You may have noticed I have a lot to say about the connection between trauma and addiction. My recent blog posts have identified that people who have experienced significant trauma are more likely to misuse substances. Another recent post discussed the downside to missing this important connection between trauma and addiction.
While not everyone who has experienced trauma moves into addictive patterns, most people who struggle with addiction have been through challenging or traumatic life experiences.
Researchers have developed many different theories about why people misuse substances and eventually become addicted to them. Genetics, brain chemistry, social norms, and personality traits are commonly identified as contributing to patterns of addiction. But the life stories of those who are addicted reveal a very clear pattern – most have had painful and overwhelming life experiences and have struggled with unmanageable emotions as a result. There is a much greater understanding of the impact that trauma has on the development of addiction issues.
We know the more someone experiences the ongoing disruptions of trauma symptoms, the more likely they will gravitate to substances and behaviours that help them mood-alter and self-medicate.
One explanation for the high rate of connection between trauma symptoms and substance abuse is that people are self-medicating common trauma symptoms as well as their emotional pain with the use of drugs and alcohol. You may be someone who uses substances to help you cope with a daily experience of anxiety, depression, or shame. Or you may be someone who uses alcohol, drugs, or certain behaviours to “manage” some of the painful and overwhelming symptoms you continue to experience following a traumatic life event.
Here is some research that helps us understand the connection between challenging life experiences and substance use:
Edward Khantzian’s Self-Medication Hypothesis
The Self-Medication Hypothesis was developed over 30 years ago by Edward Khantzian and his colleagues at the Harvard Medical School. Over the years, this research has made a significant contribution to our understanding of substance misuse and addiction, especially as a way of medicating overwhelming emotions and experiences. His goal was to understand what drives the misuse of drugs and alcohol.
He came to the conclusion that the heart of addictive disorders is suffering, not a “reward” or the seeking of pleasure – addiction is about self-medicating distress and painful feelings.
"Addiction problems are less a statement about pleasure seeking, reward, or self-destructiveness than they are about human psychological vulnerabilities." Addictive substances may help relieve emotional pain, but these attempts to self-medicate are short-lived.
Everyone who experiences addiction knows the temporary relief of self-medicating is quickly replaced by the suffering that comes with addiction.
Adverse Childhood Experiences (ACE) Study
The Adverse Childhood Experience Study (ACE Study) is an important study that shows the clear link between trauma and addiction. In the 1990’s, Vincent Felitti and Robert Anda spearheaded a ground-breaking study of over 17000 participants that looked at the association between adverse childhood experiences and the health or social problems they experienced as an adult.
The researchers began by identifying ten specific categories of common childhood trauma that included physical, emotional, and sexual abuse, physical and emotional neglect as well as family challenges including parental separation, addiction, mental illness, violence, or incarceration. Adult participants were asked how often they experienced these types of trauma in their childhood. They were also asked to identify the physical and mental health concerns they had as adults.
This study clearly shows that adverse childhood experiences are vastly more widespread than we have previously thought.
It also demonstrates that these adverse experiences have a powerful and cumulative negative impact on adult health as seen in the increased rates of substance abuse along with increased depression, obesity, cigarette smoking, and suicide attempts reported by those participants who had more of these traumatic childhood experiences. The ACE Study explains the ways that childhood traumas lead to health and mental health challenges:
If you were a child who experienced one or more adverse childhood experiences (ACEs), it makes it more likely that you experienced emotional, social, or learning challenges.
Adverse childhood experiences create more difficulties managing emotions such as anger or anxiety. Kids who grow up experiencing trauma tend to act out more. They have more trouble relating to their peers – they are often bullied, or they act aggressively towards their peers. And, because their brains are more focused on surviving difficult situations, they often struggle in school. As a result, these kids start engaging in unhealthy and high-risk behaviours (including substance abuse) as a way of connecting with others or just coping. These unhealthy behaviours then lead to more social problems, more challenges with learning, health issues, and disabilities.
Although the statistics from the ACE Study show that 33% of all participants had no significant adverse childhood experiences, at least 17% reported experiencing three or more categories of ACEs. The statistics regarding the connection between the number of ACEs experienced and the challenges experienced in adulthood are staggering.
Those who had experienced four or more ACEs were seven times more likely to be alcoholics and ten times more likely to have injected street drugs than someone with an ACE score of zero.
In fact, the highest risk of self-reported alcohol problems (30.7%) was reported by those who experienced four or more ACEs as well as a history of parental alcoholism.
How many of ACEs do you have?
If one or more of these adverse childhood experiences have occurred in your life and you have substance misuse issues, you might be using substances to help you cope with the negative impacts of those experiences.
You might use to help you feel less anxious, less irritable, or less angry. Drugs or alcohol might help you fall asleep or tone down your startle response. You may also use them to stop intrusive trauma-based thoughts or memories. Those with trauma histories are far more likely to use drugs and alcohol as a form of emotional avoidance – substances are used to numb painful feelings associated with traumatic experiences or traumatic memories.
For many people, substance misuse and addiction is often a way of dealing with distress – it is a behaviour that begins out of pain.
Drugs, alcohol and compulsive behaviours are a way to numb that pain.
The next instalment in “Trauma and Addiction: The Link Can’t Be Ignored” takes a closer look at the many types of trauma symptoms and how substance abuse helps “manage” these symptoms - "Feeling No Pain".
Here are all the posts in the "Trauma and Addiction: The Link Can't Be Ignored" series:
Introduction to Trauma Addiction Link
Part 1: The Problem is the Problem
Part 2: How Ignoring This Hurts Your Recovery
Part 3: Why People Abuse Substances
Part 4: Feeling No Pain