Trauma-Informed Care and Addiction Treatment: Bridging the Gap

Trauma is a term used more frequently today. There are various types of trauma and certain traumatic experiences make a person more likely to become a substance or alcohol abuser. As trauma and substance use and alcohol use disorder rates rise so too does the need for trauma-informed care in addiction treatment. Understanding just what trauma is, how it impacts a person to become addicted to alcohol or another substance, and what to seek in an addiction treatment center is essential to long-lasting recovery from both addiction and trauma. 

What is Trauma?

During the last decade, research into the field of trauma has been growing. What research shows is that trauma leads to an increased risk of long-term physical and behavioral health issues. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma as “an event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

There are many types of trauma that a person can experience. Some of these events would result in trauma for most all, however, there are also some experiences that may be traumatic for one person but not another. Events that are generally considered to be traumatic for most are:

• Childhood neglect
• Emotional, physical, sexual abuse 
• A family member with a mental health issue
• A family member with an alcohol or substance use disorder
• Sudden death of a loved one or separation from a loved one or family member
• Community violence
• Homelessness
• Natural and human-driven disasters
• Poverty and discrimination

Trauma, just like addiction, does not discriminate. People from all walks of life—different ages, genders, socioeconomic groups, race, ethnicity, geographic location, and sexuality—can and do experience trauma. 

Trauma and Long-term Health Issues

Research shows that when trauma is experienced in childhood, an individual is more likely to have both physical and mental health issues in life. Childhood trauma is often referred to as adverse childhood experiences or ACE. According to the Centers for Disease Control and Prevention (CDC), the more ACE that occurs, the higher the risk for these issues. In fact, the CDC reports that having a higher number of ACE (three or more) has been associated with eight of the ten leading causes of death decreasing a person’s life expectancy by 19 years. 

Some of these lifelong health issues are:

• Chronic lung diseases
• Chronic heart diseases
• Liver cancer and liver disease
• Viral hepatitis
• Autoimmune diseases
• Sexually transmitted infections (STIs)
• Depression and other mental health issues
• Substance use issues

The rates of abuse and violence in the United States are on the rise and are alarming. The CDC reports that one in four children today experience some sort of abuse; physical, sexual, emotional. In addition, one in four women have experienced domestic abuse, one in seven females have been raped, one in 71 men have been raped, and what’s more for 12% of these women and 30% of these men the rape occurred before the age of 10. That’s a great deal of ACE for many in our country. 

Due to the tremendous impact of trauma not only on individuals but on the family and community, it’s essential that trauma-informed care be more available to those in need of it. 

The statistics reveal that women, both in childhood and adulthood, are more likely to have experienced trauma. An article in the Journal of Psychoactive Drugs reports that 74% of women with a substance use disorder (SUD) reported sexual abuse, 52% reported physical abuse, and 72% emotional abuse. 

The need for trauma-informed addiction treatment has never been greater. When someone with trauma from childhood or adulthood seeks treatment for an alcohol or substance use issue, they stand the best chance of long-lasting recovery if their trauma issues are addressed too. 

Futures Recovery Healthcare knows first-hand how vital addressing both SUDs or AUDs along with trauma issues is. This is reflected not only in their staff one of whom is the 60th Certified Trauma Therapist (CTT) in the nation but also with trauma-informed care and programming. 

The Connection Between Trauma and Addiction

Trauma, particularly childhood trauma impacts the brain and its functioning. Up to the age of five, the brain is undergoing formidable growth. During this time experiences, both positive and negative, impact this development. Positive experiences create healthy brain development and negative experiences are more likely to create negative brain development. Trauma that is ongoing has been shown to decrease the volume in areas of the brain responsible for cognitive functions, short-term memory, and emotional regulation. 

Additionally, this toxic stress can damage the nervous, endocrine, and immune systems. This, in turn, can change the brain structure and messaging systems and even the physical structure of the DNA. The results? Adverse impacts on impulse-driven behaviors, decision-making, attention, learning, emotional control, and stress responses in the future. 

Childhood trauma not only hurts when it’s happening but as illustrated, can go on to wreak havoc all through life if not processed in a healthy, supportive environment. When this processing doesn’t occur, many turn to unhealthy coping mechanisms to deal with the ongoing feelings associated with it. For many, this becomes the use of alcohol or a substance. And at first, the use may seem to help or take the edge off, however, for most people who have ACE, this turns into a dependence on the substance which leads to addiction. Having even just one ACE increases the risk for using illicit drugs, abusing alcohol, and suicide. In fact, the CDC reports that individuals who have had these adverse childhood experiences have an increased risk of dying from two of the leading causes of death; drug overdose and suicide. 

When trauma is experienced early on in life, not only is the brain development in key areas altered, shame, negative self-image, and an inability to process the trauma occur. These have also been associated with increased risk for developing an AUD or SUD. 

Trauma in adulthood is also associated with an increased risk of developing a dependence on alcohol or another substance.  Many first responders and those in the military suffer from trauma. Their daily experience of seeing the worst can impact them. And just like those with ACEs, they often turn to alcohol or another substance to help them cope, release stress, and deal with uncomfortable feelings. The SAMHSA reports 30% of first responders will develop a mental health issue. Addiction treatment programs specifically aimed at the unique issues facing first responders and military personnel are key to long term recovery. 

Healing from Trauma and Addiction: The Integral Connection 

Childhood and adult trauma that goes untreated or unprocessed in healthy ways can result in certain risky behaviors and life patterns. According to the Trauma-Informed Care Implementation Resource Center, a division of the Center for Health Care Strategies, Inc., 62% of all U.S. adults have at least one ACE and 25% have three or more ACEs. And while many of these individuals may ‘hide’ their past trauma, many will exhibit behaviors and lifestyle choices that, to someone who understands, shows they have experienced childhood trauma. What do these look like?

According to an ACE study, respondents with four or more ACEs, as compared to those without ACE, were shown to be:

• 2x more likely to smoke
• 2.5x more likely to have STIs
• 4x more likely to have COPD
• 7x more likely to be alcoholic
• 10x more likely to have injected illicit drugs
• 12x more likely to have attempted suicide

In addition, many people with trauma experiences also have relationship issues. Whether to a significant other, friends, family, or the community as a whole, those who have experienced trauma, particularly in childhood, tend to struggle with issues that negatively impact relationships. This is a reason that when a person with an AUD or SUD enters treatment the family and healing together are important. Addiction treatment centers that provide family education, therapy, and support are vital in giving everyone the best chance for recovery that lasts. Futures understands the important role of the family in recovery. Striving to collaborate with the family, Futures invests in the family from the first contact. 

For anyone who has trauma and an addiction issue getting the right treatment is crucial to long-lasting recovery and going on to live a vibrant, happy life free from both. When it comes to trauma-informed care there are a few essentials factors that must be part of any effective program. 

Safety. Establishing a safe, trusting environment for the client in treatment is the first step in any trauma-informed program. This vital first step is the cornerstone for all other parts of treatment. Often those who are living with trauma don’t feel safe in their own bodies let alone with others. For many who have experienced trauma, there are issues of trust and feeling safe. In addition, in order for the client to open up to therapists, a high level of trust is irreplaceable. A safe environment in which the healing process can begin is essential. 

Connection. When it comes to trauma, especially in childhood, vital life-giving bonds and relationships are often not formed. These positive relationships, critical to human development, are undermined by the trauma or abuse. The importance of these positive relationships has been shown by science to be integral in healing and growth. Encouraging these positive, healthy relationships with therapists, peers, other staff, as well as family and loved ones is vital for effective treatment of both addiction and trauma.

Trauma-specific therapies. For anyone who has an alcohol or substance use issue and a related trauma simultaneously treating both is imperative. Having both a substance abuse issue and another mental health issue, such as post-traumatic stress disorder (PTSD), is referred to as having co-occurring disorders. Addiction treatment centers who treat co-occurring disorders with evidence-based programming are the best option for anyone who suspects they may have co-occurring disorders. 

In addition, there are certain types of therapy that are found to be more effective when it comes to trauma. These include dialectical-behavioral therapy (DBT), eye-movement desensitization and reprocessing (EMDR), and other trauma-specific therapies. 

Futures knows how many in the community and nation at large are suffering from both addiction and related issues from trauma. The compassionate, experienced staff understands how untreated trauma plays a role in addiction. Futures offers specialized treatment programs for anyone with a trauma issue which includes intensified and trauma-specific therapies and the Seeking Safety program.  The Seeking Safety program is an evidence-based counseling model that directly addresses trauma and addiction. 

If you know someone—or are someone—who has experienced trauma in childhood or adulthood and has an addiction issue, seek treatment today, and begin to reclaim your life and joy tomorrow. While getting help for addiction and any other mental health issue can be daunting, it is the first step to the life you’ve always dreamed of for yourself. The outreach team at Futures is compassionate, caring, and dedicated to helping each person who reaches out to find the best treatment program which will meet their unique recovery needs. 

Contact Futures confidentially online or by phone at 866-804-2098 and start the journey of healing and recovery. You are not alone.