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For some people, drinking or using drugs begins as a way to manage the effects of trauma. Alcohol might make it easier to fall asleep, while other substances may temporarily quiet anxiety, intrusive memories, or emotions that feel difficult to control.
Over time, that attempt to find relief can develop into a substance use problem of its own. Understanding the connection between PTSD and substance use can help you recognize what is happening and find treatment that addresses both concerns.
If you are experiencing trauma-related symptoms, learn more about PTSD and trauma treatment at Bold Steps Rhode Island.
Trauma can change how a person responds to stress and perceived danger. Someone who has experienced a traumatic event may remain unusually alert to their surroundings, have difficulty relaxing, or feel unsafe even when there is no immediate threat. Others experience emotional numbness or feel disconnected from themselves and the people around them.
These responses can be exhausting. When someone has difficulty sleeping, managing anxiety, or feeling comfortable in everyday situations, alcohol or drugs may seem to offer a way to get through the day. This pattern is sometimes called self-medication: using a substance to manage distressing symptoms rather than seeking intoxication for its own sake.
Alcohol is one substance people may turn to because it is widely available and can initially create a sense of relaxation. Someone might drink before a social event to feel less anxious or at night to quiet their thoughts. Others may use opioids, benzodiazepines, or other drugs in an attempt to manage emotional or physical distress. The substance and the reason for using it vary from person to person.
The relief is temporary, however. Alcohol and other drugs can disrupt sleep, affect mood, and make it harder to manage stress without them. As the effects wear off, the original trauma-related symptoms may return alongside cravings or withdrawal symptoms. A person may begin using more frequently, not because the substances are helping them recover, but because they have become part of how they cope.
This cycle can also create shame. Someone who is already struggling with trauma may feel guilty about drinking or using drugs, making it harder to talk openly about either concern. Recognizing substance use as a possible response to untreated distress does not remove the risks associated with it. It does, however, create an opportunity to address the reasons the pattern developed.
The relationship between trauma and substance use is not always obvious. You may recognize that drinking or using drugs has become difficult to control without connecting it to experiences from your past.
For example, you might notice that you reach for alcohol after a nightmare or that cravings become stronger following an argument, an unexpected noise, or a visit to a place associated with a traumatic experience. You may use substances to fall asleep, feel comfortable around other people, or suppress emotions that seem overwhelming.
Some people recognize the connection when they try to stop using. Without alcohol or drugs, anxiety, intrusive memories, or sleep problems may become more noticeable. This can make it difficult to maintain changes in substance use, particularly when the underlying symptoms have never been addressed.
You may also have a history of childhood trauma, an abusive relationship, assault, military service, a serious accident, or a distressing medical experience that you have not previously discussed in treatment.
If you recognize these patterns in yourself, they are worth taking seriously. A professional assessment can help you understand the connection between trauma and substance use, especially if alcohol or drug use is affecting your health, relationships, responsibilities, or sense of control.
PTSD symptoms and substance use can reinforce one another.
Someone experiencing PTSD may drink to reduce anxiety or fall asleep. Although alcohol can initially cause drowsiness, it can also disrupt sleep later in the night. Poor sleep may leave the person more irritable, anxious, or vulnerable to distressing memories the following day. They may then feel a stronger urge to drink again.
A similar pattern can develop when someone uses drugs to manage trauma-related distress. As tolerance or dependence develops, the person may need more of the substance to experience the same effects. Withdrawal can introduce additional symptoms, including anxiety, sleep disturbances, and physical discomfort, that make existing PTSD symptoms harder to manage.
Trauma reminders can also become closely associated with cravings. If someone repeatedly uses a substance after experiencing a flashback or another distressing reminder, those experiences may begin to trigger an urge to use. Avoiding the substance without developing other ways to respond to the trigger can leave the person feeling unprepared when symptoms return.
This helps explain why treating substance use alone may not fully address someone’s recovery needs. A person can make meaningful progress in reducing alcohol or drug use while continuing to struggle with the trauma-related symptoms that contributed to it. Addressing both concerns provides an opportunity to develop coping strategies that support recovery beyond the immediate period of substance use treatment.
When PTSD and a substance use disorder occur together, they are often described as co-occurring disorders or a dual diagnosis. These terms mean that a person is experiencing more than one condition that may need clinical attention.
Integrated treatment addresses both conditions through a coordinated care plan. Rather than requiring someone to complete addiction treatment before receiving any support for PTSD, clinicians consider how the conditions interact and determine which interventions are appropriate at each stage of recovery.
That does not mean trauma processing must begin immediately. Some individuals need help establishing safety, managing withdrawal, developing coping skills, or stabilizing their daily routines before beginning more intensive trauma-focused work. An individualized treatment plan can account for those needs while continuing to address both conditions.
A trauma-informed approach is particularly important. People who have experienced trauma may find certain situations, conversations, or treatment environments distressing. Trauma-informed care emphasizes safety, collaboration, choice, and awareness of how past experiences may affect a person’s response to treatment.
For someone experiencing both PTSD and substance use, the goal is not simply to stop using alcohol or drugs. It is also to build healthier ways to manage distress, recognize triggers, improve daily functioning, and work toward a more stable life.
At Bold Steps Rhode Island, treatment for co-occurring PTSD and substance use considers both the immediate challenges of recovery and the trauma-related symptoms that may contribute to them. Our team develops individualized treatment plans based on each person’s symptoms, treatment history, daily functioning, and clinical needs.
Treatment may involve several complementary approaches:
Our therapeutic approach helps individuals recognize how trauma-related symptoms may influence their emotions, behavior, relationships, and substance use.
EMDR therapy may be incorporated when clinically appropriate to help individuals process traumatic experiences. The timing and suitability of trauma-focused interventions depend on individual needs and readiness.
Cognitive behavioral therapy can help individuals identify patterns of thinking and behavior that contribute to distress or substance use. Dialectical behavior therapy can support emotional regulation, distress tolerance, and the development of healthier responses to difficult situations.
Together with other therapeutic approaches, these interventions can help individuals develop skills for managing trauma-related symptoms without relying on alcohol or drugs.
For a broader look at the available approaches, explore our trauma therapy in Rhode Island.
The appropriate level of care depends on how significantly symptoms affect daily life, the amount of clinical support needed, and whether an individual can safely participate in outpatient treatment.
Our partial hospitalization program (PHP) offers a more intensive treatment schedule for individuals who need substantial structure and support. For someone experiencing both PTSD and substance use, PHP may provide an opportunity to work on emotional stabilization, coping skills, and recovery within a consistent therapeutic routine.
Our intensive outpatient program (IOP) provides structured treatment with greater scheduling flexibility. It may be appropriate for individuals who can manage daily responsibilities while continuing to receive clinical support for trauma-related symptoms and substance use.
Some individuals begin treatment in PHP and transition to IOP as their needs change. Others may enter IOP directly following a clinical assessment. Our team helps determine which level of care is appropriate for each person.
Trauma-related symptoms and substance use do not need to be considered as unrelated problems. Treatment can address the connection between them, including how triggers, sleep disturbances, emotional distress, and cravings may affect recovery.
Our approach to addiction treatment includes individualized care that considers co-occurring mental health concerns. By identifying the role trauma may play in substance use, individuals can work toward managing both conditions rather than focusing exclusively on one.
Yes. PTSD and substance use disorders can occur together. Some people use alcohol or drugs to cope with trauma-related symptoms, while others develop substance use problems for different reasons. A clinical assessment can help identify whether both conditions are present and what treatment may be appropriate.
PTSD can contribute to patterns of alcohol use, particularly when someone drinks to manage anxiety, sleep problems, or distressing memories. However, PTSD does not inevitably lead to alcohol use disorder, and alcohol problems can develop for many reasons. When both conditions are present, treatment can address how they affect one another.
Some people use substances to temporarily reduce anxiety, quiet intrusive thoughts, fall asleep, or feel less emotionally overwhelmed. Others may use substances for reasons unrelated to their PTSD symptoms. Understanding an individual’s reasons for using alcohol or drugs can help guide treatment.
Dual diagnosis treatment addresses a substance use disorder and a co-occurring mental health condition, such as PTSD, within a coordinated treatment plan. Care may include therapy, coping skills development, substance use treatment, and other interventions based on the individual’s needs.
Bold Steps Rhode Island provides treatment for mental health and substance use concerns, including co-occurring conditions. Our team assesses each person’s needs and develops an individualized treatment plan to determine how both concerns can be addressed within the appropriate level of care.
Some people need medical detoxification before beginning outpatient treatment, particularly when stopping alcohol or certain drugs could cause dangerous withdrawal symptoms. A clinical assessment can help determine whether detox is necessary and what level of care is appropriate before starting PHP or IOP. If you may be at risk of withdrawal, seek medical guidance rather than stopping abruptly on your own.
Many insurance plans provide benefits for mental health and substance use treatment, but coverage depends on the individual policy, recommended services, and other plan requirements. Our admissions team can help review your benefits and explain the insurance verification process.
PHP generally provides a more intensive treatment schedule, while IOP offers structured clinical support with greater flexibility for daily responsibilities. The appropriate program depends on your symptoms, safety, current substance use, treatment history, and support needs. A clinical assessment can help determine which level of care is suitable.
You do not have to figure out the relationship between trauma and substance use on your own. Bold Steps Rhode Island can help you explore treatment options that address both concerns and identify the level of care that fits your needs.
Call (401) 287-8652 to speak confidentially with our admissions team, or verify your insurance to learn more about your coverage for treatment.
Friendly Operators are Standing By
We’ll check your coverage and explain your options in plain language—no pressure, no jargon. Most plans include part of treatment; we’ll confirm what’s in-network and your estimated out-of-pocket before you decide.
You’ll get:
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Treatment should match your life—not the other way around. We’ll recommend a level that fits your symptoms, safety needs, and schedule so progress sticks at home, work, and school.
Options include:
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Recovery is easier when care works with your real life. Choose daytime or evening partial hospitalization and intensive outpatient programs—both with evidence-based therapy and a clear weekly plan. Switch times if your schedule changes.
Highlights:
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
When it helps, we include family—on your terms. We offer education, boundary coaching, and ways to rebuild trust while keeping your privacy and safety at the center.
We cover:
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Will group therapy be part of my plan?
Yes — group therapy is a cornerstone of every Bold Steps program.
Best fit if you struggle with: isolation, shame, difficulty opening up, relapse triggers, or needing accountability.
Pairs with: CBT, DBT, Trauma Therapy, EMDR, Family Therapy, and our Alumni Program.
Where you’ll get it: Offered across our partial hospitalization, intensive outpatient and outpatient programs, with daytime and evening schedules; format and frequency adjust by level of care.
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Will family therapy be part of the plan?
Almost always, yes. Bold Steps includes a free weekly virtual Family Support Group (open to loved ones even if their family member isn’t in treatment), plus scheduled family therapy sessions as part of treatment.
Best fit if your family struggles with: broken trust, enabling patterns, miscommunication, resentment, or uncertainty about how to help.
Pairs with: CBT, DBT, Trauma Therapy, EMDR, Family Therapy, and our Alumni Program.
Where you’ll get it: Across all levels of care — Day, Half-Day, Outpatient — plus our virtual group accessible from anywhere.
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Will EMDR be part of my plan?
Likely if you struggle with trauma memories, flashbacks, nightmares, panic tied to past events, or relapse linked to trauma triggers.
What EMDR pairs well with: DBT for emotion stabilization, CBT for thought reframing, MAT for cravings that block therapy work, and mindfulness/yoga for grounding.
Where you’ll get it: Often in our partial hospitalization or intensive outpatient programs, on daytime or evening schedules, once you’ve built some stabilization skills.
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Will DBT be part of my plan?
Likely if you struggle with big emotion swings, impulsive actions (including substance use), self-harm urges, relationship blowups, or relapse tied to “I can’t handle this feeling.”
What DBT pairs well with: CBT for thought work, trauma therapy like EMDR, MAT for opioid cravings, or mindfulness/yoga for nervous system reset.
Where you’ll get it: our partial hospitalization program or intensive outpatient program, with daytime and evening schedules, or outpatient care — intensity depends on your level of care.
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
Will CBT be part of my plan?
Likely if you’re dealing with racing thoughts, catastrophic thinking, relapse triggers, shame spirals, avoidance, panic, or insomnia.
We may combine it with: DBT for emotion regulation, EMDR for trauma, MAT for opioid cravings, or mindfulness/yoga for calming your nervous system.
Where you’ll get it: CBT is woven into our partial hospitalization program, intensive outpatient program, and outpatient care.
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
We combine therapies that work—CBT, DBT skills, medication management—with holistic supports like mindfulness, movement, and creative groups. You’ll build practical tools you can use the same day.
You’ll practice:
We’re here to help with your recovery. Please fill out this short form so our team can
understand your needs.
If you have any further questions about treatment, you may contact us directly at (888) 440-4306
