The Link Between Trauma and Addiction

There is an important link between trauma and addiction. In recent years, researchers have extensively studied this link and established a causal relationship. Doctors, clinicians, and social workers experienced in the field of addiction and mental health report a statistically high association between unresolved trauma and the addictive disorders and mental health conditions they routinely treat. According to the Substance Abuse and Mental Health Administration (SAMHSA), a Kaiser Permanente study on adverse childhood experiences revealed that multiple traumatic events produced a number of negative future consequences. In the study, data collected from approximately 17,000 patients indicated that children who experienced four or more traumatic events are:

• Five times more likely to become alcoholics
• Over 40 percent more likely to become (illicit) injection-drug users when compared to the general population
• 60 percent more likely to become obese and suffer from negative self-image

Similar studies conducted by the Veterans Administration (VA) revealed that up to 75 percent of veterans suffering from post-traumatic stress disorder (PTSD) also suffer from concurrent substance abuse disorders (SUDs).  Despite these statistics, misunderstandings about the nature of trauma and substance abuse continue to be perpetuated.

Towards a Deeper Understanding of Trauma

One commonly misunderstood aspect of trauma is its subjective nature. Although all major traumas are experienced as negative, there is no objective criterion for what constitutes trauma. Essentially, trauma is defined as “a deeply distressing or disturbing experience.” Physically and psychologically speaking, this varies from person to person. For example, while a divorce, assault, or the death of a close friend may be highly distressing or debilitating to one individual, it may be considered manageable by another. Therefore, while trauma is universal in nature, it remains subjective in expression and experience.

The following traumas are all clinically significant, with repeated traumas being the most damaging and producing the longest lasting consequences:

• The death of a family member, friend, pet, or loved one
• The voluntary or involuntary loss of a job
• Physical, emotional, or sexual abuse
• Social isolation, bullying, or emotional abandonment
• Medical conditions, diseases, or chronic physical pain
• Strained relationships
• Separation or divorce
• Witnessing domestic violence or family dysfunction
• Imprisonment or loss of freedom
• Mental health disorders or conditions
• Car accidents or other near-death experiences
• Exposure to combat induced violence or war-related casualties  
• Immigration or being forced to seek political asylum
• Being the victim of prejudice or hate for living an alternative lifestyle
• Reputational damage

Human beings are incredibly resilient and adaptable by nature. However, once someone is exposed to physically or psychologically overwhelming events, they are more likely to experience unresolved trauma that is subconsciously or unconsciously repressed. Although certain individuals may be conscious in their compartmentalization or repression of traumatic memories and events, many are not. It is extremely common for people suffering from unhealed trauma to escape from their heavy burden by abusing substances, a practice which offers only temporary escape from the pain. Even individuals who are undergoing therapy and committed to personal growth and healing may not experience total relief from the pain of their traumas— despite applying maximum effort.

A Closer Look at Trauma and Substance Abuse

Trauma’s negative impact on self-esteem, physical functioning and cognitive health are all well-documented. This, in part, helps explain the high rates of substance abuse among those suffering from unhealed traumas (compared to those who are not).  The following statistics provide an even clearer window of insight into this phenomenon:

• Approximately 70 percent of teens undergoing treatment for an SUD have a known history of trauma.
• Approximately 33 percent of female and 24 percent of male alcoholics have experienced physical abuse compared to just 8.4 percent of the general population.
• Teens who are victims of physical or sexual abuse are three times more likely to abuse drugs or alcohol.
• Approximately 60 percent of young adults diagnosed with PTSD develop SUDs.

As daunting as these statistics may be, trauma is highly treatable and favorable long-term outcomes can be achieved with appropriate treatment. Ideally, a holistic treatment program that includes psychotherapy, proper medication as prescribed by a physician for both SUDs and co-occurring mental health disorders, and creative and expressive modalities will be utilized.

All of these interventions help the affected individual slowly return to optimal functioning and reduce the burden of guilt and shame they may secretly feel. Most importantly, healing from trauma and addiction require the non-judgmental presence of a skilled clinician— someone capable of observing and addressing the underlying issues without resorting to blame, criticism, or judgment. In the words of poet J.M. Storm, “Before you pass judgment on one who is self-destructing, it is important to remember they usually aren’t trying to destroy themselves. They are trying to destroy something inside that doesn’t belong.”