Issues That Matter: How is Trauma Tied to Substance Abuse? 2/4/22

This entry comes to us from Heidi Bitsoli at Sunshine Behavioral Health. Thank you, Heidi, for sharing your research on this topic!

How Is Trauma Tied to Substance Abuse?  

Numerous studies and scientific reviews confirm the well-established connection between trauma and substance abuse. Much of it has to do with how the brain responds to traumatic events such as an accident, abuse, or the death of a loved one.

What Is Trauma?

The general definition of trauma is an emotional response to a distressing event that is dangerous, frightening, or violent. The response can be triggered in the person who directly experienced the distress or someone who witnessed it. Trauma can result from a single emotionally disturbing event (acute trauma), repeated exposure to the ordeal (chronic trauma), or multiple distressing events (complex trauma).

How Trauma Affects the Brain

In an attempt to protect you from the distressing emotions of a traumatic event, the brain shuts off certain functions. Brain functions also become dysregulated and interfere with your ability to cope following the event. Important parts of the brain affected are the amygdala, medial prefrontal cortex (mPFC), and hippocampus. These regions are responsible for functions such as memory, learning, and response to stress. Swift protective reaction by the brain to suppress memories often makes it difficult for survivors of trauma to put their experiences into context.

Signs of Trauma in Adults

Children and adults experience and encounter traumatic events, but studies show that children are far less prepared to deal with them. That means the long-term effects of unresolved trauma often continue to play out in their lives into adulthood. While acute physical effects of trauma are short-lived, the emotional and psychological effects tend to persist. Common signs or symptoms seen in adults include:

  • Flashbacks (associated with post-traumatic stress disorder, or PTSD)
  • Re-living the event repeatedly, leading to retraumatization
  • Intrusive thoughts
  • Nightmares
  • Dissociation (mental escape)
  • Negative changes in behavior, e.g., social isolation, avoidance, or loss of emotional control
  • Feeling ashamed, guilty, afraid, emotionally numb, or worthless
  • Psychological problems, e.g., anxiety, depression, PTSD, or chronic insomnia
  • Difficulty with attachment in relationships or turbulent relationships

You can experience these symptoms whether the event recently occurred or happened during childhood. But everyone responds to trauma differently and some show a great level of resilience.

Ways People Cope with Traumatic Events

There are adaptive (healthy) and maladaptive (unhealthy) ways of dealing with trauma related to physical or sexual abuse, neglect, losing a parent or child, or witnessing a homicide. Positive coping skills include asking for emotional support from your family, confronting your feelings, practicing self-care, staying socially connected, and accepting that the trauma happened to you.

While some individuals make progress with these coping strategies, others find it difficult to get past the trauma. They may resort to substance abuse to escape emotional pain. These are unhealthy ways to cope and can lead to substance dependence and addiction.

Correlation Between Trauma and Substance Abuse?

Substance abuse is described as using illicit drugs, misusing prescription drugs, and drinking too much on a frequent or long-term basis. Negative thoughts or feelings and mental health conditions, such as post-traumatic stress disorder, anxiety, and depression, are risk factors of substance use. Incidentally, all these factors are associated with trauma.

A high percentage of people battling substance abuse suffered trauma in childhood. Furthermore, the rates of alcohol and drug use disorders are higher among men and women reporting sexual abuse.

Many of these people have yet to process the memories and feelings concerning the event. Unprocessed trauma is an underlying reason why people who suffered such an intense ordeal drink or use drugs to cope. They self-medicate with substances to numb emotional pain.

Drinking and drug use are also associated with euphoria that comes from the release of dopamine in the brain. However, drug and alcohol abuse does not resolve trauma. The pleasure these behaviors provide is short-lived. If anything, it can lead to heavier substance use and addiction, worsen the symptoms of mental disorders, and leave you less able to cope.

Healing with Dual Diagnosis Treatment

Trauma and substance abuse are two different things. One is an emotional experience that is psychologically damaging; the other is an unhealthy coping behavior that can turn into a substance use disorder (SUD), or addiction. It’s not unusual for these conditions to co-occur and relate to each other. They are also jointly associated with PTSD.

Because of the strong correlation, it is necessary to receive comprehensive treatment tailored to your needs. While individual treatments are available for trauma and addiction, you can receive them simultaneously. Doctors call it dual-diagnosis treatment. If the inability to cope with trauma is the root cause of substance use, then processing the disturbing events may help curtail the need to self-medicate with addictive substances.

Therapists also seek to help you manage triggers of substance use, such as negative thoughts and feelings about your experience. You’ll also learn positive coping skills to manage PTSD. Treatments and therapies used to accomplish these goals are as follows:

Addiction treatment

Starts with medical detox to eliminate harmful chemicals and toxins in the body. Treatment continues with behavioral therapies, mainly cognitive-behavioral therapy (CBT). CBT is an effective science-based therapy for anxiety and depression. Family therapy may be initiated to counsel loved ones on how to provide you with support.

Trauma therapy

Cognitive processing therapy (CPT) is a standard treatment for PTSD associated with childhood trauma. Another crucial aspect of recovery is processing the memories of the traumatic experience. Your therapist can try to accomplish this using eye movement desensitization and reprocessing (EMDR). There’s also trauma-focused cognitive behavioral therapy (TF-CBT), which involves combining trauma-sensitive techniques with cognitive-behavioral techniques to promote healing.

The Light at the End of the Tunnel

The unfortunate event that left you traumatized does not have to define the rest of your life. Healing from it can seem impossible at times, particularly when addiction is involved. Through self-compassion and seeking treatment, there’s hope for putting your life back together.

Sources – Substance Use, Childhood Traumatic Experience, and Posttraumatic Stress Disorder in an Urban Civilian Population – Coping with a Traumatic Event – How Can Trauma Affect the Brain? -Post-Traumatic Stress Disorder – Self-Help and Coping – When Trauma Slips into Addiction – Traumatic Stress and Substance Abuse Problems – Dual Diagnosis Addiction Treatment – Cognitive Processing Therapy for PTSD

*Notes from Melissa: If you need treatment, please consider using our Agency Members (logos and links to their websites are on our Members page), who have committed themselves to practicing more trauma-informed and trauma-responsive care. You may also consult our Trauma Therapist Listing found on our Resources page. Your care and wellbeing is important. Always research a provider or agency for goodness of fit with your needs before engaging in services.

May your day, no matter what part of it you are currently in, show you that there is HOPE around every corner and sometimes it’s right in front of you, perhaps in the eyes of the person you next meet!

Melissa Adamchik, MA, LPP

Executive Director, Tristate Trauma Network