Should I do trauma work before or after getting sober?

Alongside, in a proper trauma-informed programme. 'Get sober first, then we'll do the trauma' often means people can't stay sober because the trauma is what's driving the use. Look for rehabs that offer EMDR or trauma-focused CBT during the stay.

EMDR (Eye Movement Desensitisation and Reprocessing) is a NICE-recommended trauma therapy that helps the brain reprocess stuck traumatic memories. Sessions use guided eye movements or tapping while you briefly focus on the memory. Response is often faster than traditional talking therapy.

Is there NHS help for PTSD + addiction?

Yes, but often via two separate services (community mental health team + community drug service). Some UK trusts have specialist dual-diagnosis teams; most don't. Private trauma-informed rehab is faster but self-funded.

PTSD and addiction

Untreated trauma is at the root of most severe addiction cases in the UK. Alcohol, opioids, ketamine and cannabis all numb intrusive memories, nightmares and hypervigilance — until they stop working. Treating one without the other rarely holds.

Key signs

Intrusive memories, flashbacks, nightmares
Hypervigilance — always scanning for threat
Avoidance — of people, places, feelings, conversations
Emotional numbing, or sudden intense rage
Using to sleep, or to switch the mind off

The link to addiction

Substances calm the nervous system short-term. As tolerance climbs, PTSD symptoms rebound harder — and the substance stops working. The way out is trauma-informed treatment that runs alongside detox, not after it.

UK treatment pathway

The evidence base is EMDR (Eye Movement Desensitisation and Reprocessing) and trauma-focused CBT, ideally in a dual-diagnosis setting. Not every UK rehab has a trained trauma therapist on staff — ask specifically before you book.

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FAQs

Should I do trauma work before or after getting sober?
Alongside, in a proper trauma-informed programme. 'Get sober first, then we'll do the trauma' often means people can't stay sober because the trauma is what's driving the use. Look for rehabs that offer EMDR or trauma-focused CBT during the stay.
What is EMDR?
EMDR (Eye Movement Desensitisation and Reprocessing) is a NICE-recommended trauma therapy that helps the brain reprocess stuck traumatic memories. Sessions use guided eye movements or tapping while you briefly focus on the memory. Response is often faster than traditional talking therapy.
Is there NHS help for PTSD + addiction?
Yes, but often via two separate services (community mental health team + community drug service). Some UK trusts have specialist dual-diagnosis teams; most don't. Private trauma-informed rehab is faster but self-funded.