PTSD and substance misuse

What Is PTSD and Its Relationship to Substance Misuse?

Published on April 14, 2020 by First Responder Wellness

Post-traumatic stress disorder, known as PTSD, is an anxiety disorder brought about by exposure to a disturbing or shocking event. PTSD may occur due to experiencing or witnessing:


  • Natural disasters
  • A serious accident
  • War or combat
  • Violent personal assaults or attacks
  • Rape


People exposed to these types of terrifying situations may become witnesses, survivors, or victims. As a first responder, these types of situations present themselves more frequently than they would for your average adult.

Due to the various situations that may cause PTSD, it is also expected that first responders may suffer from PTSD stemming from these types of occurrences.


Symptoms of PTSD

The symptoms of PTSD may occur in any person after experiencing a traumatic event or sequence of events. These symptoms include, but are not limited to:


  • Reliving or re-experiencing the trauma, possibly through flashbacks
  • Avoiding people, including family members and friends
  • Feeling emotionally numb
  • Experiencing thoughts related to the event
  • Difficulties sleeping
  • Exaggerated response when startled
  • Being abnormally alert to potential threats or dangers


It is normal for individuals to suffer from some or all of these symptoms at any period of time following the traumatic event. These indications are also not limited to the “Hollywood” representation of what PTSD looks like.

While yes, PTSD is common in those who are in the armed services, it can affect first responders in an equally debilitating fashion. PTSD is an overarching diagnosis for a very intimate and personal issue, requiring specialized care in the recovery process.

Every person’s trauma is different in its own way, and labeling something as just “part of the job” can be a barrier to identifying and healing from the occupational struggles that appear. This is important to remember as one seeks to heal and grow from life’s obstacles, such as PTSD.


PTSD and Substance Misuse

When left untreated, PTSD is a burden that is often unrecognized or dealt with in unhealthy ways. One of the most common ways individuals cope with PTSD is using substances such as drugs and alcohol to drown out or numb the painful trauma that lies within.

When dealing with immense emotional pain, such as trauma, the fight-or-flight response is left in an open loop. The brain is now stuck in a state where there is an overactive fight-or-flight response and alternates between the two when the response need not be active.

An example of this occurring as it pertains to a situation is a firework going off. Someone who does not suffer from PTSD hears the loud noise, and processes this as a firework, and continues to carry on with their day.

They may be startled from the loud noise at worst, but the person processes this for what it is: a firework. For someone who has suffered from PTSD due to, say, a shooting or an explosive device going off, this loud sound may be processed in direct relation to the traumatic event that occurred, causing them to relive the event.

The brain, stuck in the fight/flight loop, cannot respond in the proper way and is left in this hyperactive state for a period of time. This is just one example of how this loop leads to improper response mechanisms in the brain. 


With this debilitating disorder now present in day-to-day life, seemingly innocuous situations to some prove to be huge triggers for those with PTSD. For many, the only way to turn off or drown out this response mechanism is to use substances in an unhealthy manner.

Research points to a strong relationship between substance misuse and PTSD. In some instances, substance use begins following both the traumatic event and the development of PTSD.

Therefore, PTSD is considered a risk factor for subsequent substance use disorders (SUDs). Recognizing signs early and seeking treatment for those who suffered severe trauma, violence, or experienced a disaster is crucial for aiding in the prevention of PTSD development.

Those with clinically diagnosed PTSD and SUDs also tend to suffer from more severe PTSD symptoms than those with PTSD who do not have SUDs. PTSD can work hand in hand with SUDs to create a dynamic that is difficult but not impossible to recover from.

There is hope for recovery, and many people who have experienced PTSD, SUD, or both have recovered and gone on to live incredible lives. PTSD is not a death sentence, nor does it have to be something that one struggles with for life. Recovery is possible with the proper treatment.


Looking for a Helping Hand? The First Responders Treatment Program at Simple Recovery uses trauma-informed strategies to cater to the unique needs of law enforcement, firefighters, paramedics, and other first responders with substance use disorders and co-occurring mental illnesses. We recognize that first responders encounter job-specific barriers and obstacles that come with the culture of their careers, and that existing stigma may make seeking help for addiction and mental health issues especially difficult. Addiction does not have to mean the end of your career or a lifetime of struggling with your health and relationships.

By taking a holistic approach to treatment and addressing the underlying causes of addiction, Simple Recovery makes it possible for first responders to regain control of every aspect of their wellbeing. First responders dedicate their lives to protecting their community, and at Simple Recovery’s First Responder Treatment Program, we believe in dedicating our time and expertise to helping these compassionate individuals find a path to lasting sobriety and mental wellness. If you or someone you love is struggling with addiction and/or PTSD, call us now at 888-743-0490.