The connection between trauma and substance use

Addiction

Mental Health and Wellness

Tuesday, August 8, 2023

Older man with his hand on the arm of a younger man in therapy.

It's not uncommon for people to turn to substance use to cope with the lasting effects of trauma. Unfortunately, many times this can lead to substance abuse and addiction.

That's where trauma-informed and trauma-focused treatments comes in. Both can provide support and guidance for individuals struggling with both trauma and substance use, and can help them manage the difficult emotions associated with the trauma.

Understanding the link between trauma and substance use

Traumatic experiences, whether they occur in childhood or later in life, can have a profound impact on an individual's mental and emotional wellbeing. Trauma can lead to feelings of hyperarousal, reactivity, overwhelm, hopelessness, panic, anxiety, depression and other mental health conditions, which can often be difficult to manage without proper support. Complex traumatic experiences, trauma that is reoccurring, relational and often in childhood, can leave one with a distorted view of self, relationships and the world.

"For many people, substance use becomes a coping mechanism for dealing with the emotional pain and distress caused by trauma," says Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP, director of trauma services at Mirmont Treatment Center. "Addiction is often seen as a form of self-medication, with drugs or alcohol providing a temporary escape from painful memories and emotions."

Unfortunately, this coping mechanism often leads to addiction and relapse, creating a vicious cycle of substance use and trauma.

It's important to understand that trauma and substance use can affect anyone, regardless of age, gender or background. The key to breaking the cycle of addiction and trauma is to seek help from professionals who specialize in trauma-informed and trauma-focused treatments. By addressing the root causes of addiction and providing support for trauma-related issues, individuals can learn new coping mechanisms and skills for managing their emotions in healthy ways.

Types of trauma-focused treatments for substance use

There are various types of trauma-focused treatments that can be effective in addressing substance use. These treatments aim to help individuals understand how past trauma can affect their substance use and provide them with tools and strategies to cope with their experiences in healthier ways.

One of the most popular types of trauma treatment is cognitive-behavioral therapy (CBT), which focuses on identifying and changing negative patterns of thinking and behavior. This can include learning skills such as mindfulness and relaxation techniques, as well as coping strategies for dealing with triggers that may lead to thoughts of behaviors associated with substance use.

Another effective trauma treatment is eye movement desensitization and reprocessing (EMDR), which helps individuals process and reduce the intensity of traumatic memories through eye movements, or other forms of bi-lateral stimulation such as sounds or tactile sensations. EMDR directly addresses the source of the pain by targeting and alleviating the disturbance attached to traumatic memories. It can also be used to reduce the intensity of cravings associated with substance use.

Experiential trauma therapies such as psychodrama, gestalt and Internal Family Systems (IFS) therapies are also highly effective in addressing trauma. New neuroscience research suggests that trauma impacts the brain and nervous system in areas beyond cognition or thinking and that simply talking about a traumatic memory may not be enough to heal from it.

"Experiential therapies allow clients to explore healing in action through role playing, empty chair work or exploring parts of self," says Dr. Giacomucci.

For example, in psychodrama, a client could have a discussion for closure with a deceased loved one, offer nurturing to themselves as a child at the time of trauma or connect with strength-based roles that are needed to transform how the trauma lives within us.

Other trauma-focused treatments for substance use may include group therapy, creative arts therapies, mindfulness-based therapies and dialectical behavior therapy (DBT), which teaches skills to manage emotions and develop positive coping mechanisms. In some research, yoga was found more effective at reducing PTSD symptoms than medications.

It's important to note that different treatments may work better for different individuals, and a customized treatment plan should be developed in consultation with a mental health professional.

Overcoming barriers to trauma-focused treatment

Despite the benefits of trauma-focused treatment, there are often barriers that prevent individuals from accessing it. Some common barriers include financial limitations, stigma, lack of available resources and fear of judgment or misunderstanding from healthcare providers.

One of the most significant barriers is financial limitations. Trauma-focused treatments can be expensive, and insurance may not always cover the full cost. Some people may also struggle to take time off work or find childcare during treatment, making it difficult to commit to a treatment plan.

Stigma is another barrier, with some people feeling ashamed or embarrassed about seeking help for substance use and trauma. This can lead to a reluctance to disclose personal experiences and hinder access to appropriate care. Many people minimize their trauma or its impact, or they don't believe that what they experienced measures up to other people's experiences of trauma.

Lack of available resources is another issue that can prevent individuals from accessing trauma treatment. Some areas may not have enough providers trained in this type of therapy, or the waiting list for treatment may be long.

Finally, fear of judgment or misunderstanding from healthcare providers can be a significant barrier. Some individuals may worry that their healthcare providers will not understand or believe their experiences, leading them to avoid seeking help. Many trauma survivors have been hurt by people in power who were responsible for helping them in the past such as parents, caregivers, employers or even other healthcare providers.

"To overcome these barriers, it's important to find a supportive treatment program that understands and prioritizes trauma-informed care principles and offers trauma-focused treatments," says Dr. Giacomucci.

It's also essential to talk openly and honestly with healthcare providers and loved ones to break down stigma and encourage understanding and empathy. There are often community resources available for financial assistance, childcare and other logistical support, which can help individuals access the care they need.

Remember that everyone's journey to healing is different, and it's essential to find a program and approach that feels right for each person.

The benefits of trauma treatment

Overcoming barriers to trauma treatment may be challenging, but the benefits of addressing underlying trauma and addiction can lead to long-lasting recovery and a healthier, happier life.

"Trauma-focused treatment is a type of therapy that helps individuals who have experienced trauma to cope with the associated symptoms, including substance use," says Dr. Giacomucci.

Trauma-informed care, on the other hand, is an overarching approach that takes into account how trauma impacts people and attempts to mitigate the potential of retraumatizing clients. Trauma-informed care principles can be implemented into any agency, organization, university or system. A provider attempting to offer trauma-focused treatment, without first committing to trauma-informed care philosophy is more likely to be ineffective or cause harm in their approach.

One of the primary benefits of trauma-informed and trauma-focused treatments are that they are designed to address the underlying issues that contribute to substance use. By treating the trauma that is often at the root of addiction, individuals are better equipped to manage their substance use and achieve lasting recovery.

When it comes to substance use and trauma, there is often a strong correlation between the two. Individuals who have experienced trauma are more likely to develop a substance use disorder, and those who have a substance use disorder are more likely to have experienced trauma.

"Another benefit of trauma treatment is that it can help individuals to better understand their emotions and behaviors. Trauma can be deeply distressing and can manifest in a variety of ways, including anger, anxiety, depression and negative beliefs about oneself," says Dr. Giacomucci.

Trauma treatment helps individuals to identify their triggers, recognize their emotions and develop healthy coping mechanisms.

In addition, trauma-informed and trauma-focused treatments are often more personalized than traditional treatment methods. Rather than taking a one-size-fits-all approach, trauma treatment is tailored to the individual's specific needs and experiences. This can lead to a more successful and effective treatment experience.

Finally, trauma-informed treatment is often more empowering for individuals. By helping individuals to recognize their strengths and resiliency, they're better equipped to overcome the challenges associated with trauma and substance use. This sense of empowerment can be crucial to long-term recovery and personal growth.

Choosing the right program for trauma-informed and trauma-focused treatment

Choosing the right program for trauma-informed treatment is an important step towards recovery. Not all treatment programs are created equal, and it's essential to find one that fits your specific needs.

When looking for a program, consider the following:

Accreditation and credentials: Ensure that the program is accredited and that the staff members have the necessary credentials to provide quality care. Look particularly for therapists with certifications and advanced training related to trauma modalities.
Evidence-based approaches: Look for a program that uses evidence-based approaches to treat substance use disorders and trauma. These approaches may include cognitive-behavioral therapy, EMDR, experiential therapies, creative arts therapies and dialectical behavior therapy.
Integrated care: A trauma-informed treatment program should address both substance use and trauma simultaneously. Look for a program that offers integrated care for co-occurring disorders.
Length of program: Consider the length of the program. Some programs may be short-term, while others may last for several months. The length of the program will depend on the severity of your condition and your specific needs.
Aftercare services: Recovery is an ongoing process. Look for a program that offers aftercare services, such as group therapy, individual counseling and peer support groups.
Ethics and Reputation: It's impossible to fully embrace trauma-informed care without also embracing the importance of ethical practice. Seek programs that have a reputation for ethics and excellence. Read reviews from others online and use the state's licensing board "Verify a License" feature to learn about any past disciplinary actions against an individual or facility.

It's essential to research multiple programs and ask questions to determine which program is the best fit for you. Take the time to evaluate each program's strengths and weaknesses to make an informed decision.

"And always remember that you aren't alone in your journey to recovery" says Dr. Giacomucci. "At Mirmont Treatment Center, we'll be with you every step of the way."