After a traumatic event, people often report using alcohol to relieve their symptoms of anxiety, irritability, and depression. Alcohol may relieve these symptoms, because drinking compensates for deficiencies in endorphin activity following a traumatic experience. Within minutes of exposure to a traumatic event there is an increase in the level of endorphins in the brain. During the time of the trauma, endorphin levels remain elevated and help numb the emotional and physical pain of the trauma; however, after the trauma is over, endorphin levels gradually decrease, and this may lead to a period of endorphin withdrawal that can last from hours to days. This period of endorphin withdrawal may produce emotional distress and contribute to other symptoms of posttraumatic stress disorder (PTSD). Because alcohol use increases endorphin activity, drinking following trauma may be used to compensate this endorphin withdrawal and thus avoid the associated emotional distress. This model has important implications for the treatment of PTSD and alcoholism. Therapy aimed at increasing one's sense of mastery over traumatic events can help patients cope when exposed to trauma reminders. By reversing feelings of helplessness, one can more easily recover from PTSD and related alcohol problems. The use of opioid blockers such as naltrexone may block the effects of alcohol and break the addictive cycle. 1 figure and 26 references