Trauma and Addiction

By Ioana Cozma

Updated: 29 November 2023 & medically reviewed by Morgan Blair

What is trauma?

Common types of trauma

Another way to understand trauma is by reviewing the different types of traumatic events that may inflict the above-mentioned symptoms.

Physical abuse

Physical abuse stems from physical aggression, encompassing instances where an individual is attacked, ambushed, or repeatedly struck. Physical abuse might lead to trauma, whether the aggression originates from a family member, acquaintance, or an unknown individual.

Sexual abuse

Sexual violence involves actions like rape or molestation. Unfortunately, sexual abuse is one of the most common traumatic events. Sexual abuse may be singular or repeated. Some people may face sexual abuse from family members or partners.

Household violence

Household violence emerges when an individual faces aggression from someone within their household, such as a partner or parent. Household violence may lead to physical and emotional trauma.

Psychological abuse

Psychological trauma stems from psychological maltreatment. This term refers to attempts by one person to dominate another, and it is believed to have the most negative developmental consequences in children.^[3]

Adults may also be victims of the psychological abuse practiced by family members. Covert narcissists, for example, may use emotional tactics like belittling, shaming, blaming, or manipulating other's emotions.

Parental neglect

Parental neglect typically refers to under-providing the necessary resources to one’s children, creating a tense, unfulfilling environment. These resources may be material or emotional, ranging from quality food, living, educational resources, and love. Parental neglect may be accompanied by physical and sexual abuse.

Bullying

Bullying is a traumatic event mainly experienced in childhood. If left unaddressed, this type of trauma may linger into adulthood, regardless of the perceived severity of the bullying acts.^[4]

Natural catastrophes

Natural catastrophes can displace individuals from their homes, separate them from loved ones, or disrupt their usual life patterns. Post-traumatic stress disorder (PTSD) following such events should not be ignored.

Accidents

Accidents range from car crashes, workplace accidents, or other unexpected events with severe negative consequences. Accidental harm may elicit PTSD in the people involved and their loved ones, even if they weren't directly involved. Symptoms of PTSD may include intense and recurring memories of the incident.

Medical trauma

Enduring a prolonged or chronic disease may also be a source of trauma. The ordeal and the symptoms related to the illness may trigger distressing recollections or emotions long after the event.

How trauma links to addiction

Each person’s response to trauma is unique. Therefore, each person’s tendency toward developing an addiction after a traumatic event may vary. This section explains how trauma generates addiction and how distinct traumatic events may correlate with specific addictions.

The effects of trauma on addiction

The hypothalamic-pituitary-adrenal (HPA) axis activates to handle threats effectively and thus regulates the body’s stress response. When it recognizes danger, the HPA axis stimulates the release of stress hormones like adrenaline.

Adrenaline leads to heightened alertness, increased blood pressure, faster heart rate, and quicker breathing. Thus, the brain prioritizes immediate reactions over slower processes, such as those managed by the prefrontal cortex that govern executive functions and self-control.^[5]

However, traumatic events maintain the HPA axis in constant arousal. This continuous activation leads to persistent alertness, anxiety, and hypervigilance.^[6] The long-term effects include:

• Compromised immune system

• Impaired cognitive development in children

• Emotional dysregulation

• Increased susceptibility to neurodegenerative disorders

• Attachment difficulties

• Depressive feelings^[5]

Individuals with trauma may gravitate toward addictive behaviors or substances to cope with its effects, such as persistent alertness or emotional detachment.^[7]

For those with heightened stress responses, substances or addictive behaviors may temporarily relieve chronic anxiety and hyperarousal. For instance, substances like alcohol, benzodiazepines, and cannabis may produce calming effects.^[8]

Conversely, some individuals with PTSD might resort to substances or behaviors that provide a stimulating effect to counter co-occurring dissociative disorders such as numbness and detachment. Drugs like cocaine, amphetamines, and nicotine, or even actions like gaming, can produce feelings of alertness and vitality.^[7]

What type of addiction can correlate to trauma?

Below, we explore how traumatic events influence addiction differently.

Childhood trauma

The Substance Abuse and Mental Health Services Administration’s Center (SAMHSA) indicates that challenging experiences during childhood can pave the way for an earlier introduction to alcohol, increased chances of mental health problems, tobacco use, prescription medication intake, and the likelihood of developing substance dependency.

PTSD

Post-traumatic stress disorder (PTSD) following traumatic events may lead to substance abuse as a coping mechanism and a way to alleviate physical symptoms. The relationship is possibly bidirectional; those grappling with substance issues are more prone to face traumatic events and vice-versa.

Physical abuse and chronic illness

Physical abuse and chronic illness are typically tied to considerable pain. Doctors prescribe pain relievers such as opioids for pain management.

If the level of physical distress is acute, individuals might consume amounts exceeding the recommended dose for relief. This excessive intake, however, increases addiction risks. Many see this pattern as a significant contributor to the opioid crisis in the U.S.

Emotional abuse

The impacts of emotional trauma, which can stem from experiences like bullying or emotional maltreatment, might not be immediately evident. Such experiences may, over time, lead to mental health challenges like depression or anxiety.

Individuals with a history of emotional trauma are often more susceptible to addiction, resorting to substances to dull emotional pain, manage potential PTSD symptoms, or seek a temporary escape.

Treatment for trauma and addiction

Trauma and addiction both have long-term devastating effects, which is why they should be addressed in a professional setting. Below is a list of the most common treatments.

Detoxification

Detoxification entails clearing one’s body of harmful substances. Medical professionals should oversee this process since the withdrawal symptoms may be intense. Sometimes, life-threatening symptoms such as seizures or escalated heart rate may arise.

To manage and alleviate these symptoms, physicians may gradually reduce the dosage of the substance over a set period. If someone is battling addiction, they should consult a rehabilitation center to ensure a secure and professionally supervised detox experience.

Dual diagnosis treatment

This approach addresses the ensuing addiction and co-occurring disorders, such as mental health problems and other trauma symptoms. The method recognizes that addiction treatment is more effective when addressing the underlying causes that provoked that addiction.

Cognitive behavioral therapy (CBT)

Both addiction and trauma entail negative behavior, overwhelming emotions, and sometimes uncontrollable stress responses. CBT is a type of psychological therapy that teaches patients specific behavioral tools to address these responses and their detrimental coping mechanisms.

Related: Managing Triggers: Self-control for a fulfilling life

EMDR therapy

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic technique designed specifically to reduce the distress tied to traumatic memories.

During an EMDR session, patients are guided to briefly recall traumatic events. They simultaneously focus on external stimuli, such as hand-tapping or musical cues.

EMDR aims to foster these new neurological associations between the traumatic event and innocuous stimuli, thus reducing the emotional pain linked to trauma.

Residential treatment

Residential or inpatient treatment may be needed if symptoms are too severe to manage outpatient. Residential treatment provides a space where patients can reside during their recovery journey. These centers often prioritize managing withdrawal symptoms and addressing the underlying trauma. As a result, they achieve better results in terms of sobriety.

Support groups

Support groups provide a safe space for individuals grappling with trauma and addiction to share experiences and feelings. These groups facilitate a sense of community and mutual encouragement and reduce feelings of isolation.

Members learn effective coping strategies and gain insights from others’ recovery journeys. Additionally, observing peers who overcame similar challenges successfully may inspire hope and motivation.