The Opioid Crisis and Complex Post-Traumatic Stress Disorder

CPTSD Foundation
6 min readOct 3, 2022

One of the defining symptoms of complex post-traumatic stress disorder (CPTSD) is emotional dysregulation which can lead to survivors looking for ways to cope with how they feel.

Unfortunately, opioids are one of the ways that people with CPTSD turn for relief. This article will focus on the opioid crisis as it affects those living with complex post-traumatic stress disorder.

Briefly, What is Complex Post-Traumatic Stress Disorder?

While complex post-traumatic stress disorder occurs in adults under certain circumstances, it is most common among those who have experienced prolonged childhood abuse and neglect.

CPTSD is more involved than post-traumatic stress disorder because the experiences change how they respond to stress and how they see themselves.

One could write a book about the many symptoms of CPTSD, but several are listed below.

  • Reliving the trauma through flashbacks and nightmares
  • Avoiding situations that remind them of the trauma
  • Dizziness or nausea when remembering the trauma
  • Hyperarousal
  • The belief that the world is a dangerous place
  • A loss of trust in the self or others
  • Difficulty sleeping
  • Startling easy by loud noises
  • A negative self-view
  • Problems with relationships
  • Thoughts or actions of suicide
  • Fixating on the abuser or seeking revenge
  • Losing memories of trauma or reliving them
  • Difficulty regulating emotions that often manifest as rage
  • Depression
  • Sudden mood swings
  • Feeling detached from oneself
  • Feeling different from others
  • Feeling ashamed
  • Feeling guilty
  • Difficulty maintaining relationships
  • Seeking our or becoming a rescuer
  • Feeling afraid for no apparent reason
  • Difficulty sleeping
  • Startling easy by loud noises
  • A negative self-view
  • Emotional regulation difficulties
  • Problems with relationships
  • Thoughts or actions of suicide

Complex post-traumatic stress disorder is a complicated mental health condition that affects millions of people around the world. Not listed above is the reality of emotional dysregulation among those living with CPTSD.

What is Emotional Dysregulation?

People who are emotionally dysregulated experience intense emotions more frequently than average that last longer than usual. Those who experience emotional dysregulation have great difficulty accepting their emotional responses, leading to behavioral dysregulation.

Behavioral dysregulations include non-suicidal self-injury, suicidal ideation, and substance abuse. Using substances decreases their emotional distress, making them want to recreate the relief they feel.

Substance abuse allows one to experience a ‘high’ where they feel euphoria, allowing people with CPTSD to escape their intense emotions. However, this euphoria is short-lived, forcing people to seek another ‘high.’

Street drugs are common go-to substances that are used by those who have complex post-traumatic stress disorder. However, illicit drugs such as Heroin and Meth are not the only ways that people living with CPTSD find escape; some drugs are found only from a doctor’s order (prescription drugs).

Other signs of emotional dysregulation are as follows.

  • Major depression
  • Anxiety
  • Shame
  • Uncontrolled anger
  • Risky sexual behaviors
  • Disordered eating
  • Difficulty finding and maintaining relationships

If you feel unsafe or know someone else who does, you must reach out for help, such as calling, texting, or chatting with the 988 suicide prevention and crisis line.

What Causes Emotional Dysregulation?

Child abuse has devastating effects on the mental health of adults, including the formation of mental health challenges such as substance abuse disorder. Research had shown that individuals who were abused and neglected when they were children have a 1.5 times more likelihood of using illicit drugs or prescription drugs than healthy non-abused adults (Mandavia et al. 2016).

Childhood abuse is also a leading cause of complex post-traumatic stress disorder formation. CPTSD is a chronic condition where survivors are left with attempts to regulate their emotions. Substance abuse disorder (SUD) is a maladaptive strategy to manage the negative results of trauma exposure (Banducci et al., 2014)

In short, the cause of the emotional dysregulation of trauma survivors also leads to substance abuse disorder in some individuals with CPTSD.

Methods to Heal from Substance Abuse Disorder

The most noticeable symptoms of complex PTSD are intense anxiety and fear when remembering or flashing back to a traumatic event. One might imagine how a person with CPTSD may choose to hide within the stress relief of illicit or prescription opioids.

Simply getting up in the morning to face a new day and not knowing what will happen that day can drive the fear of trauma, leading to the person getting high or, more commonly, drunk.

It is challenging to end a substance abuse disorder once it has begun, but treatment options are available, including complete abstinence. Learning to deal with the powerful emotions locked inside the mind of someone with CPTSD is vital to healing and overcoming opioid addiction.

The primary caregivers to heal substance abuse are specially trained individuals who are certified or licensed substance treatment counselors. Around half of these caregivers are people in recovery. Most treatment programs designate patients with a treatment team that includes social workers, counselors, nurses, psychologists, doctors, or other professionals.

The first thing that is done in treating a person with a substance abuse disorder is to assess them. The assessment is to tell the professionals who will care for the individual how to proceed because withdrawal from substances is often dangerous. Sometimes people admitted to a program need close monitoring to ensure they detoxify safely and effectively.

Medically supervised withdrawal takes several days or even weeks and occurs in a hospital’s regular medical ward, specialized inpatient detox unit, or an outpatient setting. During this time, the client will receive proper medical care and education about substance abuse.

Tying It All Together

Not all people who have complex post-traumatic stress disorder will form a substance abuse disorder, but I suspect trauma is what drives the opioid crisis.

While opioids have their place in treating pain, they can be extremely dangerous if not taken exactly as the doctor orders them to be used.

The only way to defeat the opioid crisis is to treat the underlying trauma that drives it. Until we do, many more people who are now children will grow up to crave and use opioids to numb their pain.

I don’t write this piece not knowing what I am talking about. I was the victim of severe and repeated childhood trauma and live with the effects of complex post-traumatic stress disorder. I used prescription painkillers to numb my emotions because they were too painful to handle.

After I entered treatment, it still took another twenty years for me to become sober and to begin to understand how to regulate my emotions. After forty-plus years of being tethered to a pill bottle, I was finally free and remain clean to this day.

The opioid crisis touches every household in the United States either directly or indirectly with either you, a family friend, or a relative living in its shadow. This piece is meant to be a beacon to warn the reader that you can fall victim to opioids.

“I realized that I only had two choices: I was either going to die, or I was going to live, and which one did I want to do? And then I said those words, ‘I’ll get help,’ or, ‘I need help. I’ll get help.’ And my life turned around. Ridiculous for a human being to take 16 years to say, ‘I need help.’” ―Sir Elton John

“Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.” ―Carl Bard


Banducci, A. N. , Hoffman, E. M. , Lejuez, C. W. , & Koenen, K. C. (2014). The impact of childhood abuse on inpatient substance users: Specific links with risky sex, aggression, and emotion dysregulation. Child Abuse & Neglect, 38, 928–938. doi:10.1016/j.chiabu.2013.12.007

Mandavia, A., Robinson, G. G., Bradley, B., Ressler, K. J., & Powers, A. (2016). Exposure to childhood abuse and later substance use: Indirect effects of emotion dysregulation and exposure to trauma. Journal of Traumatic Stress, 29(5), 422–429.

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CPTSD Foundation

Successfully equipping complex trauma survivors and practitioners with compassionate support, skills, and trauma-informed education since 2014.