According to SAMHSA, 21.5 million Americans struggle with a substance use disorder, many of whom also struggle with some form of mental health disorder. Science is starting to understand the connections between genetics, mental health, life experiences, and addiction and thus we have become better equipped to help people overcome the challenges they face. Alongside genetic disposition, negative experiences can have a dramatic role in the development of mood systems that influence the development of anxiety disorders and addiction. These negative experiences or trauma is often an overlooked factor in regards to substance abuse treatment, but the resolution of past trauma can play a significant role in successful addiction treatment.
Surviving even one traumatic experience can lead to anxiety disorders, depression, or PTSD. Trauma is defined by any event or repeated experience that causes lasting fear and distress. Traumatic experiences can differ from person to person; an experience can be traumatic for one person and not another. Therefore, the presence of trauma is subjective to each person’s reaction to the event.
Examples of traumatic experiences can include involvement in active military combat; witnessing or experiencing physical, emotional, or sexual abuse; major injuries; the death of a loved one; or any other catastrophic events. Trauma may not always be felt or understood immediately but can lead to post-traumatic stress disorder (PTSD) later on.
PTSD can include mood swings, loss of motivation, poor concentration, nightmares, sleep issues, hopelessness, impulsivity, relationships problems, and negative thinkings. Unfortunately, many people who suffer from PSTD turn to alcohol and/or drugs to cope with these feelings of distress. Studies have shown that up to two-thirds of people suffering from addiction experienced some sort of significant trauma at some point in their lives.
The risk for addiction increases if an individual experiences trauma during childhood while their brain is still developing. A famous study of 17,000 people by Permanente called the Adverse Childhood Experience (ACE) concluded that the greater the number of adverse experiences (traumatic events) in childhood, the greater the risk for addiction. Adverse experiences ranged from parental divorce, physical abuse, emotional neglect, and household mental illness. For example, the study found a 500% increase in developing alcoholism and a 4,600% increase in using injectable drugs in the person experienced four or more adverse experiences.
A single traumatic event can cause psychological changes in the rain (including hypothalamic-pituitary-adrenal axis, prefrontal cortex, striatum, and limbic system), resulting in a cascade of difficulties from mood, behavior and thinking. These behavioral changes are the effects of imbalances in hormones and chemical in the brain such as glutamine, GABA, and dopamine levels. These changes can make an individual more prone to substance use.
Drug and alcohol abuse begins to relieve the chronic stress of PTSD temporarily, but in the long run, the symptoms and overall quality of life end up much worse. Substance abuse is a devastating force that can cause additional trauma exacerbating the problem. For people with comorbid diagnoses, both the trauma and addiction must be treated effectively. Very rarely does addiction happen on its own without any underlying factors of mental health or trauma but sadly many people looking to heal their addiction are only treated on their addiction in isolation. Dual Diagnosis treatment centers can address both of these problems. Without addressing each problem, an individual increases their potential of dropping the program or even relapse. For example, if you treat alcohol abuse without treating the underlying trauma, the person will look to a supplemental substance to cope with the untreated problem.
Addiction and Trauma Treatment
If you or a loved one is struggling with both trauma and addiction there is hope. Modern substance abuse rehabs will use psychological techniques to heal each disorder. A meta-analysis by Roberts, Roberts, Jones, and Bisson (2015) concluded that trauma-focused psychological interventions delivered with substance use treatment led to reduced PTSD severity and decreased alcohol and substance abuse. Trauma-informed therapies also lead to greater sobriety maintenance, whereas non-trauma-focused interventions lead to less positive outcomes.
Traditionally, trauma was treated after an individual had obtained their sobriety for a period of time. This method has been shown to be less effective because individuals rarely make it through the program without treatment of their trauma. Before trauma treatment takes place, those entering a drug rehab may be required to participate in a detoxification process. Treatment will then begin after the completion of detox.
To treat trauma, trauma-informed CBT (cognitive-behavioral therapy) with exposure techniques is highly effective in long-term symptom relief and improved overall well-being. Such treatment includes coping relaxation exercises, processing of trauma, psychoeducation, skills training, problem-solving, future planning, and relapse prevention skills.
Trauma therapies should help with decreasing avoidance behaviors, achieving and maintaining sobriety, improving self-concept, understanding the relationship between trauma and addiction, and eliminating self-destructive behaviors. Building recovery is about establishing an improved quality of life. The process takes time, but by improving our relationships, thought processes, and the environment, we can create a life that is improved and meaningful. This is what we believe is the key to lifelong sobriety. If you or a loved one has struggled with trauma and substance abuse, remember that help is available.