According to Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine, addiction should not be called addiction. It should be called “ritualized compulsive comfort-seeking.” Why? Because, he believes, most addiction is a normal response to difficult or traumatic experiences in childhood.
An article in The Guardian quotes Dr. Gabor Mate’s similar understanding of addiction: “Don’t ask why the addiction, ask why the pain. To understand people’s pain, you have to understand their lives. In other words, addiction is a normal response to trauma.”
Let’s look at what trauma is and how it connects to substance use disorder.
What is Trauma?
Many people may still associate trauma with post-traumatic stress disorder (PTSD) and veterans. While war certainly causes trauma for everyone involved, it is not the only cause. A major source of trauma for many people are adverse childhood experiences (ACEs). The Centers for Disease Control and Prevention (CDC) lists three categories of ACEs:
- Abuse – can be emotional, physical, or sexual. Sometimes abuse is obvious (slapping, hitting, yelling insults, sexual touch or rape), while other times it may be less so (feeling afraid that you might get hurt, even if you never did; being sworn at, put down, or having something thrown at you). It can be easy to shrug off parental behavior as normal or as justified (“I was a bad kid; I deserved it.”), but abuse of any kind is unacceptable and will have consequences for the child.
- Household Challenges – this can include witnessing domestic violence between adults in the household, living with people who abused alcohol or drugs, or living with people who had a mental illness, whether or not it was diagnosed. It can also include parental separation, divorce, or incarceration.
- Neglect – maybe you weren’t abused, but no one in your family made you feel special or loved or could be relied on to help you, care for you, or protect you. Neglect can include not getting enough to eat, having to wear dirty clothes, not being taken to the doctor when sick, and more.
Of course, the opportunity to experience trauma doesn’t end with childhood. And while certain events are more commonly associated with a trauma response (abuse, violence, natural disaster, medical trauma, traumatic grief, bullying, and others), everyone is different, with different sensitivities and different avenues for support and healing. Basically, any experience that feels psychologically overwhelming can result in trauma. And adults who experience trauma are also at risk for developing substance use disorder.
The use of alcohol and/or drugs is a way to escape painful feelings and memories. When someone has experienced trauma, they may experience a number of the following symptoms that can make day-to-day functioning feel difficult or impossible:
- Intrusive thoughts, including flashbacks or nightmares about the traumatic event
- Avoidance of any people, places, or objects that recall the traumatic event
- Hypervigilance, and being easily startled
- Changes in self-perception, like believing you are “bad,” or feeling excessive guilt or shame
- Difficulty controlling emotions
- Chronic pain
- Sleep problems
- Chest pain and/or headaches
Sometimes it seems like the easiest way to avoid these painful feelings, at least temporarily, is to self-medicate with drugs or alcohol. But what starts as an avenue to relief can quickly turn into tolerance (requiring more of the substance to get the same “high”), dependence, and addiction.
When someone suffers from addiction and trauma, they are said to have co-occurring disorders. Co-occurring disorders are best treated holistically, addressing both the addiction and the trauma together. Treatment may begin with a medical detox to safely wean the body from the toxic substances and then continue with residential or outpatient treatment that typically includes intensive individual and group therapy, holistic treatments, family education, and relapse prevention education and aftercare.
If you or a loved one is struggling with substance use and suspect trauma may be an underlying factor, contact St. Gregory Recovery Center in Bayard, Iowa. Our compassionate team can help you find the path to long-term well-being.