Orlando Shooting May Lead to PTSD and Addiction

Flowers and other tributes were left in front of the landmark Stonewall Inn in New York City to honor the victims of the mass shooting at Pulse nightclub in Orlando, Fla., in June 2016.

The June 12, 2016, mass shooting at the Pulse gay nightclub in Orlando, Fla., has left thousands of people in shock over the gun violence that claimed the lives of 49 clubgoers and injured 53 others, and a nation reeling in the aftermath of what has been called the most deadly shooting on American soil in recent history.

The effects of what has transpired will be felt for many years to come by those who survived. The wounds of such violence go beyond the flesh, tearing into the spirits of everyone who is trying to make sense of a senseless crime and figure out how to move forwardif they can.

Some survivors of traumatic events will struggle with the guilt that they are among the survivors. Some will feel shame and a grave sense of loss; others will feel angry as they work to regain the sense of safety and freedom they felt before bullets took that away on that fateful night.

An already vulnerable community

The LGBTQ+ community in Orlando and abroad grapple daily with violence, discrimination, bullying, and rejection, which they face over their sexual orientation and identity.

FBI data show that LGBTQ+ people are more likely to be targeted for a hate crime than other minorities, reportsThe New York Times. One statistic reads that people in this community, “are twice as likely to be targeted as African-Americans and the rate of hate crimes against them has surpassed that of crimes against Jews.”

The FBI also reported in 2014 that of the 5,922 single bias incidents reported in 2013, sexual orientation was the second-largest of the top three bias categories at 20.8 percent. Race was No. 1 at 48.5 percent and religion was No. 3 at 17.4 percent.

The National Coalition of Anti-Violence Programs (NCAVP) recently released its National Report on Hate Violence Against Lesbian, Gay, Bisexual, Transgender, Queer and HIV-Affected Hate Violence in 2015, which said there were 24 reported hate violence homicides in 2015, a 20 percent increase from the 20 reported anti-LGBTQ homicides in 2014. Transgender and gender-nonconforming people of color made up the majority of those homicides, according to the report.

“Anti-LGBTQ hate violence can no longer be viewed in isolation from other forms of bias-motivated violence that our community members are experiencing based on their identities,” authors of the report wrote.

The National Alliance on Mental Illness (NAMI) reports that people in the LGBTQ+ population are three times more likely to experience a mental health condition. LGBTQ+ youths are four times more likely to attempt suicide, and questioning youths are three times more likely to attempt suicide than their peers who are straight. “Between 38-65% of transgender individuals experience suicidal ideation,” NAMI reports.

Also, according to the alliance, the LGBTQ+ community reports higher rates of drug, alcohol, and tobacco use than that of straight people. Prejudice, discrimination, lack of cultural competency in the healthcare system, and lack of peer support were cited as major factors as to why.

How this latest wave of violence will affect the mental and emotional health of the LGBTQ+ community in the US and abroad, as well as the larger community, won’t be realized for quite some time. But some observers say the fact that the gunman targeted a club where people in the community felt they were safe to go and be themselves has shattered their sense of security. Some may never feel safe again.

PTSD common after mass shootings, research shows

woman-reflectiveMany of the victims who survived the shooting at Pulse will likely experience mental and emotional distress. This is known as post-traumatic stress disorder, the condition in which a person experiences extreme stress or anxiety after seeing or being a part of a disturbing and traumatic event.

Many of the 300-plus patrons in the Pulse club that night who survived won’t forget the rounds of gunfire, or the chaos and confusion, and loss of life that played out over three hours on that morning.

Clubgoer Norman Casiano, who was shot in the back twice during the ordeal and recently released from the hospital, reported to The New York Times that he could hear gun shells “clattering to the floor” and the gunman reloading the weapon he carried. Casiano also said he’ll never forget that the gunman laughed or the sound of his laugh. Another Pulse club patron, identified in the Orlando shooting, told the newspaper, “People were screaming, begging for their lives.”

These and so many more sights and sounds will be remembered, and any memories or reminders they have could contribute to the post-traumatic stress disorder shooting victims may endure.

According to WebMd, in “1 out of 10 Americans, the traumatic event causes a cascade of psychological and biological changes known as post-traumatic stress disorder.”

“Simply put, PTSD is a state in which you ‘can’t stop remembering,’” WebMd says, which often happens after people experience military combat, violent assaults, natural disasters, car or airplane accidents, sexual assaults, kidnappings, and abusive and threatening situations, among others.

Symptoms are defined and can include having nightmares, flashbacks, jumpiness, emotional detachment or emotional outbursts, and aggressive behavior, among other disturbances. Affected persons may also isolate themselves or suffer from depression. They also may be startled by loud noises or have trouble sleeping or concentrating.

The National Center for Posttraumatic Stress Disorder has studied the effects of mass shootings in the US, concluding that “the psychological consequences of directly experiencing or witnessing a mass shooting are often serious.” The study also found that of the shootings examined, “prevalence of postdisaster diagnoses (predominantly PTSD) in these studies ranged from 10 percent to 36 percent.”

Link between PTSD, substance abuse

When violence strikes, the questions that come to mind are, “What happens to people who are left behind in its wake? How do they move forward?”

Unfortunately, some survivors with PTSD turn to substance use to manage their condition.

Sadly, as people attempt to put their lives back together, some will seek out to abuse substances, a common scenario for people affected by PTSD. Drinking alcohol or doing drugs may be the only way some people know how to cope with their illness.

Alcohol and drug use does not always lead to substance abuse. But WebMd says there are red flags that signal there is a problem with alcohol and/or drugs. Problematic substance use can lead to addiction.

The VA reports that drinking a lot of alcohol makes one more susceptible to having PTSD, along with multiple other factors. Drinking large amounts of alcohol can lead to chemical dependence that leads to substance abuse or an alcohol use disorder.

A person may be developing an Alcohol Use disorder when they are:

  • Unable to control their temper after drinking
  • Feeling guilty about drinking or using drugs
  • Avoiding personal responsibilities, obligations to themselves and others
  • Drinking to numb their feelings or deal with stress
  • Trying unsuccessfully to quit drinking, doing drugs
  • Engaging in risky behavior, such as driving under the influence or operating machinery
  • Spending a great deal of time trying to obtain illicit substances

If you, or someone you know, are exhibiting signs of an alcohol use disorder, and have experienced trauma in the recent, or not-so-recent past, that person may be suffering from post-traumatic stress disorder and needs to seek help as soon as possible.


Post-traumatic stress disorder sufferers can undergo treatment that helps them regain control over their lives, says the Mayo Clinic. The primary treatment is psychotherapy, which teaches sufferers how to address their symptoms and helps them learn healthy ways to cope with their symptoms should they arise again. Medication is also prescribed for affected individuals, though the biological, psychological, and social determinants of each person must be considered before it is.

Psychotherapy, also known as talk therapy, may include:

*Cognitive therapy. In this method of therapy, clients recognize and identify negative and inaccurate thinking patterns in normal, everyday situations that might keep them stuck. The Mayo Clinic says this type of therapy may also be used along with exposure therapy.

*Exposure therapy. This behavioral therapy method allows individuals to face their fears so they can cope with them effectively. Individuals may participate in “virtual reality” programs in which they re-enter the setting in which they experienced trauma to help them manage or overcome their reactions to it.

*Eye movement desensitization and reprocessing. Known as EMDR, this therapy method uses exposure therapy along with guided eye movements to help the individual process traumatic experiences and change their reaction to those events.

PTSD treatment may also include antidepressants, which can help improve concentration and sleep, and medicines that treat anxiety.

We are here to help

If you, or someone you know, are struggling with post-traumatic stress disorder with a co-occurring substance use disorder, or if you suspect you have symptoms of the condition, please call Palm Beach Institute at 855-534-3574. There is no better time than now to take your first step toward gaining control of your life. Our specialists are available anytime, day or night, and waiting for your call. Begin your journey to lasting health, happiness, and sobriety today.

The Craving Phenomenon: A Psychological Perspective

In the not-so-distant past, alcohol was really the only substance that was of any concern. As more and more people began to exhibit problem substance abuse behavior, people began wondering why most people didn’t have an issue with controlling their alcohol consumption while a growing number of people seemed determined not to exercise any self-control.

In most cases, people who habitually imbibed were punished, either by sending them to prison or insane asylums. The idea was that confinement would force these people to become sober while making them fear punishment would force them into abstinence; however, this was not the case. Instead, many of the individuals who had been punished for their inability to control their alcohol consumption quickly returned to their previous substance abuse.

The majority of society couldn’t understand why these people were returning to substance abuse in spite of knowing the consequences they were likely to face. In short, there was something more to alcohol abuse, and it was forcing people to defy their own logic by behaving in ways that contradicted what would have otherwise been in their best interests.

Today, there are many more substances to which people can become addicted besides alcohol although alcohol does remain a major problem. However, both alcoholism and drug addiction represent a single disease, and it’s a disease that has reached epidemic level proportions. According to the Center for Disease Control and Prevention and a number of other sources, approximately 10 percent of the U.S. population currently suffers from some form of chemical dependency, which is roughly 25 million Americans over the age of 12. These figures are staggering and convey just how serious an affliction that addiction really is.

For anyone suffering from an addiction, there are a number of recovery resources available that have proven effective at helping people to regain their sobriety and independence. However, recovering from an addiction to alcohol or drugs is a very complicated process. Each addict experiences addiction in a unique way, so not every addict requires the same types of treatments.

On the other hand, there are certain features of addiction that tend to be common among addicts, and it’s important to know these features so that they can be addressed before patients graduate from rehab and return home. Specifically, one of the most concerning and complicated aspects of an addiction is the cravings virtually all addicts experience and which can make it incredibly difficult for a person to achieve lasting sobriety.

What Exactly is the Phenomenon of Craving?

For most people, an addiction lingers for a somewhat extended period of time. There are many reasons for this, but perhaps the best way to understand why addicts tend to be addicted for longer periods of time is to think about the mindset of an addict. Any addict is going to be aware of how others would perceive his or her chemical dependence, and loved ones are likely to try to interfere; so addicts try to keep their substance abuse a secret from just about anyone else, even lying about or denying the addiction if necessary.

Therefore, most addicts tend to prolong their own addictions, and since they’re spending extended periods of time abusing alcohol or drugs, the habit of substance abuse becomes ingrained into who they are. Much like a person’s hobbies or constructive habits characterize them as individuals, substance abuse also becomes part of their psychological makeup. This is what makes it so difficult for people to overcome addictions. Otherwise, they’d just stop consuming alcohol and drugs when they started experiencing consequences.

Through rehabilitation and even in extended recovery, addicts will often get reminded of their prior alcohol or drug abuse. This occurs because addicts will frequently come to associate certain people, places, things, sensations, situations, and so on, with alcohol or drug use; in most cases, these are things with which the addict interacted or encountered when either obtaining or using chemical substances or while intoxicated.

These reminders, or “cues”, stir something in their memory, which — due to the intoxication and euphoria associated with those memories — prod the pleasure circuits in the brain. In short, recalling their previous substance abuse makes them feel urges or desires for the substance to which they were previously addicted. The strength of these urges can range from “I’d like to use again” to “I need to use right now”, the latter of which is often the precursor to relapse.

man staring at drugs

Three Types of Craving Triggers

Cravings occur because they are evoked by certain cues. An addict will likely have dozens or even hundreds of cues, but a select few of those cues will inspire cravings that are especially powerful or strong; the cues that inspire these exceptionally-strong cravings are called triggers. There are three main types of triggers: environmental triggers, re-exposure triggers, and stress triggers. Environmental triggers are, as suggested by the name, are external and situational, including the places, people, objects, and situations that induce strong cravings.

This might include a certain friend’s house where one frequently used drugs, a favorite bar where one often got intoxicated, or a person with whom one frequently used mind-altering substances. Re-exposure triggers are when those in recovery are brought into extremely close proximity to alcohol, drugs, and/or substance abuse, causing intense cravings since the substances to which they were addicted are within reach.

Stress triggers refer to situations that a recovering addict encounters after completing an addiction treatment program and returning to the community. In particular, it’s the stress caused by trying to adjust to being accountable for one’s sobriety and remaining abstinent while trying not to use alcohol or drugs to cope with hardship or adversity.

What’s Going on in the Mind During Drug Cravings?

When addicts experience the phenomenon of craving, those cravings can be traced back and attributed to a concept called habituation. The concept of habituation refers to the decrease in sensitivity or sensation that occurs as a result of increasing or repeated exposure. In fact, habituation is very much related to the development of a tolerance to alcohol or drugs with repeated consumption. 

When a person abuses alcohol or drugs, there’s a surge of neurochemicals in the brain that cause feelings of pleasure and euphoria. However, as the individual continues abusing alcohol or drugs, the surge of pleasure and euphoria begins to subside, becoming much less pronounced. The experience of cravings is due to the addicts wanting to experience the level of intensity that they felt when they first began consuming alcohol and drugs.

In other words, despite the effects of alcohol and drugs being less, it’s the initial, more pronounced effects that they associate with the substances to which they’ve become tolerant. And when recovering addicts are reminded of their previous experiences of intoxication and euphoria, they experience strong cravings for their substances of choice even though it’s been an extended period of time since they last imbibed.

Choose Health. Choose Life. Call the Palm Beach Institute Today.

If you or someone you love is suffering from alcohol or drug addiction and would like to discuss the treatment options that are available, call the Palm Beach Institute at 855-534-3574. Our team of recovery specialists is available anytime, day or night, and can help you choose the right rehab and treatment program for your or your loved one’s unique needs. Don’t wait another day to regain your health and independence: call now and begin the healing journey.

Addiction & the Military: How PTSD Leads to Addiction

Memorial Day weekend is a time that we as Americans can reflect on the sacrifices our men and women in uniform have made in order for us to continue to experience freedom. Those individuals who have served or actively serve in our military deserve nothing but the utmost in respect for giving their time, energy and lifetime to us as a society. However, there is a growing percentage of returning veterans that are coming back from active duty with significant physical injury as well as mental distress. One of the most common afflictions that returning soldiers can face is post-traumatic stress disorder (PTSD).

PTSD is one of the most emotionally debilitating disorders that one can face, especially for our soldiers. PTSD can cause intense anxiety, intrusive memories and vivid flashbacks that can interfere with daily functioning. In the absence of proper therapy, counseling and other support, a good number of our veterans turn to alcohol and drugs in order to numb the pain or to find some sort of control in their lives. With the presence of substance abuse, this can create a complicated dual diagnosis and become essential to understand the roots of the causes of PTSD along with treatment for alcohol and/or drug addiction.

Statistics: Substance Abuse and PTSD

The statistics concerning substance use and abuse and the prevalence of PTSD among military personnel has become increasingly concerning. For example, it is estimated that up to 75% of combat veterans that have lifetime PTSD also met the criteria for lifetime alcohol and/or drug dependence. Male soldiers are twice as likely to develop substance abuse issues when PTSD is present in comparison to female soldiers. One area of concern is the growing tide of prescription drug abuse. In the period between 2002-2005 prescription drug abuse among the military doubled and in the years 2005-2008 the rate tripled.

Alcohol abuse is the most prevalent problem and one which poses a significant health risk. A study of Army soldiers screened 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk for related harmful behaviors. Additionally, there is the specter of mental illness. In another study of returning soldiers, clinicians identified 20 percent of active and 42 percent of reserve component soldiers as requiring mental health treatment. Drug or alcohol use frequently accompanies mental health problems and was involved in 30 percent of the Army’s suicide deaths from 2003 to 2009 and in more than 45 percent of non-fatal suicide attempts from 2005 to 2009.

Why Turn To Drugs and Alcohol?

There are several key reasons regarding why those in the military who suffer from PTSD turn to drugs and alcohol to cope with their disorder. A common reason those in the military turn to drugs—and especially alcohol—is the fact that it is viewed as the best “over the counter” medication available. In the case of alcohol, it is legal and inexpensive and the results of drinking can be seen as predictable in the fact that it can numb and slow things to the point where life is seemingly more manageable.

Secondly, the military’s “zero tolerance” policy can also contribute to the problem of substance abuse among military personnel. While this type of policy does lower the instance of illicit drug use while soldiers on are active duty it does not provide any sort of outlet for help in case someone were to develop a substance dependence issue. Additionally, military medicine follows the concept of “partitioning” where the addiction counselor, the psychiatrist, the neurologist and the doctor work separately rather than in conjunction with one another.

While the wounds and trauma may be healed on those individual levels, substance abuse is a complex issue which has a presence of many levels. In order to effectively treat the substance abuse, the mental and physical pain and trauma must all be acknowledged and accounted for in addition to the substance abuse. The best thing we could do for the thousands of Americans in uniform now, who often return troubled by their experiences, is to apply some common sense to their healing. If you or someone you know is suffering from a drug & alcohol problem call The Palm Beach Institute today at 1-855-470-2050.