Understanding the Link Between Trauma and Substance Use Disorders
The connection between trauma and an increased risk for substance use disorders has been well-documented over the years. Individuals with a history of trauma are more likely to use substances and face higher risks of dependence and related complications compared to those without such a history. Learn more about the connection between trauma and substance use.
What Is Trauma?
Trauma refers to distressing, disturbing, or upsetting events. The DSM-5-TR defines a traumatic event as “exposure to actual or threatened death, serious injury, or sexual violence.” This can occur in four ways:
- Directly experiencing the event
- Witnessing the event as it happens to someone else
- Learning about a traumatic event affecting a close friend or family member
- Repeated exposure to extreme details of the traumatic event, such as first responders or therapists
Traumatic events can be single incidents, like a car accident or a loved one's death, or long-term stressors, like living in an abusive household. Trauma can occur at any point in life and affect anyone.
Adverse childhood experiences (ACEs) are traumatic events that occur between birth and age 17. According to the CDC, ACEs include:
- Physical abuse
- Emotional abuse
- Sexual abuse
- Physical neglect
- Emotional neglect
- Caregiver with untreated mental illness
- Violence against the mother, stepmother, or maternal figure
- Loss of a parent through abandonment, separation, divorce, or death
- Incarceration of a household member
- Substance dependence by a household member
ACEs are common, with nearly two-thirds of adults reporting at least one. They can lead to mental health issues, medical problems, poor social support, unemployment, substance dependence, and early death.
How Does Trauma Lead to Substance Dependence?
Trauma can result in mental health issues like PTSD, manifesting as hypervigilance and re-experiencing the trauma. Although substance use isn't a symptom of PTSD, about 59% of those with PTSD develop substance use issues. The earlier the trauma occurs, the higher the risk for substance use problems. More traumas also increase the likelihood of substance dependence.
People may use substances to regulate unpleasant moods caused by trauma symptoms, using them as a form of self-medication. Immediate intervention and social support following trauma can reduce the risk and severity of trauma symptoms and related substance use issues.
Signs of Trauma-Related Substance Use
Substance dependence can manifest in various ways. According to the DSM-5-TR, it may include:
- Taking the substance in larger amounts or for longer than intended
- Repeated unsuccessful attempts to reduce or control use
- Spending significant time obtaining, using, and recovering from the substance
- Cravings or urges to use the substance
- Functional problems, such as failing to fulfill obligations
- Continued use despite negative consequences
- Abandoning social, occupational, or recreational activities
- Risky or unsafe use
- Continued use despite awareness of problems caused by use
- Increased tolerance
- Withdrawal symptoms
If you notice increased substance use following a traumatic event or use substances to cope with trauma triggers, your substance use may be related to the trauma.
How to Get Help
If you struggle with substance use and have a history of trauma, help is available. Treatment can lead to fulfilling lives despite these challenges. Asking for help can be difficult, but you deserve support and care. Both trauma and substance use disorders are mental health issues and do not reflect your value as a person.
Seek therapists experienced in treating substance dependence and trauma. Group therapy or peer support might also be beneficial. Your therapist or doctor can provide information about local resources.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a directory of clinicians and national resources, including information on supporting loved ones, seeking help in a crisis, harm reduction, and substance use education.
