More Information on Seeking Safety?

There is a website devoted to Seeking Safety that describes the treatment in more detail, as well as how to locate groups being offered across the United States. The website also describes studies that provide support for Seeking Safety. You can also learn more about Seeking Safety, as well as other cognitive behavioral treatments for PTSD that have support in reducing the symptoms of PTSD (such as Prolonged Exposure and Cognitive Processing Therapy) at the American Psychological Association.


Hien, D.A., Cohen, L.R., Miele, G.M., Litt, L.C., & Capstick, C. (2004). Promising treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry, 161, 1426-1432.

Najavits, L.M. (2002). Seeking Safety: A treatment manual for PTSD and substance abuse. New York, NY: Guilford Press.

Najavits, L.M., Weiss, R.D., & Liese, B.S. (1996). Group cognitive-behavioral therapy for women with PTSD and substance use disorder. Journal of Substance Abuse Treatment, 13, 13-22.

Zlotnick, C., Najavits, L.M., Rohsenow, D.J., & Johnson, D.M. (2003). A cognitive-behavioral treatment for incarcerated women with substance abuse disorder and posttraumatic stress disorder: Findings from a pilot study. Journal of Substance Abuse Treatment, 25, 99-105.

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