Trauma and Addiction: When Survival Hurts

In recognition of Mental Health Month, let’s take a look at the link between two of the most common co-occurring conditions; Substance Abuse Disorder (SUD) and Post-Traumatic Stress Disorder (PTSD).

First Things First – What Is Trauma?

Trauma refers to any previous experience that is painful, emotionally distressing, and out of the control of the person. Examples might include:

  • Childhood abuse or neglect
  • As a child, witnessing parental substance abuse or domestic violence
  • Being a victim of violence
  • Sexual assault
  • Death of a loved one
  • Disease or major illness
  • Surviving or witnessing a serious accident
  • Lingering injuries
  • Natural disasters – earthquakes, fires, floods, hurricanes, etc.
  • Divorce

Psychological Symptoms of PTSD

Post-Traumatic Stress Disorder is a lasting, unhealthy reaction to any emotionally or physically painful event. PTSD is characterized by disruptive psychological symptoms that interfere with everyday life. These psychological symptoms can include:

  • Reliving the event through flashbacks, nightmares, or hallucinations
  • Avoiding any memories, places, people, or things that remind them of the trauma
  • Excessive arousal, evidenced by irritability, restlessness, anger, hatred, hyper-alertness, insomnia, or an inability to concentrate
  • Persistent negative emotions, such as guilt or shame

What Causes PTSD?

PTSD results from unprocessed emotions following trauma that threatened the person’s safety or life—or even just had the potential to, such as:

  • Physical or sexual assault or abuse
  • Serious accidents
  • Automobile wrecks
  • Witnessing a death, especially that of a family member or friend
  • Major illness or injury —either to one’s self or to a loved one
  • Combat or warfare—Among veterans, PTSD was formerly called shell shock, battle fatigue, or combat neurosis.
  • Natural disasters

Substance Abuse as an Unhealthy Coping Mechanism

Severe trauma can result in uncomfortable feelings that can be difficult to process, so a person with unresolved issues may turn to drugs and/or alcohol. They do this for two main reasons:

  • To numb physical and/or emotional pain.
  • To forget about or escape from the negative emotions and painful memories associated with the past trauma.

But ultimately, using intoxicants to cope with past traumatic experiences only makes the current situation worse – by increasing the risk of new trauma.

Trauma, PTSD, and Substance Abuse

While psychological trauma is characterized by disruptions in a person’s sense of control, addiction can also be viewed as a disorder of control, or more accurately, an inability to control. The loss of control is insidious, often unrecognized by the addict until, in Alcoholics Anonymous terms, life becomes unmanageable.” ~ Psychological Trauma and Addiction Treatment, edited by Dr. Bruce Carruth, PhD, LCSW

Trauma and substance abuse frequently co-occur, because PTSD sufferers will try to “self-medicate” to numb emotional pain:

  • Victims of physical or sexual abuse or assault are three times as likely to abuse alcohol or drugs.
  • Over 70% of rehab clients have personal histories that include trauma.
  • Almost 60% of individuals diagnosed with PTSD will eventually develop Substance Use Disorder.
  • Of special relevance, two-thirds of traumatic experiences are preceded by substance use.

The Effect of Childhood Trauma

A 2012 study concluded that trauma during childhood strongly influences the likelihood of developing depression or SUD as an adult. Adverse Childhood Events alter the regions of the brain associated with impulse control and emotional regulation.

The National Child Traumatic Stress Network estimates that 1 out of every 4 American children experience at least one ACE. Significantly, research shows that for each ACE witnessed or experience, the risk of initiating alcohol or drug use jumps by up to 400%. This means a child with 5 or more ACEs is up to 2000% more likely to abuse substances than a child who has experienced zero.

Substance abuse also seems to increase an adolescent’s vulnerability to PTSD. Teenagers who use drugs or alcohol are twice as likely to develop PTSD following a traumatic event, compared to their peers who abstain.

How Substance Abuse Leads to Trauma

Drug use and excessive drinking often lead to other risky behaviors which in turn result in new trauma, such as:

  • Binge drinking
  • Drunken-driving – 28% of all traffic-related deaths in the US involve alcohol. Drugs other than alcohol are involved in 16% of all crashes.
  • Sexual assault – Nearly 75% of perpetrators and more than 50% of the victims admit to drinking prior to the incident.
  • Violence—Half of all assaults and homicides are committed when the victim, the offender, or both have been drinking.
  • Domestic violence – Among female victims of domestic abuse, 33% report problems with drugs and alcohol, compared to just 16% of non-victims. In up to 65% of cases, batterers drank beforehand.
  • Self-harm – People with SUD are 6 times more likely to attempt suicide.
  • Child abuse – 40% of offenders were drinking at the time of the crime.

This creates a self-perpetuating cycle of trauma, substance abuse, and new trauma.

Prevalence of PTSD

To start with, trauma is more common than you might think. 60% of men and 50% of women will experience at least one traumatic event during their lifetime. But there are differences:

  • Men tend to suffer trauma due to physical assault, accidents, combat, or natural disaster. They are also more likely than women to witness serious injury or death.
  • Women, on the other hand, are more often victims of domestic violence, sexual assault, or childhood sexual abuse.

Every year, between 3% and 4% of American adults experience symptoms of PTSD. According to the Veterans Administration, approximately 8 million adults have PTSD in a given year. About 9% of the population develops the disorder at some point during their lifetime.

Certain occupations put workers at greater risk of experiencing or witnessing disasters or violence:

  • Military – Among veterans, the lifetime prevalence of PTSD is 31% for males and 27% for females. It is even higher for those who served in a combat zone.
  • Police officers
  • Paramedics
  • Firefighters
  • Healthcare professionals
  • Divers
  • Train drivers
  • Journalists
  • Bank employees
  • Post office personnel
  • Store workers

How to Treat A Dual Diagnosis of Addiction and PTSD

There are special challenges to treating a dual diagnosis of PTSD and SUD. For treatment to be truly effective and recovery to be successful, both addiction and PTSD must be addressed simultaneously. The person must abstain from alcohol or drug use to avoid new trauma, while at the same time, they must learn new and healthier coping methods that don’t involve substance use.

Successful treatment strategies for PTSD and addiction might include:

  • Cognitive Behavioral Therapy
  • Individual Counseling
  • Group Therapy
  • Grief/Trauma Processing
  • Holistic Therapies – yoga, meditation, exercise, nutrition, art therapy, etc.
  • Psychodrama
  • Behavioral modification
  • Medication-Assisted Treatment (MAT)
  • Eye Movement Desensitization and Reprocessing (EMDR)

If you or a loved one are locked into a vicious cycle of substance abuse and recurring trauma, Lasting Recovery can help. As one of the leading drug and alcohol rehab programs in San Diego, Lasting Recovery is one of the most trusted resources for people struggling from co-occurring addiction and PTSD. We provide comprehensive and integrated substance abuse and mental health treatment that can help you overcome these co-occurring disorders.

By using evidence-based and wellness-focused strategies, Lasting Recovery treats you as a whole person and helps you return to a sober and more balanced life.

Lasting Recovery – “Where Wellness Begins…”

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