The Role of Trauma in Addiction: Healing the Wounds

Steve Trevino
April 11, 2024

Trauma refers to deeply distressing events that can leave lasting scars on our minds and hearts. These events can range from childhood struggles to life-threatening situations like natural disasters, accidents, or even military combat. When people face such distress, they often turn to drugs or alcohol to cope with the overwhelming emotions. This explains the strong link between substance abuse and trauma.

The link between Addiction and Trauma

Trauma and addiction are closely intertwined, with trauma often serving as a catalyst for the development of substance use disorders. Numerous studies have shown that traumatic experiences, especially during childhood, can raise the risk of people turning to substances as a way to cope with their emotional pain and distress.


One notable study is the original study of Adverse Childhood Experiences (ACEs). Researchers discovered that the risk of drug and alcohol abuse was higher among adults who had more ACEs. ACEs are traumatic experiences within the first 18 years of life and include:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Medical trauma
  • Emotional neglect
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Domestic violence
  • Incarcerated household member

So basically, someone who has four or more ACEs is 3x more likely to experience substance use problems later on in life. This can happen due to a blend of factors like: 

  • Genetic predisposition: Some people are more prone to addiction because of their genetic makeup. It's like they're born with a higher risk factor for struggling with substances.
  • Neurological changes: Trauma, especially in childhood when the brain is still developing, can literally change the way the brain works. The stress and trauma can mess with the brain's reward system, making one more susceptible to seeking out substances to feel better.
  • Maladaptive coping mechanisms: When dealing with trauma, one can turn to substances to self-medicate. For instance, someone who has experienced sexual abuse may turn to drugs or alcohol as a way to numb the pain and escape from intrusive memories or flashbacks. Over time, this pattern of substance use can become compulsive and lead to the development of addiction.
  • Environmental factors: Family, friends, and community all play a role in shaping who someone becomes and how they deal with things. If one is surrounded by people who use substances themselves, it becomes even harder to break free from that cycle of addiction.

Post-Traumatic Stress Disorder and Addiction

When a person experiences or witnesses a traumatic event, they may develop a mental health condition referred to as PTSD. PTSD can occur in response to different traumatic experiences, including but not limited to physical or sexual assault, combat exposure, natural disasters, accidents, or childhood abuse.

Research has documented a high incidence of comorbid PTSD and substance abuse. In fact, people with PTSD are 14 times more likely to be diagnosed with SUD. And as mentioned earlier, self-medication is a huge driving factor. On the flip side, substance use can worsen PTSD symptoms and interfere with the effectiveness of treatment.

For example, drugs or alcohol can impair judgment, increase impulsivity, and interfere with the processing of traumatic memories in therapy. This can make it difficult for individuals with PTSD to engage fully in treatment and make progress towards recovery.


Types of Trauma

Trauma can be physical or emotional. Physical trauma is a bodily injury or harm caused by an external event or force. On the other hand, emotional trauma is the psychological and emotional impact of distressing events or experiences. It can either be acute or chronic, depending on the duration and intensity of the distressing events.

Signs and Symptoms of Trauma

The signs of trauma can be physical or emotional. The emotional aspect can cause intense feelings that affect one's functioning, behavior, attitude, and view of the world. They may also experience adjustment disorder or PTSD after a traumatic event.

Signs of emotional trauma in adults include:

  • Mood swings
  • Dissociation
  • Helplessness
  • Difficulty functioning
  • Anger
  • Avoidance
  • Blame
  • Guilt or shame
  • Emotional numbness
  • Social withdrawal

Signs of physical trauma in adults include:

  • Fatigue
  • Nightmares
  • Feeling on edge
  • Mood swings
  • Appetite changes
  • Difficulty sleeping
  • Tense muscles
  • Sexual dysfunction
  • Excessive alertness
  • Increased heart rate

Trauma-Informed Care in Addiction Treatment

The good news is help is available. Effective treatment approaches like trauma-informed care address both the underlying trauma and the addictive behaviors, providing a path toward healing and long-term sobriety.


As the name suggests, trauma-informed care considers the impact of trauma on a person's life and integrates this understanding into every aspect of their care. It's not just about addressing the symptoms of addiction; it's about recognizing that the patient has experienced trauma in the past and that trauma plays a significant role in their addictive behaviors.

Trauma-informed care is important because it:

  1. Creates a safe and supportive space where you feel respected, heard, and empowered to share your experiences without fear of judgment or re-traumatization.
  2. Helps you recognize that your addiction is not just about the substance itself but about the underlying pain and trauma you're trying to cope with. Your mental health professional helps you understand how trauma has shaped your thoughts, emotions, and behaviors and works with you to develop healthier coping strategies.
  3. It means treating you as a whole person, addressing both your mental health needs and your substance use issues. This might involve behavioral health therapy techniques like Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR) to help you process trauma and develop new ways of thinking and behaving.
  4. It emphasizes empowerment and collaboration. You are not just a passive recipient of treatment but an active participant in your healing journey. Your therapist will help you set goals, identify strengths, and overcome challenges as you work towards lasting sobriety and emotional well-being.

Trauma-informed care isn't just about treating the symptoms of addiction; it's about recognizing the whole person and honoring their experiences. It's about creating a safe space where people feel empowered to explore their past or childhood traumas and work toward recovery.

At More than Rehab, we believe that everyone deserves a chance to heal and rebuild their lives. With trauma-informed care, we can help you break free from the cycle of addiction and create a brighter future for yourself and those you love.


About The Author: 
Steve Trevino
Steve Trevino is married to Julie, his high school sweetheart and they have two daughters. He is the founder and executive director of CrossCentral Church and Recovery Center. With experience in both non-profit and for-profit treatment, he has helped thousands find freedom from addiction through residential programs, recovery workshops and consulting around the world.

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