Understanding the Link Between Addiction and cPTSD

Before we tackle this topic, there are a few things that I'd like to mention. I have survived 50+ years with cPTSD. I have dealt with ineffective therapies, prescriptions that made me worse,  a few in-patient visits, a few more failed therapy attempts, a bunch of meds that weren't working, and I was barely keeping my head above water. By the age of 26, I no longer cared to live. Someone talked me into smoking some weed, and for the first time in my life, I wasn't afraid. I could relax. I was with people I trusted. No one was yelling. No one was threatening. I still smoke to this day, and until I can find a more effective solution, will continue. But I'm still alive. I have experience with other substances, but they weren't a long term option. Whether you use to feel safe, or shut down the pain, or make the intrusive thoughts shut up, any addiction is not a goal. Being in a healthier place is. 

The intersection of addiction and complex Post-Traumatic Stress Disorder (cPTSD) presents significant challenges for both individuals and the healthcare system. While these conditions frequently co-occur, the complexity of their interaction often leads to misdiagnosis, ineffective treatment strategies, and limited resources for both patients and their support networks. This article explores the failures in recognizing and treating addiction and cPTSD, the inadequacy of addressing overlapping traumas, medication mismatches, and the lack of comprehensive information available to supporters and professionals.

The Overlap of Addiction and cPTSD

Addiction and cPTSD are deeply intertwined. Many individuals with cPTSD—caused by prolonged, repeated trauma—turn to substances or behaviors as coping mechanisms. Addiction, in turn, exacerbates emotional dysregulation, worsening the symptoms of cPTSD. This cyclical relationship complicates diagnosis and treatment.

Yet, many healthcare providers focus solely on one condition, often treating addiction as a primary issue without addressing underlying trauma. Conversely, others may emphasize trauma therapy without acknowledging the immediate need to manage addiction. This fragmented approach can leave patients feeling unseen and unsupported.

Misdiagnosis and the "One-Trauma-at-a-Time" Mentality

Misdiagnosis in Addiction and cPTSD

The symptoms of cPTSD—flashbacks, hypervigilance, emotional numbness, and dissociation—are often misdiagnosed as standalone psychiatric disorders such as anxiety, depression, or borderline personality disorder. This mislabeling not only delays proper treatment but can lead to harmful interventions that exacerbate the problem.

For example, a person with cPTSD might be prescribed medication for generalized anxiety, while their deeper trauma remains unacknowledged. Similarly, addiction may be dismissed as a moral failing rather than a symptom of trauma-driven survival strategies.

Addressing Multiple Traumas

Another significant issue is the “one-trauma-at-a-time” approach many professionals adopt. Patients with cPTSD often carry layers of trauma—such as childhood abuse, domestic violence, and systemic oppression—that interact and amplify each other. Yet, healthcare providers frequently insist on addressing these traumas sequentially, leaving patients overwhelmed and unsupported in the face of their interconnected experiences.

My last therapist was a "one bite at a time". I have 200 elephants in my head. He didn't realize when you took that little bite out of one elephant, the other 199 would stampede. I shut down. I couldn't trust him anymore. I couldn't no matter how much I wanted or tried.

This approach overlooks the reality that patients are living with the cumulative effects of these traumas every day. By failing to consider the whole picture, providers risk retraumatizing patients or offering piecemeal solutions that fail to address the root causes of their struggles.

Medications: Organic Illness vs. Trauma-Driven Conditions

Treating Symptoms vs. Causes

Medications are often prescribed to manage symptoms like anxiety, depression, or insomnia in people with cPTSD. However, these medications may not address the trauma at the heart of the disorder. This mismatch can leave patients feeling numbed or detached without alleviating the underlying distress.

For example, SSRIs (selective serotonin reuptake inhibitors) might help regulate mood, but they do little to resolve the intrusive memories or emotional flashbacks that define cPTSD. Similarly, medications used for addiction treatment, like methadone or naltrexone, may stabilize substance use but fail to address the trauma driving the addiction.

Misunderstanding Organic Illness

There is also a tendency among professionals to attribute physical symptoms—such as chronic pain, digestive issues, or autoimmune conditions—to psychosomatic responses rather than considering organic illnesses. For individuals with cPTSD, this can result in their physical health being dismissed or inadequately treated, exacerbating their sense of helplessness and mistrust in the medical system. Many providers will also dismiss the long term health effects from cPTSD itself which includes chronic pain, digestive issues and and autoimmune conditions. Many physical conditions related to chronic stress, including high blood pressure.

Limited Resources for Supporters and Providers

While much attention is paid to the patient’s journey, the lack of resources for supporters and healthcare providers is a glaring gap in the system.

Support Networks

Family and friends often struggle to understand the complexities of cPTSD and addiction. They may receive conflicting advice: to practice “tough love” for addiction or to provide unwavering support for trauma. The limited availability of educational materials, counseling, and peer support for loved ones leaves many feeling ill-equipped to provide meaningful assistance.

If family is a contributing factor to the trauma, support may not be available. Many abusive houses, especially if addiction is involved, will not only NOT support the abused, but will ramp up the gaslighting behaviors, denying the abuse, blaming the child, worsening the trauma. It is extremely important that professionals do not push for support and reconciliation where there is none to be had.  These same people may not have close friends for support either.  Community and Social Media support is something that needs to be available as well.

Healthcare Providers

Many clinicians lack the training to recognize and treat cPTSD effectively. Trauma-informed care is still not universally adopted, and many professionals fail to understand how trauma can manifest in addiction, physical symptoms, or behavioral patterns. This lack of understanding perpetuates cycles of misdiagnosis and mistreatment.

Additionally, the scarcity of interdisciplinary approaches—where addiction specialists, trauma therapists, and medical doctors collaborate—means that patients are often shuffled between providers without a cohesive treatment plan. Policies are placed above patients, and patients are ignored when they try to explain their illness and triggers. Facing yet another wall, street drugs become easier to get than trying to explain to someone who won't listen.

A Call for Change

Holistic Diagnosis and Treatment

To address the intertwined nature of addiction and cPTSD, healthcare providers must adopt a holistic approach. This includes:

Comprehensive Assessment: Evaluating patients for co-occurring trauma and addiction rather than treating one condition in isolation.

Integrated Treatment Plans: Combining trauma therapy, addiction recovery programs, and physical healthcare in a unified approach.

Trauma-Informed Care: Training all healthcare providers to recognize and respond to trauma sensitively.

Expanded Resources

Efforts must also be made to provide better resources for both supporters and professionals. This could include:

Educational Materials: Creating accessible guides to help loved ones understand the connection between trauma and addiction.

Provider Training: Expanding trauma-informed care training for all levels of healthcare providers.

Community Support: Establishing peer-led support groups for families and friends of individuals with cPTSD and addiction.

The relationship between addiction and cPTSD is a complex and often overlooked issue in healthcare. Misdiagnoses, the failure to address multiple traumas simultaneously, and mismatched medication strategies all contribute to poor outcomes for patients. Moreover, the lack of resources for supporters and professionals exacerbates these challenges.

Addressing these systemic failures requires a shift toward holistic, trauma-informed care and a greater emphasis on education and collaboration. By doing so, we can ensure that individuals struggling with addiction and cPTSD receive the compassionate, effective care they deserve.