Treating Substance Use Disorders and PTSD
Learn about one effective way to simultaneously treat PTSD and SUDs.
Posted February 17, 2021
“A lot of people think the problem for Philip Seymour Hoffman was drugs. It wasn’t – that was the solution to his problem.” – Seth Jaffe
I remember reading that quote a long time ago and thought it was so profound because it speaks to the fact that addiction doesn’t occur in isolation. It’s often associated with other mental health concerns, and drugs and alcohol can be used to help cope with those concerns.
Research suggests that approximately 72 percent of women and 57 percent of men experience another mental health problem in addition to their substance use disorder. Data shows that for women, major depression is often primary to the substance use disorder. Interestingly, this is the opposite finding compared to men, where depression is often a result of the primary substance use disorder diagnosis (Zilberman, Tavares, Blume, & el-Guebaly, 2003).
Dual Diagnosis Treatment
This data points to the necessity and importance of comprehensive, dual diagnosis treatment when searching for substance abuse treatment. It is not enough to treat the substance use disorder in isolation.
When treating any mental health concern, but in particular dual diagnosis issues, there’s no one-size-fits-all approach. What works for one person may not work for another. It’s important for you as the patient to find the right match who’s able to collaboratively work with you to figure out how depression, PTSD, or anxiety, etc. is related to substance use concerns.
PTSD and Substance Abuse Treatment
In particular, I want to highlight the comorbidity that exists between PTSD and substance use disorder. Many clinicians may think that treating PTSD while in substance abuse treatment is premature and dangerous for recovery. Although clinical judgment and discernment are definitely needed in these complicated situations, research has shown that working through PTSD and substance use disorders simultaneously is effective (Schumm & Gore, 2016). Furthermore, specific treatments have been developed to deal with this issue, including COPE.
What is COPE?
COPE is Concurrent Treatment of PTSD and Substance Use Disorders through Prolonged Exposure (COPE). It is simply a modified version of Prolonged Exposure (PE), a common and extremely effective, evidence-based treatment for PTSD. PE guides patients through imaginal and in vivo exposures. Imaginal exposures are when the individual recounts and imagines themselves in their traumatic event again, while in vivo exposures are when the individual gradually exposes themselves to feared situations that have resulted from the trauma.
There is a great deal of nuance in creating these exposures, as well as what they look like in treatment, but the main point is that doing exposures (in a safe treatment environment) can help the individual learn new things about the traumatic event, see their role differently, habituate to the anxiety and feared stimuli, and, ultimately, recover from the present difficulties.
Substance Abuse Treatment Options
If you or a loved one are experiencing substance use disorders and co-occurring mental health concerns, find a local mental health provider who is familiar with PE or COPE. In particular, if you or a loved one are experiencing PTSD and substance use disorders, it’s important to find a provider who is equipped to handle both.