Is There a Link Between Trauma and Addiction?
It is not an uncommon phenomenon for individuals who experience trauma to develop substance use disorders, which are often referred to as ‘addictions’ by most popular literature and scientific research. In fact, if you have been diagnosed with, or suspect a substance abuse disorder and have experienced any type of traumatic experience, you are not alone. In observing the information available on the internet, it is possible to receive inconsistent values on how many Americans develop substance use disorders because of trauma however, what seems to be concurrent with the resources available is millions of Americans, like you, suffer. The Substance Abuse and Mental Health Services Administration (SAMHSA) released shocking results from a 2020 national survey in which 148 million adults annually have co-occurring mental health conditions but, only 5.7% of those individuals will receive care at a specialty facility (SAMSHA, 2021, p.5). At Prosperity Haven, we strive to change that statistic by offering holistic care that treats the whole person and their unique lived experiences rather than the variables of their story.
To describe the link between trauma and addiction, it is important to first clarify the differences between the two terms and define the aspects that make them a tragically enmeshed partnership. Substance Use Disorder is a diagnosable condition characterized by cravings, loss of control, increased tolerance, withdrawal symptoms, and dismissal of harmful consequences. As a result of the above-named symptoms, paranoia, depression, anxiety, aggression, loss of judgement, increased impulsiveness, and interrupted thought processes can hold a person at the mercy of the substances or behaviors that has helped them to cope with life’s challenges.
There are several risk factors that contribute to addiction, often due to its nature as a disease some believe it is linked to genetic factors, some believe it to be a moral failing, and others believe that is a way of living it that counteracts their symptoms of pain and/or helps to cope with distressing emotions. It does not matter what philosophy you most strongly align with, here at Prosperity Haven, we find it important to address habits as a powerful force that may better explain causality for this disease. Habits set the tone and tenor of our daily lives and have the authority to dictate what direction we move towards or away from since they can be used as excuses just as effectively as they can be used for change.
Habits require little energy to enact which allows our brain to direct energy towards critical thinking and decision making. The risks of habit formation in substance use, directly correlate to our brain’s motto of “work smarter, not harder” and with each use, the brain craves repetition because it wants to establish a pattern so it may become a habit. The National Institute on Drug Abuse references addiction as a “chronic, relapsing disorder” that has considerable impact on the brain (NIDA, 2018, archived retrieval). To understand the importance of this reference, there is a common stigma that is circulated that “if they want sobriety badly enough it will happen, it must not be important to them” and saying this to a struggling person, has lasting effects. This belief can facilitate a message that no matter how many times they try to reliably get out of this situation, they will never be strong enough to do so. The more they listen to that voice, the more likely it is to become a defeating thought and as the cycle repeats, it becomes a habit to associate every use, conflict, behavior, and shortcoming as a personal failure. Therefore, despite the persons deep desire for change, they can feel powerless to overcome it once it has established ownership over the mind.
Addiction is a highly prevalent concern in our society and yet sadly, it remains consistently misunderstood. This can leave individuals displaced and discouraged as we blame the substance a person is addicted to as the cause for the addiction itself. It is important to address the role trauma plays in addiction because not only can it influence these patterns to develop, but the addiction can also become both a source of trauma and a solution to its pain.
What Is Trauma?
Trauma is complex human experience, and the causes of trauma may differ between individuals, and it makes it near impossible to generalize such a condition. However, there are three major aspects that contribute to its intensity and impact in our lives:
- An External Cause: this condenses the experience of an event that is/was unpredictable, sudden, and inflicted by an outside person, place, or event such as a natural disaster, assault, or other violent attack. This leads to the formation of fear, relying on plans and outcomes to guide daily choices, uncertainty, or unwillingness to try new things or meet new people, and you may be critical of society or towards a higher power.
- Violation or Betrayal: this condenses the sufferers experience in which the physical, emotional, or psychological self was mistreated by a trusted person. this is associated with being harmed by a romantic partner, a close friend, a coworker, a peer, and can happen within parent-child relationships. This specific type of event leads to a person feeling unsafe in relationships, they can develop patterns of codependency, become mistrustful of the motives of others, and possibly have strict standards for the people in their life or will have no standards at all. These behaviors are unified in their ability to give the sufferer a sense of control or data to justify their choices for being self-reliant.
- Loss of Control/Loss of Self: this condenses the feeling of helplessness, and an inability to control one’s own body. Loss of control is an extremely painful experience that leads to a person losing chances to gain or benefit from the life they have been given due to an inability to manage impulses. This category is for any person that says “_________ happened because I didn’t try hard enough” or “not surprising that I failed” or “I made the mistake of doing that once and I won’t do that again” and while there is an intense focus to avoid overwhelming feelings, such perfectionism when it faulters, leads to intense agitation, mood swings, and personality changes. Over time, the person’s identity, memory, consciousness, and perception of reality is unstable, and it is hard to separate the person you know from the version they created. When it is believed that restraint, suppression, and denial is an effective approach, you can experience altered personality traits such as isolating when you were once a highly sociable person, confrontational or argumentative in conversations when you were once easy going and perhaps, as you are reading this thought of some of your own qualities to include.
As you observe what trauma is, you can see parallels in how it presents itself to what addiction has done to change you or a loved one. Like substance use, a reaction to a stressful situation begins with experimentation and the questions of “did that help?”, “how did that work?, or “why didn’t that work?”, so then, you make changes because it didn’t work or it works a little too well, and it becomes a pattern, and once it becomes a habitual response the cycle feels too overwhelming to overcome. We at Prosperity Haven want to signify that experiencing trauma does not guarantee a person will develop a substance use disorder however, it does have a pattern of showing up as an underlying source of addictive behavior because abusing substances lowers your tolerance to stress and decreases your ability to use critical thinking to access alternative coping.
How Childhood Trauma Leads To Addiction
Many experts like Dr. Peter Levine, Dr. Gabor Maté, and Dr. Bessel van der Kolk have tried to explain the paradoxical nature between childhood trauma and drug addiction while focusing on the correlations between both if left untreated, decline an individual’s wellbeing and mental abilities. However, continued research on childhood trauma and attachment is showing that individuals who report ruptured or inconsistent relationships with caregivers, particularly during years 1-13, have social and emotional experiences that are consistent with adult substance abusing populations such as feeling unsafe, disconnected, undervalued/unwanted, and depressed. All humans are wired for secure attachment, but many of us go through life without it. a well-known example is that of the infant crying when wet, hungry, or bored and the caregiver responds to meet the need of the infant. Over time, if this has been consistent, feelings of safety develop, and a secure attachment begins to form. However, if needs are not met, or met inconsistently, or perhaps the caregiver was confused, overwhelmed, or dysregulated themselves and behaved in a way that frightened the child, an insecure attachment will form and then, the child is primed to adapt their needs for survival instead of for connection. This is an isolated example for how unmet needs in childhood can develop into trauma, but there are many combinations equally as influential towards developing these patterns of survival.
One of the ways this unresolved trauma manifests is through unhealthy adult relationships, feelings of anxiety or paranoia, shame and avoidance, unhealthy eating behaviors such as binging or obsessing over body image, sleeping difficulties such as going to sleep or staying asleep, feeling numb or empty, being on guard (hypervigilant), self-harm, uncontrollable anger, and unresolved childhood trauma is also leading many into drug addiction. An uncomfortable truth is that childhood trauma is linked as one of the underlying causes of addiction. In 1995-1997 Kaiser Permanente partnered with the CDC to perform an investigation on how childhood abuse and neglect impacted health and wellbeing later in life and in 2019 went under meta-analysis to assess the validity of what Kaiser claimed to be true. The meta-analysis concluded that data collected between 1995-1997 remained consistent with data from thousands of medical and psychological journals of similar importance two decades later, and the following was identified: that individuals who score high on the Adverse Childhood Experiences Questionnaire are five times more likely to become alcoholics and up to forty-six times more likely to inject drugs.
Dual Diagnosis Of PTSD and Addiction
Now that it is known that a person with a substance use disorder or other behavioral addictions can have underlying trauma, it is important to present the ways we can help those with undiagnosed mental health or self-managed mental health symptoms find their path to recovery. Dual Diagnosis Treatment is used to describe conditions that occur together which means treatment for both conditions will occur at the same time. Often what people ask is “what came first?” and this is like the chicken or the egg, it can be difficult to figure out which came first. While we may have a belief that one caused the other, what is more important to treatment providers is how they influence each other and if a connection can be made to support the individual in their healing. The interaction between two conditions such as anxiety and substance abuse can make rehabilitation more complex and in 1990, the healthcare systems stopped viewing these as separate issues.
Prior to this change, it was more difficult to obtain quality mental health care unless you were able to maintain sobriety and unfortunately for many, they numbed their conditions and accepted legal punishment before they believed they would receive help outside of the rooms of recovery for either condition. Thankfully, the World Health Organization (WHO) believed that there should be a concern on the quality of care a patient was receiving. The WHO worked to define what this care could look like and in 1991, The American Society of Addiction Medicine (ASAM) developed a levels system to certify facilities to treat dual diagnosis and/or differentiate between the intensity of services needed for a patient to be successful under this model by pairing them to an appropriate treatment center. This change alone started a movement to educate the medical community and the public about addiction to encourage a community approach to recovery.
Treating Addiction Caused By Trauma
When evaluating if a drug or alcohol rehab will give you the best possible chance at recovery, we at Prosperity Haven would like to share the following insights with you to help you make an informed decision:
- Specialists in mental health aren’t always trained in addictive behaviors, your provider should be able to treat both conditions to ensure your mental health needs as well as, your substance abuse and/or related behaviors are addressed.
- The treatment process should include all persons that the individual would like to include in conversations to ensure that the environment that individual is returning to is supportive of their recovery needs. The treatment center of your choosing should offer these services.
- Alcohol addiction as well as drug addiction, may require prescription medication to assist with managing co-occurring disorders. Medication, when paired with traditional therapy may help stabilize symptoms of mental health and reduce cravings to use. However, this is best discussed between you and a licensed physician at a dual diagnosis facility.
Thankfully, to reduce the stress in choosing a treatment center we are happy to share that Prosperity Haven offers the above services and more. Our treatment team can treat addiction caused by trauma and provide wraparound services to give you or a loved one the attention they deserve to overcome their drug or alcohol addiction. We pride ourselves on being more than a drug rehab, we believe in whole person healing, and we hope you do too. If any of what you read today sounds familiar to you, we are here to tell you, being affected by both conditions does not make you a flawed person, even the choices you made because of these conditions does not remove your dignity and worthiness of being a good person. It just means you had challenging life events and seek the understanding on how it is all connected so you can better your life, the lives of your loved ones, and find freedom from your past.
We at Prosperity Haven would be honored to be a part of your recovery and walk with you as you ready yourself with the necessary skills for the journey ahead.
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