The Connection Between Trauma and Substance Abuse

People can be drawn into substance misuse for all sorts of reasons. Sometimes it may be through boredom or peer pressure. People may use drugs or alcohol to help them relax or for pleasure. Sometimes it may be an attempt to self-medicate or as a coping mechanism for various issues, including past and ongoing trauma.

Understanding Trauma

In psychological terms, trauma refers to a lasting emotional response to a deeply distressing event or situation. It could be a one-off extreme event like a bereavement, assault or being involved in an accident. Trauma can also stem from long-term situations or patterns such as neglect, abuse, loss or chronic stress.

There are three main types of trauma:

• Acute trauma – This results from a single distressing event, characterised by suddenness and intensity.
• Chronic trauma – Occurs due to prolonged exposure to distressing situations or repeated exposure to traumatic events.
• Complex trauma – Similar to chronic trauma, complex trauma is triggered by prolonged exposure to various types of severe trauma, often within the context of interpersonal relationships.

Trauma can lead to long-lasting psychological effects and changes in the way the brain functions. Post-Traumatic Stress Disorder (PTSD) is one of the most well-known effects of trauma, while other effects can include depression, anxiety, dissociation and altered fight-or-flight responses.

What Is the Link Between Trauma and Substance Abuse?

There are well-established links between substance misuse, trauma and addiction. Numerous studies have found links between experiencing trauma and increased risk of substance misuse, with some finding a particular link between childhood trauma and substance abuse in later life.

This increased risk of substance misuse can also lead to a link between trauma and addiction, as the abuse of addictive substances can often lead to psychological and physical dependence.

The main reason for this link is that people who have undergone trauma will often turn to drugs or alcohol in an attempt to self-medicate symptoms such as emotional pain, anxiety, flashbacks or numbness.

Brain chemistry can play a role in all this, even if the individual is unaware of these underlying reasons. Trauma can dysregulate chemicals and systems such as dopamine, cortisol and stress pathways. The use of substances may temporarily ‘correct’ these issues, but ultimately, substance misuse will only make things worse and bring new problems to the table.

In some cases, it could be substance abuse that causes trauma or leads to traumatic situations. Chronic or severe alcohol and drug misuse could lead to illness or injury, or increase the risk of being involved in violence and other potentially traumatic events. Using more drugs or alcohol to cope with this trauma could lead to a vicious cycle.

Common Substances Linked to Trauma Coping

People who have experienced trauma can use a wide variety of substances in an attempt to cope with the lasting effects. Alcohol is a common substance associated with trauma coping, at least partly due to its easy availability and social acceptability. The charity Agenda, for example, says that almost a third of women who have experienced extensive physical and sexual violence as a child or adult have an alcohol problem. This is more than twice the rate among women who have little experience of violence and abuse.

They are also eight times more likely to be drug dependent than women with little experience of violence and abuse. People who have experienced trauma are more likely to turn to illegal drugs or misuse prescription drugs, including cannabis, opioids and benzodiazepines.

PTSD, ACEs and Addiction

Post-Traumatic Stress Disorder (PTSD) can have a wide range of symptoms including re-experiencing the traumatic events through flashbacks and nightmares, avoidance, reactivity issues such as hypervigilance and feelings of anger, guilt or shame.

The US National Centre for PTSD has found that around 4 out of 10 adults who have PTSD also have problems with drug or alcohol use. People with PTSD may use drugs or alcohol to help them relax, feel more comfortable in social settings or block out thoughts and feelings they would rather avoid.

There are also clear links between Adverse Childhood Experiences (ACEs) and substance misuse. One study found that adults with any history of ACEs have a 4.3-times higher likelihood of developing a substance use disorder. Female adults had a 5.9-times higher likelihood of developing an alcohol use disorder.

Dual Diagnosis: When Trauma and Addiction Coexist

There is often a complex link between trauma, mental health, substance misuse and addiction, with each element influencing the others in different ways.

Guidance from the National Institute for Health and Care Excellence (NICE) says it is important that people with mental health conditions should not be excluded from treatment or services due to co-existing substance misuse issues. In fact, a comprehensive assessment of the person’s mental health and substance misuse needs should be undertaken.

Dual diagnosis treatment is specialised treatment that looks to address substance misuse and addiction issues alongside any mental health conditions that co-exist at the same time. This is important because treating any one element alone could lead to a higher chance of failure or later relapse due to the problems presented by the others.

How Trauma-Informed Addiction Treatment Helps

A holistic drug or alcohol rehab programme should be personally tailored to your own unique circumstances and needs, addressing the physical and psychological aspects of addiction as well as any co-existing mental health issues, including those linked to trauma.

Trauma-informed care should emphasise safety, empathy and trust-building alongside any physical detox programme and psychological therapies aimed at tackling the root causes of the addiction.

Some therapies that may be used could include:

• Cognitive behavioural therapy (CBT) and trauma-focused CBT
• EMDR (Eye Movement Desensitisation and Reprocessing (EMDR)
• Somatic therapies or mindfulness-based approaches

Recognising and addressing trauma issues at the same time as addiction treatment can help reduce the risks of relapse and provide a real chance to break the cycle of trauma and substance misuse.

Getting Help: You Don’t Have to Go Through It Alone

Trauma and addiction are both very complex issues and can be very difficult to deal with alone. They can be successfully treated, though, and it’s possible to heal from both with the right support and expert advice.

Addiction Advocates has a wealth of experience in connecting individuals with the treatments and programmes that are right for their own unique circumstances, including trauma-informed rehab services.

If you or a loved one needs help with any of these issues, contact us today for confidential advice or to get our admissions process rolling.