Trauma and addiction are realities for millions of Americans. In this article, you will learn why these two mental health conditions often co-occur, why they make each other worse, signs to identify their co-existence and effective treatment interventions to address them both and start a new life.
What Counts as Trauma?
Trauma is an event that causes a profound emotional reaction due to its distressing nature. So, what counts as trauma varies from person to person.
Common traumatic events include:
- Sexual abuse
- Violence
- Death of a loved one
- War
- Accidents
- A natural disaster
A traumatic experience can leave emotional scars in a person, which may result in long-lasting consequences such as intrusive memories, negative moods, avoidance patterns and hypersensitivity to everyday situations, which can disrupt normal functioning.
Trauma is classified as acute or chronic:
- Acute trauma: The death of a close friend causes profound sadness that, as time goes on, gradually subsides and turns into acceptance.
- Chronic trauma: A spouse’s passing results in deep sorrow. As months go by, the confusion and chronic low mood disrupt the person’s capacity to hold a job.
Posttraumatic Stress Disorder (PTSD)
Some individuals, after exposure to extensive trauma, may develop PTSD in the aftermath of these events.
This psychiatric condition is characterized by severe functional impairment as its effects may lead to a person withdrawing from daily activities, experiencing negative emotions and having relationship issues.
It’s estimated that 6.8% of American adults have PTSD.
Why Trauma Increases Addiction Risk
Trauma can increase the risk of developing substance use disorders. In the US, studies have found that about 40% of individuals who access addiction treatment have co-occurring PTSD.
Early traumatic experiences can shape an individual’s life trajectory, potentially making them more susceptible to struggling later in life with addiction.
For instance, survivors of childhood trauma have over a 70% greater risk of developing a substance use disorder later in life.
Traumatic experiences can shift how an individual interprets daily events, potentially making them more sensitive to stress and influencing the development of insecure attachment styles that can predispose them to experiencing intense emotional pain.
Trauma’s long-term effects on mood may result in individuals seeking relief from negative feelings by relying on substances, which can increase the risk of becoming addicted to them.
The effects of trauma on the brain can be severe, impacting the capacity of a person to make good choices and exert self-control. This could expose them to environments where alcohol and drugs are common.
Neurological studies have found that the same heightened response to stress that characterizes chronic trauma may aggravate cravings for substances when an individual experiences challenging situations.
Personality traits such as impulsivity and heightened emotional reactivity are common in both PTSD and substance abuse, offering another explanation for the frequent co-occurrence of these disorders.
Common Signs of Trauma-Driven Substance Use
Only a licensed professional can diagnose a substance abuse disorder and evaluate if trauma is potentially influencing its trajectory.
However, if you or someone close to you is struggling with any of the following signs, it is a good idea to seek specialized support.
Symptoms of Substance Use Disorders
Symptoms of addictive disorders include:
- Substance use is affecting academic or work performance.
- There’s a constant preoccupation with using or accessing drugs or alcohol.
- Developing tolerance, cravings or withdrawal symptoms for a substance.
- Using substances despite their negative impact on your life.
- Losing interest in hobbies and social activities.
- Putting yourself at risk while procuring or using drugs or alcohol.
- Loss of self-control and reckless decision-making.
Signs Trauma May Be Fueling Addiction
Distinguishing whether alcohol or drug use is being driven by trauma requires careful analysis that only an expert is qualified to do.
Some signs that could indicate that trauma is linked to substance abuse are:
- Drug or alcohol use escalates after exposure to triggering situations.
- Substances are used to deal with sleep difficulties related to trauma.
- A person tries to alter mood states or reduce stress caused by trauma with substances.
- Drugs or alcohol are utilized to avoid painful memories.
- An individual relies on substances to navigate social situations that induce stress.
- PTSD symptoms include anger, intrusive thoughts, nightmares, insomnia, occupational problems, painful flashbacks and avoidance patterns.
Why Treating Trauma Matters in Recovery
Both trauma and substance use disorders can aggravate each other. People may try to deal with trauma’s sleeping difficulties with alcohol, which could lead to addiction while simultaneously worsening trauma symptoms such as irritability.
These interrelationships between substance use disorders and mental health conditions are common. Out of the 46.3 million Americans who struggle with addiction, almost half (21.2 million) also have a mental health condition such as PTSD.
That’ s why it’s critical to address trauma in recovery, as each condition may perpetuate the other.
Co-occurrence of PTSD and substance use disorders is associated with higher suicide rates, poorer treatment outcomes and prognosis, worse social functioning and a higher likelihood of relapse.
Co-occurrence may indicate personal or social vulnerabilities, such as an elevated sensitivity to stress or a family history of substance use.
If a person is facing disordered substance use, all the circumstances in their life, such as unresolved trauma, can have a massive impact, so they must be considered and treated.
The best approach is to address addiction and trauma simultaneously in a comprehensive treatment protocol that considers every aspect of an individual and, by doing so, offers them the best chance to recover and care for their emotional health.
Trauma-Informed Treatment Approaches
Trauma-informed addiction treatment is a recovery approach that recognizes the impact of trauma in the development, progression and outcomes of substance use disorders.
A trauma-informed approach meets individuals where they are, helping them build resilience skills while they access evidence-based protocols to get clean and maintain long-term sobriety.
Both trauma and addiction can present with profound shame, which can dissuade individuals from accessing the care they need and deserve.
Trauma-informed professionals are equipped with tools and a healthy dose of compassion to act as catalysts for change.
Types of Trauma-Informed Treatments
Recovery from addiction and trauma demands a personalized approach to treatment.
In the past, it was standard to address substance use disorders first due to the now discredited belief that sobriety was a prerequisite for effective treatment, while, in some cases, ignoring or postponing dealing with the lingering effects of trauma.
Currently, due to the reinforcing nature of both conditions, meaning each can make the other worse, it’s best, from the initial assessment, to design interventions that help a person detox while also commencing work on reducing the lingering effects of trauma.
Programs that incorporate trauma-informed therapies are more effective than non-trauma-focused interventions when dealing with PTSD and addiction.
Effective treatment modalities include:
- Cognitive Behavioral Therapies (CBT): In these interventions, trained therapists can help you develop skills to reevaluate your thoughts about the past, process painful memories, build self-control and manage cravings.
- Concurrent Treatment of PTSD and Substance Use Disorder Using Prolonged Exposure (COPE): This specialized type of treatment, which also employs CBT methodologies, focuses on confronting triggering scenarios in a safe space that may be fueling addictive behaviors in connection with trauma.
- Here, you can also develop skills to manage cravings and nurture empowering beliefs to prevent relapse.
- Medications and talk therapies: Depending on your addiction, such as alcohol use disorders or opioid use disorders, effective medications exist for managing cravings and withdrawal symptoms.
- When combined with talk therapies tailored to your unique background, emotional trauma and goals, it can help you quit and work through the past.
Recovery from addiction and healing from trauma are possible. With the help of a qualified team and consistent effort, you can address both conditions, develop resilience skills and start a new chapter that makes you proud.
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Trauma and Addiction FAQs
Can Trauma Cause Addiction?
Addiction is a complex mental health disorder that isn’t the result of a unique cause, including trauma. Substance use disorders develop gradually as a person consumes drugs or alcohol for a prolonged time, leading to neurological changes.
Mental health conditions (such as trauma), adverse childhood experiences, genetics, and environmental influences can contribute to addiction, but pinpointing a unique cause in clinical cases is unfeasible due to the interrelated nature of these disorders.
Does Everyone With Addiction Have Trauma?
Not everyone with alcohol or drug addiction necessarily has trauma. While substance use disorders and trauma often co-occur and can aggravate each other, they are separate psychiatric disorders with unique symptoms, causes and outcomes. Not everyone with trauma will become addicted to drugs or alcohol, nor will everyone who abuses substances experience trauma.
What is Trauma-Informed Care?
Trauma-informed care is an addiction recovery modality that acknowledges the impact of trauma in the development and evolution of addictive disorders. In these programs, individuals can access care that adapts to their life experiences, addressing the wounds of the past simultaneously while getting sober with the help of qualified professionals.
Can Untreated Trauma Cause Relapse?
Yes, untreated trauma can potentially elevate the risk of relapse. Trauma often manifests in low mood, elevated stress levels and sleeping difficulties. Relapse can be a real concern in these cases, as some individuals can use substances as a coping mechanism to alleviate these symptoms.