How Trauma and Substance Use Disorders are Linked

Trauma and substance use disorders are deeply interconnected, with trauma often serving as a root cause or contributing factor to substance use and other addictive behaviors. Understanding this link can inform effective treatment approaches. Here are key aspects of their relationship: 

Trauma as a Precursor to Substance Use Disorder

Trauma—especially unresolved or chronic trauma—can leave individuals struggling with emotional pain, dysregulation, and distress. To cope, many turn to substances or addictive behaviors as a way to:

• Self-medicate emotional or physical pain.
• Numb distressing memories or feelings.
• Provide a sense of control or escape.

Common sources of trauma include:

• Childhood trauma: abuse, neglect, or exposure to violence.
• Adverse life events: loss, injury, or disasters.
• Relational trauma: betrayal or abandonment by loved ones.

Impact of Trauma on the Brain

Trauma affects brain regions like the amygdala, hippocampus, and prefrontal cortex, leading to:

• Hyperarousal or being constantly on edge.
• Impaired decision-making and impulse control.
• Heightened vulnerability to reward-seeking behaviors, including substance use.

These changes can make individuals more likely to use drugs or engage in addictive behaviors as a way to self-soothe.

Substance Use Disorder as a Trigger for Trauma

Substance use disorder itself can create traumatic experiences, such as:

• Risky behaviors leading to accidents, injuries, or legal problems.
• Interpersonal conflicts or breakdowns in relationships.
• Loss of control over one’s life, which can feel overwhelming and destabilizing.

The Vicious Cycle

Trauma and substance use disorder often reinforce each other in a cycle:

• Trauma leads to substance use or substance use disorder.
• Substance use disorder causes further trauma (e.g., overdoses, abuse).
• The new trauma worsens the need for self-medication.

The Role of PTSD in Substance Use Disorder

Many individuals with substance use disorder also meet criteria for post-traumatic stress disorder (PTSD). The symptoms of PTSD—such as intrusive memories, flashbacks, and avoidance—are powerful triggers for substance use. Studies suggest:

• Individuals with PTSD are 2-4 times more likely to develop substance use disorders.
• The co-occurrence of PTSD and substance use disorder makes recovery more challenging.

Treatment Implications

Recognizing the trauma-substance use disorder connection is crucial for effective care. Key approaches include:

• Trauma-informed care: Ensures safety, empowerment, and understanding of trauma’s impact.
• Integrated treatment: Addresses both trauma and substance use disorder concurrently, often using:
  • Cognitive-behavioral therapy (CBT): to reframe harmful thoughts.
  • EMDR (Eye Movement Desensitization and Reprocessing): for processing traumatic memories.
  • Somatic therapies: to reconnect with the body and reduce distress.
  • Group support: such as 12-step programs or trauma-informed therapy groups.

Addressing both trauma and substance use disorders in tandem can break the cycle, fostering recovery, healing, and resilience.  All of the therapists at Silver Lining are trained to treat trauma and substance use disorders concurrently.  If you are looking for integrated care for trauma and substance use disorders, we can help!  Send us a message through our website to schedule a free phone consult.