Trauma and Addiction: Signs, Symptoms, and Recovery

Understanding Trauma

Trauma is a persistent emotional response to an event, series of events, or situations that someone perceives as harmful or threatening.[1] It can cause increased stress and other lasting impacts on well-being and daily function.

Traumatic experiences can be shocking, scary, or dangerous, such as natural disasters, assaults, terrorist attacks, mass shootings, car accidents, or abuse. In some cases, the emotional response to a traumatic event or circumstance or trauma response, continues for long periods of time and interferes with everyday life, which is known as post-traumatic stress disorder (PTSD).[2]

Common Types of Trauma

What may be traumatic to one person may not be to another, but most people experience some type of trauma at some point. It can be a single event or ongoing experience, such as child abuse or living in a combat zone.

Trauma is categorized as overt or covert. Overt trauma is a clear, definable event that’s considered generally traumatic, such as physical abuse, sexual assault, war, or natural disasters [3]. Covert trauma, also known as relational trauma, is subtle and may go on for long periods, such as emotional neglect from a parent, bullying, or experiencing racism [4]. Both types of trauma can have a significant impact on health and well-being.

Some types of trauma have an increased risk of addiction, such as [5]:

• Physical and sexual abuse: In a survey of over 600 people with substance use disorder, nearly half reported physical or sexual abuse. Women have much higher rates of both, but abuse in children has a higher risk of addiction at a rate of 74% for physical abuse and 73% for sexual abuse.[6]
• Violence: Victims of violent crimes or witnesses to violent crimes are more likely to engage in substance use and misuse. Exposure to domestic violence is also associated with a higher risk of substance use and addiction, particularly for women.
• Military service: Military personnel who have had multiple deployments, combat exposure, and combat-related injuries are at a higher risk of developing an addiction. Studies also show an increase in alcohol or drug use after experiencing acts of terrorism.
• Family conflict: Divorce and parental conflict, the loss of a parent, and poor family relationships can contribute to severe, chronic stress that can lead to addiction.
• Racism and discrimination: Experiencing racism and systemic discrimination can cause chronic stress, increasing the risk of substance use and misuse. The same is true of discrimination based on gender identity.
• Physical injury: A serious head injury, particularly in children, can increase the risk of addiction. This can be common in children and adults who are victims of abuse or violent crimes.

The Link Between Trauma and Addiction

Mental health and substance use are often deeply intertwined.

People often engage in substance use to get the immediate psychological effects, such as a high or being “buzzed.” Alcohol and other drugs change the way you feel by causing pleasure and reducing negative feelings.

However, for people with dysregulated stress systems that come from trauma, drugs and alcohol can offer a break from the constant state of arousal and anxiety. Alcohol, opioids, and benzodiazepines have a relaxing effect to relieve anxiety.

Someone with trauma may be more vulnerable to addiction as a way to regulate their mood, shut off intrusive thoughts, and suppress the heightened state of arousal caused by stress hormones. They may feel numb from drug use, giving them temporary relief.

Conversely, some people experience the ongoing effects of trauma as disengagement and a chronic feeling of numbness instead of a heightened state of arousal. In this case, they may turn to stimulants like cocaine or amphetamines to increase alertness and energy that snaps them out of their numbness.

Because of this complex relationship, treatment for trauma and addiction requires a trauma-informed perspective and integrated treatment plan that addresses the experience and ongoing effects of trauma and addictive behaviors simultaneously.

How Trauma Changes the Brain

Trauma can affect the way the brain responds to stress, safety, memory, and reward. After a traumatic experience, the body may stay on high alert even when there is no immediate threat. This can make a person more sensitive to stress, more reactive to reminders of the trauma, or more likely to feel emotionally overwhelmed.

Research on traumatic stress has found changes in brain areas involved in fear response, memory, emotional regulation, and stress hormones.[7] Addiction can involve some of these same pathways, especially the brain’s reward circuitry. When substances temporarily reduce distress or create relief, the brain may begin to connect drug or alcohol use with survival, comfort, or escape.[8]

Over time, this can make trauma and addiction reinforce each other. Trauma symptoms may increase the urge to use substances, while substance use can make it harder for the brain and body to recover from trauma. This is one reason treatment often needs to address both conditions together rather than treating one as separate from the other.

How Trauma and Addiction Affect the Body

Trauma and addiction have some similar effects on the brain. They both have an impact on neurotransmitters that increase stress hormones and cortisol.[9] In fact, urine samples may reveal elevated stress hormones, which take a toll on the central nervous system over time.[10]

Left untreated, trauma and addiction can cause chronic health problems, a higher risk of suicide, an increase in violence and legal issues, and a difficult treatment experience.[11]

Treatment Options for Trauma and Addiction

Trauma therapy is a type of psychotherapy that helps with processing and overcoming traumatic experiences. Trauma-informed care is defined as an approach that recognizes the widespread impact of trauma, understands possible paths for recovery, and avoids practices that could re-traumatize clients.[12] In treatment for trauma and addiction, this means care should focus on safety, trust, coping skills, and support while addressing substance use and mental health symptoms together.

Other evidence-based therapies can be beneficial in treating trauma and addiction, including:

• Cognitive behavioral therapy (CBT): CBT works to identify unhealthy thoughts and feelings that lead to your actions, helping you create healthier habits and understand what motivates you.
• Dialectical behavioral therapy: Originally developed for borderline personality disorder, DBT is now widely used to treat addiction and mental health issues, including those with trauma history, where extreme emotional dysregulation are the root causes for substance misuse and other symptoms.
• Family therapy: Depending on your individual needs, family therapy can be beneficial to create a safe space for everyone to share their experiences and gain support.
• Holistic therapies: Holistic therapies take a “whole-person” approach to care that addresses the mind, body, emotions, and spirit.
• Medication-assisted therapy (MAT): MAT is a medical intervention that uses medications to reduce substance cravings, alleviate withdrawal symptoms, and promote comfort to ensure you can focus on your treatment.
• Gender-specific treatment: Men and women have unique needs and challenges with both trauma and addiction. Gender-specific treatment takes this into account to create a safe space for healing.
• Experiential therapy: Experiential therapy is an interactive approach to treatment that involves musical or artistic activities, nature activities, or other experiential therapies that can help you create new associations with past experiences.
• Eye movement desensitization and reprocessing (EMDR): EMDR is an essential part of treating trauma by helping you process past trauma and develop new thoughts, emotions, and behaviors associated with the experience.
• Psycho-education: Psycho-education is a structured form of therapy to help you understand your disorder, treatment, and coping skills.
• Dual diagnosis trauma treatment: Integrated care for clients who present with co-occurring disorders, including substance use along with one or more mental health disorders. Treating addiction and mental health challenges together helps to reduce relapse and often leads to more positive outcomes.

Trauma-Informed Healing at Epiphany Wellness

If you’re struggling with trauma and chronic substance use or any other underlying issue, you don’t have to do it alone. Seeking comprehensive treatment from Epiphany Wellness’s trauma-informed team and addiction specialists can help you address your past trauma, learn healthy coping skills, and overcome the overwhelming feelings that trauma has been causing to help you achieve lasting healing.