Trauma and Addiction


In our everyday lives, we need to think about the addicts we work alongside, live alongside, and love.  When people are having problems, it is time to stop asking what is wrong with them and start asking what happened to them?

outcome-measuresTrauma can be defined as any stress that causes physical or emotional harm from which you cannot remove yourself and from which your biology cannot reset itself.

Although often overlooked, emotional trauma lies at the heart of many types of addictions.  Since the 1970’s, treatment professionals have understood the role of trauma in the development of substance abuse disorders and relapse.  However recently, there is a welcomed resurgence in awareness and treatment of trauma as a co-occurring disorder.

Trauma has been associated not only with drug addiction but also overeating, compulsive sexual behavior and other types of addictions.  The Adverse Childhood Experiences study found a correlation between severe childhood stress (abuse, neglect, loss of a parent, domestic violence or having an addicted or mentally ill parent) and various types of addictions.

Addiction develops in the trauma survivor’s attempt to self- medicate.  Rather than think about or re-live the event, the individual may use drugs, alcohol or other substances or behaviors to numb feelings of fear, powerlessness, or depression or to cope with intensive memories.

Drug use may also serve other purposes for trauma survivors.  For example, it may allow them to disconnect from their feelings, dampen guilt or rage, increase feelings of relaxation or control, or reduce chronic anxiety or suicidal thinking.  Depending on the drug of abuse, clients may seek to numb painful emotions or conversely feel “alive.” Clients also report a feeling of camaraderie or unconditional acceptance among other drug users, in some ways replicating the family unit.

Unfortunately, drugs start out as a help but then become the problem.

There are three critical steps to treating Post Traumatic Stress-safety, management of anxiety, and emotional processing.  After safety is assured, it is important to re-establish contact with a natural social support system.  People need to learn to put words to the problems they face, name them and formulate appropriate solutions.  If anxiety dominates, survivors need to be helped to strengthen their coping skills.  Practical anxiety management skills may include training in deep muscle relaxation, control of breathing, role playing, yoga as well as medication.  Clients need to find a language for understanding and communicating their experiences.

Finally and most importantly, addiction and trauma is treatable and there is help available.


Pia Marinangeli, PhD, CASAC

Workforce Assistance – Mental Health Provider


Appointment call the MAP Access  Line at 914-417-5355

My office at 212 613-0062


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