Millions of Americans suffer from addiction and substance dependence. While, traditionally, addiction has been heavily stigmatized and often criminalized, research is more and more showing that it is influenced by numerous mental and psychological problems, including trauma. Over the past 20 years, addiction treatment has become significantly more complex and nuanced, working to identify and treat underlying causes such as trauma, anxiety, depression, and many other disorders.
Understanding the link between trauma and addiction can help you understand not only how someone can become addicted, but also how to get treatment to cure not just temporary substance dependence but also the underlying causes behind relapse and continued substance use.
Does Trauma Really Affect Addiction?
Data dating back to the 1990s shows that trauma is heavily linked to addiction and susceptibility to addiction. The most notable studies show that as many as 40% of Post-Traumatic Stress Disorder patients suffer from some form of substance use disorder. This number drops to between 20 and 25% for car-crash and murder survivors not suffering from PTSD – who still often use substances to cope with high levels of stress and emotional pain after traumatic events.
The Adverse Childhood Experiences (ACE) study also directly links early childhood trauma to increased susceptibility to addiction. The ACE scale directly correlates more instances of trauma with an increased risk, based on a study of 17,000+ patients and continuing studies. Trauma, including neglect, abuse, addicted parents, mental illness, car accidents, deaths in the family, domestic violence, and other forms of trauma and negative experiences all increased the chance the child would become an addict.
Trauma and the Brain
Trauma can permanently or semi-permanently impact the brain and how it functions depending on age, how long the trauma goes untreated, and the extent of post-traumatic-stress. This is especially true for children, where long-term exposure to trauma can actually change the physical makeup of the brain.
For most, trauma results in an increased stress response, creating increased anxiety, decreased concentration, panic or paranoia, and problems with emotional regulation. This can result in moderate symptoms of anxiety or extreme problems with panic attacks, mood swings, and even rage. Children, especially those exposed to trauma before the age of 13, are as much as 50% likely to develop a mental disorder or substance use disorder after a traumatic event.
Trauma Patients Use Substances to Cope
Anyone experiencing anxiety, depression, or pain from trauma is likely to seek out coping mechanisms, and drugs and alcohol are very common choices. Many people use alcohol, prescription drugs, and even illicit drugs to seek stress relief or temporary relaxation and even sleep. Substance abuse can temporarily relieve even painful traumatic emotions and memories – but with tolerance, will cease to create the same effects. Users who are drinking or using to relieve stress quickly become hooked, chasing that same feeling of relief. This same process also leads to emotional blunting and worsened trauma and anxiety symptoms, causing further reliance on substances. Because this process is often slow, building up over many months or even years, most people never notice the effects until they are completely ‘hooked’ on the drug.
Prescription Pills – While many trauma patients are eventually prescribed medication to help them process and deal with trauma, it can be highly addictive. Common medications for short-term anxiety and panic include medications like Valium and Xanax, both of which are highly addictive. Sleeping aids like Ambien and Lunesta are also commonly prescribed to help patients with insomnia as a result of trauma but are just as easily abused without careful monitoring. Patients who are left to self-manage or who are not closely monitored may find that medication doesn’t ease symptoms, it only temporarily covers them up. As tolerance grows, they are forced to take more and more of the drug to get the same effect, quickly leading to dependence and potentially substance addiction. While more and more doctors are closely monitoring patients using addictive prescription medication, this is still a risk, even for new prescriptions.
Trauma patients often try to use substances to feel better, to feel normal, or even to function normally in social settings when their trauma causes social anxiety.
Three Factors to Addiction
Most psychologists use what is known as the three-factor model when diagnosing and treating addiction. This model operates under the theory that three basic factors contribute to most addictions; genetics, nurture, and exposure. What does this mean?
Genetics have been shown to increase the risk of susceptibility to addiction by as much as 40-60%. With over 400 genes contributing to susceptibility to addiction, inheriting genes from drug users and those susceptible to addiction can dramatically increase susceptibility to addiction.
Similarly, nurture or the factors and behavior that you have been exposed to over the course of a lifetime can significantly increase susceptibility to addiction. Those raised or exposed to traumatic environments, anyone in a highly stressful environment, and those who are raised without coping skills are more susceptible to addiction. This is why persons who survive car accidents, domestic abuse, high levels of traumatic stress, or attempted murder or robbery or significantly more likely to abuse substances.
However, none of these factors are a guarantee of addiction without the final factor, repeated exposure. Also known as experience-dependent neural plasticity, repeated exposure is the concept that no one becomes addicted to a substance without repeatedly using it – in effect training their brain to need it. No one is inherently addicted to substances, but if they choose to continue using, susceptibility can result in addiction. While there are a number of factors at play in choosing to continue using, such as seeking stress relief, low inhibition, reckless behavior caused by trauma, etc., actually using it is the key factor.
What this means is that trauma doesn’t necessarily cause addiction, it only influences it. However, for those who are addicted, this is positive. It means that trauma doesn’t mean you have to stay addicted, you can seek out treatment, and while you will never be completely trauma-free, you can be substance-free.
Dual Diagnosis and Addiction
Dual diagnosis or comorbidity means that a person has been diagnosed with both addiction and a co-occurring disorder. Here, it is important to recognize the comorbid disorder, because it is often a cause, and not a result, of the addiction. Users drink or do drugs because they are stressed and anxious, and while stress and anxiety worsen with substance abuse, they cannot correct the behaviors and thought patterns leading to addiction without first approaching and treating trauma and PTSD. In order to be properly treated for addiction, PTSD survivors have to be diagnosed and treated for trauma.
Today, many rehabilitation centers recognize this strong need for more customized and inclusive care, and many offer personalized treatment with support for dual diagnosis. Patients are given individual evaluations with psychologists, who attempt to determine not only if they are addicted, but also if they suffer from trauma, depression, anxiety, or other comorbid disorders. This allows the psychologist to work to create a recovery plan specific to that person’s needs.
Here, most treatment facilities use Cognitive Behavioral Therapy or DBT, which focus on treating the worst symptoms first. So, an addicted person might be brought through detox and then given treatment for panic attacks and other trauma symptoms. With a focus on learning healthy coping mechanisms for their trauma – patients are removed from the need to use substances to live with trauma.
Seeking out a rehabilitation center with the tools and medical staff to provide personal care, therapy based around your specific needs, skills development, behavioral therapy, and stress management will help you or your loved one to recover from addiction.
If you or your loved one needs help, contact us today and feel free to talk to us about addiction treatment programs at our affordable drug and alcohol rehab that fit your needs. The Anaheim Lighthouse is a modern and effective addiction treatment center in Southern California.