We hear a lot these days about “trauma” and “Post Traumatic Stress Disorder.” Often we discover that many people who abuse drugs or alcohol also have a history of violence and trauma. Addiction often becomes one of the ways people deny or suppress their feelings and memories of past or ongoing present traumas. An estimated 30 to 90 percent of women in substance abuse treatment programs have experienced physical or sexual abuse. Alcohol and drug problems have been shown to increase women’s vulnerability to violence through exposure to unsafe situations. We also find that many military personnel suffering from PTSD use substances to cope when they return from war zones.
Trauma is experiencing, witnessing or being threatened with an event that might involve serious injury or death. Trauma also can mean a threat to the safety of others, such as one’s parents, siblings or friends. Many children are traumatized by being witness to domestic violence in their home. Traumas can be caused by many situations, including the effect of natural disasters, accidents and even medical events, such as a heart attack or surgery. The responses to traumatic events as stated, are complex, and can include intense fear, helplessness or horror. Both children and adults can experience trauma and its impacts may vary depending upon the threat and the age of the victim. The coping behaviors from a trauma can develop into a dysfunctional style of personality characteristics over the long term.
There is a critical need to address trauma as part of substance abuse treatment. Avoidance is a primary symptom of post traumatic stress disorder. Many people who come to treatment with other concerns or complaints, e.g. depression or anxiety or substance abuse, have actually detached from memories that are related to trauma. Misidentified or misdiagnosed trauma-related symptoms can interfere with a person’s willingness to seek help for their substance abuse or hamper his or her engagement in treatment. If underlying trauma is not addressed, it can also lead to early dropout from treatment and make relapse more likely.
Trauma-informed treatment systems and services take into account knowledge about trauma and incorporate this knowledge in all aspects of addiction treatment. The focus is on creating a collaborative relationship with the treatment provider and placing priority on safety, choice, and control. Programs designed with these goals minimize the possibility of re-victimization and support empowerment for the individual as well as skill development that assists in long-term recovery efforts. The treatment environment should ensure physical and emotional safety by creating an atmosphere that is engaging and supportive as well as avoiding practices or environments that are re-traumatizing or shame inducing. This comprehensive approach recognizes the need for whole person interventions that may include helping an individual in areas of vocation, education, safe housing, parenting, life skills training, healthcare and legal services.
While working through such programs, it is critical for the individual to become free of substances as well as to work toward ensuring safety from threatening environments and people. Overall, helping people understand the possible connections between trauma and substance abuse is vital.
Centerstone offers clinical staff with expertise in providing trauma informed care, available to local residents. If you or someone you know has experienced trauma, Centerstone provides both individual and group trauma informed therapy, including addictions treatment. For more information or to schedule an initial appointment contact Centerstone at 800-344-8802.