Alcohol and Substance Use in PTSD

Looks at the problem of using alcohol or drugs as a way to cope with post-traumatic stress disorder (PTSD). Covers when alcohol or drug use becomes a problem. Includes a test to see if you have a problem with alcohol or drugs and steps for getting help.

Alcohol and Substance Use in PTSD

Topic Overview

After you’ve been through a traumatic event, you may be tempted to use alcohol or drugs as a way to cope. Some people with post-traumatic stress disorder (PTSD) try to deal with their symptoms this way.

Taking alcohol or drugs to deal with stressful emotions is called self-medication. This may make you feel better for a while, but in the long run it will do more harm than good. Alcohol and drugs can make it harder to enjoy life, and they can keep you from taking care of your responsibilities. Using alcohol can even make your PTSD symptoms worse.

Taking alcohol or drugs may lead to substance use disorder. This is when alcohol or drugs cause problems in your life. It may hurt your relationships with friends and family members, and it may cause problems at work. It also may lead to serious health problems.

If you use alcohol or drugs, you may become physically dependent. This means that you can’t quit, or you have withdrawal symptoms when you try to quit. Withdrawal may cause you to feel sick or shaky. Also, you may have to use more alcohol or drugs to get the same effect. This is called tolerance.

Is alcohol or drug use a problem for me?

Not everyone with PTSD has a problem with drinking or using drugs, but having PTSD makes it more likely that a problem will develop. You may not know if drinking or drug use is a problem for you. It may happen very slowly so that you don’t notice it, or it may be part of another activity and isn’t obvious. For example, you may spend Saturdays watching football and drinking with your friends. You may not see that the alcohol is more important to you than the football.

Drinking or using drugs is a problem if it causes your behavior to change or changes how you use alcohol or drugs. Take this test or reply to the statements below to see if you have a problem with drugs or alcohol.

Behavior change

My drinking or drug use has:

  • Made me more aggressive or mean.
  • Interfered with personal obligations, like taking care of my family or working.
  • Put me in danger. For example, I have used drugs or alcohol before driving or operating machinery.
  • Led to legal problems.
  • Interfered with how well I do at work.

Using alcohol or drugs

Your reasons to drink or use drugs and how much you use them can indicate a problem.

  • My friends or family members have said something to me about how often I drink or use drugs.
  • I sometimes feel guilty about drinking or using drugs.
  • I drink or use drugs to cope with stress or my problems.
  • I am drinking more or using more drugs than I used to.
  • I have wanted to or tried several times to cut down on how much I use alcohol or drugs.
  • I spend a lot of time getting alcohol or drugs.
  • I need to drink more or use more drugs to get the same effect.
  • I am sick when I try to stop drinking or using drugs.

At times you may try to convince yourself that you don’t have a problem. This may keep you from getting the help you need. You may tell yourself or others things like:

  • “I just drink beer or wine.”
  • “I don’t use hard drugs.”
  • “I’m not an alcoholic.”
  • “I gave it up for 3 weeks last year.”
  • “I don’t drink every day.”
  • “I’ve never missed a day of work.”
  • “I’m not as bad as my friend.”
  • “I can handle it.”

If any of these statements are true, you may be developing or already have a problem with alcohol or drugs.

Getting help

Admitting you need help is very hard. It may be tough to seek help because you feel shame or guilt, or because you have doubts about whether you can stop. Remember that many people have beaten alcohol or drug problems, and all have started with these feelings and doubts.

If you feel you are drinking or using drugs because of PTSD, be sure to tell the people who are helping you.

  • Talk to your doctor. Be honest about your use. Your doctor can help you find counseling, group support, or another type of help.
  • Call an alcohol or drug treatment program. You can get education and other kinds of therapy.
  • Talk to someone in your family or a close friend. Your loved ones can provide support and help you find treatment.

For more information, see the topics Post-Traumatic Stress Disorder and Alcohol Use Disorder.

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Related Information



  1. U.S. Department of Veterans Affairs (2011). PTSD and problems with alcohol use. A National Center for PTSD fact sheet. Available online:


Current as ofMay 28, 2019

Author: Healthwise Staff
Medical Review: Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Jessica Hamblen PhD – Post Traumatic Stress Disorder

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