CPTSD and Substance Abuse

CPTSD and Substance Abuse – Complex post-traumatic stress disorder (CPTSD) is a more complex form of PTSD that may occur among those who experience repeated trauma. In addition to encountering many of the same symptoms as people with PTSD, those with complex PTSD (CPTSD) may undergo changes in how they react to stress or how they perceive themselves.

Identifying CPTSD

Complex PTSD is usually identified in individuals who have survived trauma, such as the following, for long periods of time:

  • Child abuse or exploitation
  • Domestic violence
  • Concentration camps or wartime imprisonment
  • Sex trafficking or brothel work

Some common PTSD symptoms include:

  • Re-experiencing the trauma as flashbacks, physical reactions, stressful memories and thoughts, or nightmares
  • Hyperarousal, which may be characterized by excessive alertness, difficulty relaxing, insomnia, lack of focus, irritability, and anger
  • Emotional detachment, in which some people refuse to discuss what triggers them, and avoidance of people or places that remind them of the trauma they have encountered
  • Mental health issues, such as the development of phobias or depression
  • Physical symptoms, which may include headaches, chest or stomach pain, and dizziness

People with complex PTSD experience the above symptoms, but they usually also suffer from additional symptoms, including:

  • Changes in beliefs, in which one may lose their faith or change their entire moral code
  • Disturbing thoughts, in which one may exhibit a strong desire for revenge against the person who traumatized them
  • Changes in their self-concept, in which one may feel guilty, helpless, or different from others
  • Severe emotional changes, in which one may feel outraged, depressed, or suicidal

Some factors can make CPTSD more intense, such as:

  • If the trauma occurred during childhood
  • If a parent, relative, or trusted adult was the person who inflicted the trauma
  • If the person accountable for the trauma has remained in contact with the victim

Effects of CPTSD

The most common effect of complex PTSD is feeling extreme anxiety when recalling the traumatic event. Those people suffering from CPTSD may feel that they are actually reliving the event, and may often think of the trauma, their desire to avoid focus on it notwithstanding.

Moreover, a person may completely change their life after a series of traumatic events. That is, they may alter their behaviors, belief systems, and self-image.

Complex PTSD often appears differently in men and women. While men are slightly more likely to encounter trauma than women, about half of all women experience a traumatic event sometime in their life, and most often, this trauma is related to sexual assault. Although not all women who suffer from trauma develop PTSD, the disorder is more likely to develop in women who have endured trauma than men.

One common problem that is often diagnosed alongside PTSD or CPTSD is the abuse of alcohol. Also, CPTSD is frequently associated with mental health illnesses, misuse of other substances, and a greater need for healthcare.

Treatment for CPTSD

Many current treatments for PTSD can also address symptoms of CPTSD effectively, including the following:


Individual or group cognitive-behavioral therapy (CBT) can provide tools for people experiencing CPTSD to cope with their stress, grief, and triggers. It can also teach people how to strengthen their relationships with loved ones.


Some medications that have historically been used for depression can also assist people with CPTSD. These drugs are best employed in conjunction with therapy, and they may be used in the short-term until individuals can learn how to manage underlying issues.

Eye Movement Desensitization and Reprocessing (EMDR)

Primarily used for PTSD, this technique can also help people with CPTSD. EMDR helps people process traumatic events by asking them to recall a past trauma and moving their eyes along with a trained therapist’s hand motion.

CPTSD and the Misuse of Substances

Although we still need more data on CPTSD and substance abuse, the National Center for PTSD has collected a considerable amount of information on PTSD and the use of drugs and alcohol. In fact, people who live with PTSD may be more likely to experience problems with drinking. Consider the following statistics:

  • Up to 30% of people who have survived accidents, disasters, or serious ailments report having drinking issues.
  • Up to 75% of people who have experienced violence or abuse also engage in problematic drinking.
  • Vietnam veterans who seek treatment for PTSD report issues with drinking about 70% of the time.


Dissociation interferes with self-awareness, memory, identity, and consciousness. These interruptions can cause a person not to recall certain things and to feel a break in their personality. Some PTSD and CPTSD sufferers may unwittingly employ dissociation tactics as a means to deal with trauma.

Some common symptoms of dissociation related to CPTSD and PTSD are:

  • The inability to recall certain life events
  • Losing touch with certain life events
  • Encountering unwanted flashbacks

More severe symptoms can include the following:

  • Derealization, or the feeling that one’s surroundings aren’t real
  • Depersonalization, or feeling that one’s thoughts and experiences belong to another person

Risk factors for people who suffer from these more severe symptoms include:

  • Experiencing multiple traumatic events
  • Being male
  • Experiencing other mental health issues
  • Having a disability that causes numerous daily obstacles


According to a study published in the journal Depression and Anxiety, about 20% of those who experience PTSD self-medicate with drugs or alcohol in order to cope with its symptoms and their past trauma. This results in a poorer quality of mental health and increases the risk of suicide ideations and attempts.

While some people with PTSD or CPTSD may abuse prescription or illegal drugs in order to cope with symptoms of PTSD, many will turn to alcohol. One theory on the association between alcohol and PTSD is that alcohol might release endorphins that temporarily help the person feel better.

Treatment for CPTSD and Drug Abuse

According to the National Institute of Drug Abuse, employing an integrated approach to addiction treatment can help people suffering from co-occurring substance abuse and mental illnesses, such as CPTSD. As many as 6 out of 10 users of illicit drugs may also be dealing with mental health issues.

To treat symptoms and underlying issues related to both CPTSD and substance abuse, people should seek an accredited and licensed addiction treatment center, such as Recovery in Tune, which uses a comprehensive approach to physical and mental health. Any program, whether inpatient, partial hospitalization, or outpatient, should employ qualified medical and mental health staff who specialize in addiction.

Also, programs should include the following features:

  • Treatment is focused on the whole, unique individual, not just the addiction or mental health issue.
  • Treatment needs to be customized because no one responds to one form of treatment in the same way as others.
  • Clients must remain in treatment for an appropriate amount of time.
  • Follow-up care is critical to experiencing sustained recovery.
  • Care providers should evaluate and modify treatment as necessary according to the person’s progress and changing needs if any.
  • Support from family and friends is vital to a successful recovery process.

There is no instant cure for CPTSD or addiction, but long-term care can manage both conditions. We can help you reclaim your life, learn how to deal with trauma using healthy coping mechanisms, and experience a fulfilling life free of drugs and alcohol. Contact us today!

Related: Social Anxiety and Alcohol Use Disorder

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