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Substance Abuse or Use Disorder and Trauma

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The more we learn about Substance Use Disorder (SUD) (still also searched as "substance abuse"), the more we are convinced, that often, there is a connection between SUD and individual trauma or PTSD (Post Traumatic Stress Syndrome).


The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that personal trauma results from “an event, series of events, or set of circumstances that is experienced by that person as physically harmful or life-threatening and that has lasting adverse effects on that person’s functioning and mental, physical, social or spiritual well-being.”


Some of the common causes of trauma or PTSD are:

  • A sexual assault
  • A physical assault
  • Domestic violence
  • A car accident
  • Severe weather phenomenon like an earthquake, tornado, flood, or fire
  • Witnessing a violent crime
  • Witnessing the unexpected death of someone you care about
  • Being the victim of a violent crime
  • Childhood abuse
  • Participating in combat or living in a war zone

Clinically, in order to be diagnosed with PTSD, a person must experience the specific symptoms for six months.

As the name suggests, PTSD is an anxiety disorder created by a catastrophic event that overwhelms the brain and disrupts the individual’s capacity to cope.


Trauma affects different people in different ways. Sometimes, people suffering from this kind of anxiety as a result of trauma or PTSD turn to opioids to ease the anguish. In some cases, patients in addiction recovery could be experiencing trauma as a result of their SUD.


Today’s leading recovery facilities have become “trauma-informed” practices. These practices recognize the likelihood that a patient might be suffering from trauma and they are equipped to treat SUD and trauma simultaneously. This awareness allows them to provide services that can be shaped to minimize the possibility that someone will be re-traumatized.


“We are approaching every patient in a way that takes into account that they might be experiencing trauma,” explains Jennifer DiCostanzo, Program Director and Licensed Counselor at Symetria Recovery in Des Plaines, Illinois. “We begin addressing it when the patient comes through the door. (Our dialog) with the patient allows the patient to tell us if they are suffering from trauma.”


There are some schools of thought that argue that trauma or PTSD cannot be effectively treated until the patient has gone through treatment for SUD. DiCostanzo says that is more old-school thinking.


“It’s the chicken or the egg. You don’t know which came first,” she said. “At Symetria, it’s really important the we give treatment for both at the same time. It’s kind of like putting an envelope around the patient because it’s all happening at the same time.”


There is also interesting epidemiological research on traumatic in-vitro influences and what effect they may have on generational illnesses.  For example, starvation or war-like conditions may have effects on the next generation.   


Trauma-aware recovery treatment facilities play an important role in helping to identify, validate and reframe trauma responses in order to help patients cope with and recover from overwhelming experiences. This can empower patients to take more control of their own recovery.


So, the clear first question in addiction or substance use treatment becomes “What has happened to this person?” rather than “What is wrong with this person?”


Dale Willenbrink
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