Can Long-Term Opioid Use Cause Mental Illness?
Did you know that there’s a link between PTSD and opioid use disorder? Many people who receive one diagnosis will eventually receive the other.
The Department of Veterans Affairs estimates that about 22 percent of people with post-traumatic stress disorder will abuse drugs, including opioids.
PTSD patients often use opioids to cope with distressing symptoms and chronic pain related to the symptoms of their trauma. It typically surfaces due to a lack of coping skills and is worsened by social isolation and withdrawal.
On the other hand, opioid use puts you at greater risk of trauma exposure and worsens mental health.
For the best treatment results, you’ll need to address both conditions simultaneously. Here at Icarus Nevada, we have experienced clinicians who can asses your needs and help you to take the first steps toward healing. Keep reading to learn more about how these conditions are related.
How Does Post-Traumatic Stress Disorder Impact Substance Abuse?
It’s easy to feel overwhelmed when coping with a complex diagnosis like post-traumatic stress disorder. The problem is that it can lead to substance use disorder if left untreated. While not everyone who has PTSD symptoms will exhibit a tendency toward opioid use, it’s more common than you may think.
The Substance Abuse and Mental Health Services Administration estimates that one in four people with a mental illness will also struggle with a substance use disorder. Understanding the connection between PTSD and opioid use disorder is critical to managing both conditions.
Using Opioids to Cope with Posttraumatic Stress Symptoms
The first thing to note about comorbid PTSD and substance use disorder of any kind is its origin. People who have experienced traumatic events will have symptoms that disrupt their day-to-day lives. It could mean flashbacks, intense anxiety, avoidance of certain situations, depression, and more.
Many people who experience these intense symptoms will want to find a way to take the edge off their pain and discomfort. Turning to a bottle of alcohol or prescription opioids is a logical next step if they’re searching for something to alleviate the feelings they experience.
It starts as a way to self-soothe and cope, but it quickly morphs into something difficult to control. It may require residential treatment and rehab to get both PTSD and opioid use disorder under control.
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A Lack of Healthy Coping Skills for Traumatic Events
One issue with a posttraumatic stress disorder diagnosis is that the events may have happened to you before you had the language to express your situation. Adverse childhood events can have long-term impacts on your mental health. It isn’t just veterans who struggle with PTSD symptoms, after all.
If you never had the opportunity to develop coping skills when you were younger, you may be that much more likely to develop an opiate addiction later in life. Just because you age doesn’t mean the memories of what you lived through will disappear.
You’ll have to shore up your toolbox of coping mechanisms to kick a comorbid substance use disorder to the curb once and for all.
Chronic Pain Leads to Co-Occurring PTSD and Opiate Addiction
Chronic pain patients face another hurdle when it comes to their substance abuse. Mental disorders like PTSD will often surface with somatic complaints like chronic, unexplained pain. You may first consult a primary care physician for your ailments. Without proper assessment, they might miss a PTSD diagnosis.
Why is the prevalence of chronic pain and PTSD so high? In many cases, it has to do with the trauma itself. If you experienced an accident, abuse, or physical trauma exposure, it could lead to long-term pain that needs further treatment.
Even if you didn’t suffer physical pain as a result of your trauma, you can still have chronic non-cancer pain. You might experience heightened awareness, starting with your body. Your brain might throw up the signal that there is something wrong internally, making it a psychosomatic complaint.
When you have chronic pain with PTSD, the symptoms of both conditions tend to worsen each other.
Social Withdrawal and Comorbid Opioid Use Disorder
Concurrent posttraumatic stress disorder and substance use disorder can be hard to pinpoint. The issue for many people suffering from a dual diagnosis is that they tend to isolate themselves. They withdraw from family and friends, preferring to spend time on their own. This reinforces the patterns of negative thoughts that lead to substance misuse.
The other problem with social isolation is that other people can’t see the effects of an opioid addiction.
Because you aren’t spending time with loved ones, they have no idea how frequently you are using. One of the signs of a substance use disorder is withdrawing from your community. It results in poor physical and mental health, which only reinforces the cycle of opioid use.
Can Long-Term Substance Use Disorder Cause Mental Health Disorders?
While the influence of posttraumatic stress disorder (PTSD) on opioid misuse is clear, there is another aspect of this relationship that needs to be considered. Can the situation exist the other way around?
Figuring out which disorder comes first is a lot like deciding whether the chicken or the egg comes first. However, here are some things to consider if you think that your opioid use could have caused PTSD in your life.
The Risk of Dangerous Situations Arising with Opioid Use
Perhaps the most common situation where substance use leads to post-traumatic stress disorder is the situations that you find yourself in when using. You might go to great lengths to obtain more drugs, and it’s quite possible to find yourself in a dangerous situation.
Someone may abuse you in some capacity before they give you access to the drugs.
While you may ultimately leave with the prescription painkillers that you came for, it’s not without a long-term impact on your mental health. This abuse is compounded each time you seek more drugs, worsening PTSD symptoms and reinforcing a habit of substance misuse.
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Mood Changes with Prolonged Exposure to Opioids
One of the hallmarks of a PTSD diagnosis is depression and withdrawal from things you once enjoyed or people you once loved. This isolation further fuels your symptoms and leads to more drug use. Even so, there could be an argument that opioid use disorder leads to more depressive symptoms that worsen a PTSD diagnosis.
Research shows that depressed patients are more than twice as likely to turn to long-term opioid use to manage their discomfort. On the other hand, this opioid use leads to treatment-resistant depression, as well as recurrent depressive episodes.
These mood shifts lead to worse treatment outcomes for comorbid posttraumatic stress disorder and substance use. You’ll have to treat both conditions simultaneously to get to the bottom of your feelings and finally find sobriety.
How is a Dual Diagnosis of PTSD and Opioid Use Disorder Treated?
With the connection between post-traumatic stress disorder and opioid use disorder clearly defined, you may be wondering whether there’s help for both conditions. Icarus in Nevada exists to help our clients heal from a dual diagnosis, regardless of which one came first.
Here are some of the treatments you may want to explore if you’re going to face them both.
The Importance of Getting Help from an Experienced Clinician
The first thing you need to do is put yourself under the care of an experienced therapist or counselor. The issue with many people who have comorbid PTSD and opioid use disorder is that the symptoms can often mimic one another. For example, opioid withdrawal worsens symptoms of PTSD such as hypervigilance and an increased startle response.
To get to the bottom of what’s causing your issues, you’ll need a clinician-administered PTSD scale to see whether your issue is primarily the result of an adverse event or whether it’s truly just opioids that are leaving your system. From here, they can create a comprehensive and customized treatment plan just for you.
Your path to healing won’t look the same as someone else’s. Identical psychological treatments will still play out differently from person to person, so tracking your progress and being open about what helps is key to facilitating a healing therapeutic relationship with your team.
Integrated Cognitive Behavioral Therapy to Improve Symptoms
One of the first-line treatments for someone with both PTSD symptoms and substance use issues is an approach known as integrated cognitive behavioral therapy. It has a multi-faceted approach uniquely designed to improve treatment outcomes.
The manual proposes three activities: education on dual diagnosis symptoms, mindfulness practices, and cognitive restructuring. There is an emphasis on teaching you how your thoughts and feelings can influence your actions. Interrupting this pattern of thoughts and feelings can change outcomes, making flexible thinking crucial to recovery.
And this approach isn’t just for your time in the therapy room. There will be plenty of homework for you to assess your situation and practice your newfound skills on your own as well.
Opioid Agonist Therapy and Addiction Treatment
If you’ve been using opioids for a while to manage chronic pain or comorbid post-traumatic stress, then you may need more than psychosocial treatments. Opioid agonist treatment is best administered under the umbrella of a residential or inpatient treatment facility where you’re monitored around the clock.
This opioid agonist treatment involves taking an opioid agonist like methadone or buprenorphine to minimize the effects that your opioid use will have on you. Both medications can reduce your withdrawal symptoms and are frequently employed in a detox setting, but they also reduce long-term cravings for more opioids.
It’s important to note that these prescription drugs won’t get you high and are part of an integrated treatment program where you can get a handle on both mental health and substance use. Opioid substitution therapy may not be for everyone, which is why it helps to consult with a medical team at Icarus Nevada to assess your options.
EMDR Treatments to Alleviate PTSD Symptom Severity
Treating an opioid addiction may appear to be the primary concern when you enter treatment, but there is equal importance to getting PTSD symptoms under control. Eye Movement Desensitization and Reprocessing (EMDR) is a proven way to help your brain cope with traumatic memories in a healthier way compared to turning to illicit drug use.
An experienced therapist will allow you space to think and talk about your trauma while engaging you in bilateral stimulation through eye movements. This opens the door for your brain to reprocess memories that it has been holding on to, placing them at the forefront of your mind.
It follows an eight-step process to help you move through trauma. The good news is that there usually is an end to this type of treatment, with just eight to twelve sessions needed. These trauma-focused psychological interventions are crucial to teach you to manage your thoughts without drug or alcohol dependence.
Transition to Lower Levels of Care
Eventually, you won’t need to be monitored around the clock to ensure that you don’t return to a drug problem or experience worsening posttraumatic stress disorder. It’s often best to start out in Icarus’s residential treatment program for intensive help and integrated treatment from the start, but where do you go from here?
Look for a program that will allow you to transition to a lower level of care. Partial hospitalization and intensive outpatient are both options that allow you to receive help at varying levels during the day while you return to your own family and bed at night.
You can also ensure you have access to good community resources, such as recovery meetings. Going to a Narcotics Anonymous meeting can help you connect with others who seek a sober lifestyle and can help prevent social isolation that worsens your symptoms.
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Reserve a Spot and Get Support at Icarus in Nevada Today
If you’re struggling with both post-traumatic stress disorder and opioid use disorder, you need the help of a clinical program experienced in dual diagnosis. Icarus Nevada offers all of the treatments you need to have the best outcomes on both conditions. Allow us to walk with you and give you 24/7 access to experienced clinicians and care.
Our enrollment team is ready and waiting to answer any of your questions about the process. They can also verify your insurance benefits for free in a quick and confidential call.
When you’re ready to get help, don’t delay another moment. Call Icarus Nevada and reserve a spot in our program for same-day admission!
References
- Bernardy, N., & Montano, M. (n.d.). Opioid use among individuals with posttraumatic stress … National Center for PTSD.
- Mental health and substance use co-occurring disorders. SAMHSA. (n.d.).
- López-Martínez, A. E., Reyes-Pérez, Á., Serrano-Ibáñez, E. R., Esteve, R., & Ramírez-Maestre, C. (2019). Chronic pain, posttraumatic stress disorder, and opioid intake: A systematic review. World journal of clinical cases, 7(24), 4254–4269.
- U.S. Department of Veterans Affairs. (2018, August 3). Chronic Pain and PTSD. National Center for PTSD.
- Ingram, I., Kelly, P. J., Deane, F. P., Baker, A. L., Goh, M. C. W., Raftery, D. K., & Dingle, G. A. (2020). Loneliness among people with substance use problems: A narrative systematic review. Drug and alcohol review, 39(5), 447–483.
- Sullivan M. D. (2018). Depression Effects on Long-term Prescription Opioid Use, Abuse, and Addiction. The Clinical journal of pain, 34(9), 878–884.
- Capone, C., Eaton, E., McGrath, A. C., & McGovern, M. P. (2014). Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study. Journal of Traumatic Stress Disorders & Treatment, 3(4), 1000134.
- Nielsen, S., Tse, W. C., & Larance, B. (2022). Opioid agonist treatment for people who are dependent on pharmaceutical opioids. The Cochrane database of systematic reviews, 9(9), CD011117.
- Gainer, D., Alam, S., Alam, H., & Redding, H. (2020). A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Innovations in clinical neuroscience, 17(7-9), 12–20.