Trauma and Addiction: What's the Connection?

- Elda-Rosa Coulthrust, MA, LCMHC, LCAS, CCS

“There are all kinds of addicts, I guess. We all have pain. And we all look for ways to make the pain go away.”

― Sherman Alexie, The Absolutely True Diary of a Part-Time Indian

An event (or series of events) which cause stress that exceeds a ‘normal’ stress reaction can be referred to as a traumatic event. As such, a traumatic event can have significant consequences on our well-being, and make us vulnerable to mental health issues and/or development of maladaptive behaviors.

Research suggests a correlation between childhood trauma and addiction. Chronic (repeated) and complicated trauma (trauma that involves exposure to multiple traumatic events), in particular, can compromise a person's chemistry and adaptive coping mechanisms, which may pave a path to maladaptive behaviors and substance use.

Many who have experienced a difficult upbringing may carry these experiences into adulthood. Difficult childhood experiences, such as abuse, neglect, domestic/community violence and drug use or other social inequities can have a wide range of lasting consequences.

According to research, those who have had adverse childhood experiences (ACEs) are more likely to express symptoms of Post Traumatic Stress. ACE’s are strongly related to the development and prevalence of a wide range of health problems throughout a person’s lifespan, including those associated with substance misuse.

Outcomes of Childhood Trauma

Childhood experience shape individuals, affecting their view of themselves and the world.

Trauma is an event or sequence of events that overcome a person's typical response to stress. As a result, it may interrupt a child's healthy progression of emotional, physical, and social well-being.

Please note - I am not suggesting that early exposure to trauma is the gateway, only that it presents a host of risk factors. Exposure to a traumatic event across the life-span is very important to recognize here.

In stressful conditions, the body produces stress hormones such as cortisol and adrenaline to help us cope. When the brain senses threat, a group of nerve cells in the middle of the brain called the amygdala starts the fight-flight-freeze response, which causes stress hormones to be released.

But because the brain may perceive an event as dangerous or life-threatening, this causes a strong stress response.

Chronic stress interferes with adaptive recovery from the fight-flight-freeze reaction. So, if stress hormone levels remain elevated for an extended period, it can cause chronic hyperarousal.

A trauma reaction may push the neurological system beyond its capacity to self-regulate, causing emotional and behavior challenges. In addition, memories/feelings linked to the event create an imprint which can influence a person's thoughts and behaviors. This may result in mental health issues, compulsive behaviors and suppression of traumatic memories / feelings by self-medicating with alcohol and other substances.

Does the Experience of A Traumatic Event Morph into Post-traumatic Stress Disorder (PTSD)?

The main difference between PTSD and the experience of trauma is important to note. A traumatic event is time-based, while PTSD is a longer-term condition where one continues to have flashbacks and re-experiencing the traumatic event.

Symptoms of Post-traumatic stress disorder may start immediately after a traumatic event, but sometimes symptoms may not appear until years later. These symptoms may cause significant problems in social or work situations and in relationships. They can also interfere with normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.

Can PTSD Lead to Addiction?

I will keep it short. Some people with PTSD may develop addictive behaviors to cope with their symptoms.

Addictive behaviors, such as substance use, binge eating, or gambling, stimulate the reward regions in the limbic system (control board for our emotional responses, mood, and attentiveness) of the brain. And when something feels good to the brain, it wants more.

The dopamine production in the brain's reward system increases when a person uses drugs or engages in other addictive behaviors. The production of this neurotransmitter causes a person to feel pleased and fulfilled, referred to as "feeling high."

Furthermore, addictive behaviors divert a person's focus away from trauma-related symptoms and suppress symptoms by engaging in addictive behaviors.

- How can I prevent trauma from turning into PTSD?

Experiencing a traumatic event does not mean that you will develop PTSD. Everyone’s response to trauma will differ based on numerous factors, including conditions and resources.

- Will I get addicted to drugs or anything else if I have childhood trauma?

Short answer is - NO. However, substance misuse/abuse can lead to a maladaptive pattern of use and someone can cross over to addiction with continued use. A screening or assessment by a qualified practitioner can help identify a Substance Use Disorder.

- How can I get better from my trauma?

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

- What do you mean by ‘negative changes in thinking and mood’?

Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world
Hopelessness about the future
Memory problems, including not remembering important aspects of the traumatic event
Difficulty maintaining close relationships
Feeling detached from family and friends
Lack of interest in activities you once enjoyed
Difficulty experiencing positive emotions
Feeling emotionally numb