Dual diagnosis describes the presence of both a mental health condition and a substance use disorder. The two can reinforce one another, complicate symptoms, increase risk, and make it harder to identify what is driving a person’s distress.
Symptoms vary from person to person. Some reflect the mental health condition, some reflect substance use, and many overlap.
More than 4 in 10 U.S. adults with PTSD also have problems with drug or alcohol use.
Veterans with lifetime PTSD were about twice as likely to have alcohol-use problems.
Veterans with lifetime PTSD were about three times as likely to have drug-use problems.
About 80% of people with PTSD have at least one additional mental health diagnosis.
Dual diagnosis does not follow one pattern. A person may have several overlapping conditions, and the presentation can change over time.
PTSD, complex trauma, Military Sexual Trauma-related symptoms, moral injury, nightmares, hypervigilance, and avoidance.
Depression, anxiety disorders, panic symptoms, grief, irritability, emotional dysregulation, and sleep disturbance.
Alcohol use disorder, opioid use disorder, stimulant use, cannabis use disorder, sedative misuse, and polysubstance use.
Substances may initially be used to blunt anxiety, intrusive memories, insomnia, grief, or emotional pain. Over time, substance use can worsen sleep, mood, judgment, relationships, physical health, and suicide risk. At the same time, untreated trauma or depression can make it harder to reduce substance use. Understanding the full picture is essential.
Statistics above are drawn from the U.S. Department of Veterans Affairs National Center for PTSD and national epidemiologic data cited by VA. For current clinical guidance, see the VA National Center for PTSD and VA/DoD resources.
Emergent care information
Call 911, go to the nearest emergency department, or call 988 and press 1 for the Veterans Crisis Line. For non-immediate questions about CCC residential admissions, contact our admissions team.