Trauma Tips for Understanding and Healing—Part 3 of 4

The connection between trauma and addiction is considerable and intimate.

Posted Mar 07, 2016

CC0 Public Domain / FAQ
Source: CC0 Public Domain / FAQ

There is a clear relationship between trauma and addiction. Although addiction is not caused by trauma, and trauma is not caused by addiction, it has become increasingly clear that trauma and addiction frequently go together. Extensive research suggests that approximately 50 percent of people with histories of addiction have experienced trauma.

Based on different scientific studies, the percentage of people with both trauma and addiction ranges from about 20 percent to as high as 80 percent, with the figure being somewhat higher for women than for men. The connection between trauma and addiction is a two-way street: trauma increases the risk of developing addiction and active addiction increases the likelihood of experiencing trauma.

How trauma increases the risk of developing addiction

Through the use of substances people experience the reward of feeling “good” and/or the relief of feeling “better.” They use alcohol and other drugs as a way to temporarily numb or escape the distressing effects of trauma. Using can take the form of self-medicating in response to intrusive memories, distressing thoughts, and painful emotions of traumatic experiences. In this way, addiction may begin as a coping method and evolve into an emotional survival strategy.

When trauma-related memories or emotions come to the surface and are too much to handle, many people seek the rapid relief available through substance use. When using provides the relief they’re looking for, alcohol and other drug use becomes positively reinforced, they progressively gravitate to it obsessively and compulsively, and over time and repetition it becomes an addiction.

Frequently, alcohol and other drug use increases in response to the surfacing or intensifying of trauma symptoms. Using allows trauma survivors to disconnect from their feelings—dampening shame and guilt, softening anger and rage, displacing anxiety and fear, and reducing sadness and depression. Depending on the particular substance(s) using can also serve other purposes for people with trauma—helping to increase feelings of relaxation, of being in control, or of feeling “alive.”

How active addiction increases the likelihood of experiencing trauma

The obsessive-compulsive cycle of using alcohol and other drugs impairs judgment and decision-making in ways that often lead to risk-taking behaviors and puts people in situations that greatly increase the likelihood they will be traumatized or (if they have been traumatized previously) re-traumatized. This trauma most often takes the form of physical assault/mugging, robbery, or sexual assault/rape.

The need to find the ways and means to continue to use often results in risk-taking behaviors and puts people in situations that greatly increase the likelihood they will be traumatized or re-traumatized.

The urgency of avoiding the misery of withdrawal and becoming “sick” can also lead to risk-taking behaviors and place people in situations that greatly increase the likelihood they will be traumatized or re-traumatized. And, of course, being under the influence puts people at much greater risk of being traumatized or re-traumatized. Sometimes the resulting trauma involves the person under the influence who is traumatized, and sometimes his or her actions create trauma (including serious injury or death) for others.

Childhood trauma and addiction

Research confirms that the more trauma you are exposed to, the more vulnerable you become to developing addiction.

As noted in Parts 1 & 2 of Trauma Tips for Understanding and Healing, trauma is particularly damaging when it occurs in childhood. Although some addicts have no apparent childhood trauma, it is estimated at least half have suffered one or more forms of severe childhood stress, and many have had multiple traumatic experiences.

Young children do not have a frame of reference to put traumatic experiences in context or to make sense of them. The primary source of support for children is the family, and yet the family is most often the source of trauma during childhood.

The Adverse Childhood Experiences (ACE) Study, which is based on data from over 17,000 Kaiser Permanente HMO members, found correlations between childhood trauma and various forms of addiction. The ACE Study is one of the largest scientific investigations ever conducted on the effects of childhood stress/maltreatment/trauma on health and well-being in adulthood. In the study, adverse childhood experiences  were defined as follows:

  • Recurrent and severe physical abuse
  • Recurrent and severe emotional abuse
  • Sexual abuse involving physical contact

Growing up in a household with:

  • An addicted family member
  • An incarcerated family member
  • A mentally ill, chronically depressed, or institutionalized family member
  • A mother who was treated violently
  • Both biological parents not being present

The ACE Study found that adverse childhood experiences are much more common than most people think, although they are usually concealed from others outside the family, and frequently go unrecognized. There is a direct correlation between the number of adverse childhood experiences (ACEs) from the above list someone has had and the number and severity of problems related to addiction, mental health, and health he or she experiences as an adult.

In other words, the more ACEs someone has, the more problems he or she will have as an adult and the more serious those problems will be. Specifically, a child with four or more of the above adverse childhood experiences is five times more likely to become an addict compared to children with no history of ACEs. Trauma was also linked to a higher risk of anxiety disorders, depression, and suicide. The researchers also found that the effects of childhood trauma are cumulative, and that one of the most destructive forms is “chronic recurrent humiliation” (e.g. verbal/emotional abuse in the form of name-calling or ridicule).

As indicated above, this is the third of a four-part series. Part 4 will be devoted to discussing trauma recovery and healing, related to both professional treatment and self-help approaches.

Copyright 2016 Dan Mager, MSW All Rights Reserved.

Author of Some Assembly Required: A Balanced Approach to Recovery from Addiction and Chronic Pain