It should come as no surprise that there is a strong link between people who have experienced trauma in their lives and the subsequent development of an addiction or substance use disorder.
For some, a traumatic experience could be the catalyst for professional help, while for others, the pain and intrusive disruption associated with a traumatic event can create a need to escape, avoid and numb. In these instances, drugs and alcohol provide a very convenient means to “cope” with the emotional pain the sufferer is experiencing.
However, the irony in this cycle is that rather than working to heal, repair and move forward, the individual that turns to drugs and alcohol to cope is merely prolonging the agony of what the trauma created by avoiding, compartmentalizing and checking out.
The impact of the trauma is still there, alive and well and what ultimately happens in these instances is that there is no resolution around the traumatic event and the individual’s circumstances are made infinitely worse by the addition of a substance use disorder and all of the chaos, destruction and turbulence that accompanies it.
Does this resonate? If so, read on!
Trauma: Defined
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma as “the result of an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional or spiritual well- being.”
In therapeutic and clinical settings, we often talk about “small t traumas” (conflict with significant other or children, legal trouble, or financial worries or difficulty), and “big T traumas” (death of a loved one, suffering physical, emotional or sexual abuse, experiencing a natural disaster, being diagnosed with a terminal illness, etc.)
The reality is, we all interpret and perceive things differently, so what one person might consider to be a “big T trauma” another might consider a “small t trauma” and vice versa.
Experiencing an event such as this can lead us down a path of substance abuse/ misuse as a maladaptive form of self-medicating and the impact can be catastrophic if not treated.
How can someone with co-occurring trauma and substance use/ misuse or addiction heal?
The answer is never “one size fits all”.
For some, the severity of the substance use disorder may take precedence and priority over treating the underlying trauma(s). Substance use disorders are diagnosed on a spectrum of mild, moderate and severe. If, for example, an individual meets diagnostic criteria for a severe substance use disorder, then the best course of action would be a medically supervised detox, followed by a residential (inpatient) level of care. Once the individual has stabilized emotionally and physically clinical work can begin and once the individual’s treatment team deems it appropriate, trauma work can begin.
However, if someone’s experience with a traumatic event is creating a need to self-medicate and the severity of the substance use disorder meets mild or moderate criteria, the trauma and the substance use disorder can be treated concurrently.
If the substance use/ misuse is a byproduct of the trauma and criteria are low enough for an outpatient level of care to be appropriate, then the individual and his therapist should work to develop a treatment plan to address both. More often than not, this approach will involve working to reinforce healthy coping skills, identifying triggers and ongoing psychotherapy to develop insight and promote awareness of patterns.
There is hope!
In cases of more severe trauma, modalities such as Eye Movement Desensitization Reprocessing (EMDR), Prolonged Exposure Therapy and skills-based approaches such as Dialectical Behavior Therapy (DBT) have shown a very high efficacy for treating trauma and substance use disorders concurrently, in conjunction with traditional psychotherapy.
The objective and goal is to partner together to stabilize and treat the trauma while building awareness around healthy versus unhealthy coping skills.
Experiencing trauma can be a catalyst for a downward spiral into attempts to self-soothe, that can lead to substance abuse or addiction. If you or someone you know needs help, please reach out and schedule a free phone consult with a member of our caring team!