The Relationship between Trauma and Addiction

Trauma and addiction are often connected. According to the National Institutes of Health (NIH), traumatic events including childhood trauma, can become triggers for drug misuse, alcohol misuse and other types of substance abuse. Experiencing trauma increases the co-occurrence of mental health conditions and substance use. This is due to the endured feelings of continued anxiety, hypervigilance, and alertness. During prolonged exposure to these types of symptoms, people can develop a dysregulated stress system in which individuals then turn to substances to help block such negative feelings.

A young woman is bent over with her hands on her temples and forehead has trauma and addiction.

Studies show an estimated one-fourth to three-fourths of people who survived abuse or a traumatic experience reported having problems with alcohol misuse. About 59% of individuals with post-traumatic stress disorder (PTSD) have developed issues with substance abuse and dependence. An estimated 80% of Vietnam veterans seeking treatment for PTSD have an alcohol use disorder. Women who are exposed to trauma are also at a higher risk for developing alcohol use disorder.

People who experience trauma in general are at risk for a wide range of detrimental factors. They are more likely to abuse alcohol and drugs as well as develop mental health conditions such as PTSD. Both conditions affect each other negatively. In the majority of cases, PTSD and traumatic experiences can lead to the development of a substance addiction. However, there are some cases in which a substance addiction fuels the development of mental health conditions including PTSD. 

What is Trauma?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, trauma is defined as an “exposure to actual or threatened death, serious injury, or sexual violence.” Trauma refers to continuous and prolonged events and experiences that are distressing, disturbing and upsetting.

Trauma can occur in different ways.

  • You can directly experience the event or have it happen to you.
  • You can witness the event as it is happening to someone else.
  • You can learn of traumatic events happening to a close friend or family member.
  • You can repeatedly be exposed to an extreme detail of an event. An example of this would be first responder’s experiences following a disaster event or therapists listening to trauma stories from their clients.
Infograph showing the cycle of trauma and addiction.

Symptoms of PTSD

  • Reliving the event and experiencing flashbacks, nightmares or other triggers such as sight, sound and smells
  • Avoidance of people and places to isolate from any potential exposure to things that can evoke memories of the traumatic experience
  • Negative thoughts and feelings can begin to manifest themselves as emotional numbness, inability to engage with others and forgetfulness
  • Hyperarousal feelings consist of being jittery and always alert to potential dangers

The stress system is managed by the hypothalamic pituitary adrenal axis (HPA). This part of our body prepares us to respond to danger and stress efficiently. When stress occurs, blood and energy are diverted to the brain to offer immediate assistance to help us prepare and manage our feelings. When there is a situation in which a traumatic event is occurring, and the threat is persistent and never resolved, this is also known as chronic stress. This can overwhelm the body’s stress system in which the HPA will become chronically activated and cause a dysregulation of emotions. Dysregulation of emotions and the stress system can lead to mental health development as well as an impact on the immune system, emotional regulation, cognitive development and executive functioning skills.

An estimated 21 million Americans have PTSD. According to the Department of Veterans Affairs, about 6 out of 100 Americans will develop PTSD at some point in their lives. PTSD and other forms of trauma including childhood trauma, can lead to the development of problematic substance use and misuse.

What is Substance Misuse?

Alcohol is a substance that is most often associated with trauma and PTSD. It is legal, easily accessible and more widely accepted compared to other mind-altering substances. Those who have PTSD or trauma are more prone to experiencing some sort of substance misuse.

  • Substance dependence. Substance dependence occurs when a person has to intake more of a substance in order to experience and feel the same effects. Someone with a substance dependence can experience withdrawal symptoms when they stop using or drastically reduce their consumption of a drug. They often have difficulty controlling the amount of substances they use, spend a great deal of time using and recovering from using and often give up activities they once loved in order to continue using substances despite the negative consequences.
  • Substance abuse. Substance abuse usually occurs as a result of relationship problems, being too intoxicated in dangerous situations, or when a person is in trouble with the law due to taking substances. Abuse of substances is the act of using them in a way that was not prescribed by a physician or in an attempt to induce feelings of “high” and euphoria.

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The Relationship between Trauma and Addiction

Traumatized people are much more likely than others of a similar background to abuse alcohol and drugs. Alcohol and drugs can change the way a person feels by producing pleasure and pain relief artificially. After a traumatic experience, the brain produces fewer endorphins making us seek it elsewhere: in drugs. Drugs have properties that help artificially stimulate endorphins and increase levels of happiness and joy.

Substances such as alcohol, benzodiazepines and opioids produce a calming, euphoric and intoxicating effect that slows down the central nervous system. Oftentimes, people who have trauma use these types of drugs as a way to self-medicate and help them to regulate and manage distressing feelings.

The use of drugs can provide a temporary distraction and short-term relief for stressful emotions related to trauma and PTSD. Substance abuse is also seen as a form of avoidance, which is one of the main symptoms of PTSD.

However, it is not a long-term solution. Over time substance use reduces a person’s ability to concentrate and think clearly. It also increases emotional numbing, social isolation, anger, irritability, depression and anxiety. Individuals who experience trauma or have been diagnosed with PTSD are more vulnerable to developing a substance addiction because of the properties of drugs that are able to artificially produce rewarding feelings.

Trauma can change and affect brain chemistry in the same way that substance abuse and addiction can. It is often the reason why they are so connected. Both of the mental health disorders feed off of one another.

DSM-5 Criteria for Trauma-related Substance Use Symptoms

  • Taking substances in larger amounts over time
  • Repeated unsuccessful attempts to eliminate, reduce, or control substance use
  • Significant time is spent obtaining, using and recovering from substance use cravings
  • Substance use begins to cause functional problems
  • Substance use is continued despite the resulting negative consequences
  • The user will give up activities once loved in order to participate in substance use
  • The user will participate in unsafe or risky substance use
  • And increased tolerance for the drug is developed

Reach out to Hotel California by the Sea

We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.

Treatment of Trauma and Addiction

Trauma and substance abuse are comorbid mental health conditions that commonly occur together. It is a condition that can be overlooked if not treated concurrently and professionally by a behavioral health program. Hotel California by the Sea provides treatment for substance addiction as well as co-occurring mental health disorders.

We provide all levels of care including detox, residential, PHP and IOP. We utilize the latest evidence-based treatment methods including CBT, DBT and family therapy. Our treatments consist of medication management treatments, individual counseling and group sessions. By utilizing a wide spectrum of treatments, we are able to treat all aspects of trauma-related substance addiction.

References:

https://www.psychologytoday.com/us/blog/understanding-addiction/202109/why-trauma-can-lead-to-addiction

https://istss.org/ISTSS_Main/media/Documents/ISTSS_TraumaStressandSubstanceAbuseProb_English_FNL.pdf

https://www.verywellmind.com/connection-trauma-and-substance-abuse-7269368

https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/the-intersection-of-childhood-trauma-and-addiction

https://www.addictioncenter.com/addiction/post-traumatic-stress-disorder
https://treatmentmagazine.com/what-is-complex-trauma-in-addiction