Trauma & Addiction


trauma and addiction work hand in handWhat role does trauma play in addiction?

Throughout my work in the field of mental health and substance use disorders, I’ve often heard individuals question “Why them?”; Why are they depressed? Why did they get addicted to alcohol but their friends didn’t? Why are they feeling uncomfortable in social situations? There is no generic answer to these questions. Case by case we explore various indicators that could place an individual at a higher risk for developing such issues. One risk factor being adverse experiences which includes, but is not limited to, trauma.

So, what exactly is trauma?

I have found myself surprised by how many times I’ve heard individuals describe emotionally taxing or physically compromising life circumstances that they didn’t consider trauma because “it could have been worse” or “people have been through way worse.” Perhaps my own surprise by someone who doesn’t consider an event they experienced to be traumatic is the perfect example of how there are subjective views of what the term trauma entails.

How we define or view trauma isn’t so black and white. Trauma can be defined as an experience that is deeply distressing or disturbing and evokes strong psychological or emotional responses. Such an event can overwhelm an individual’s ability to implement coping skills to self-regulate in the immediate or foreseeable future when triggered by reminders of the distressful event. In other words, trauma occurs when someone’s response to an external event overwhelms their coping skills.

Humans are resilient, all with varying coping mechanisms, tolerance levels, and overall ability to manage challenging life circumstances. For some, witnessing a car accident could be considered a traumatic experience while others may emotionally regulate easier in the same situation. There is no sense in comparing one’s trauma to another’s. But, one thing we can examine closer is the role trauma can play in addiction. According to the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • 75% of women and men in substance abuse treatment report histories of abuse and trauma.
  • 97% of homeless women with mental illness report severe physical and/or sexual abuse
  • 12%-34% of individuals in substance abuse treatment have PTSD.

Sitting with internal distress is incredibly difficult. We look for ways to “fix it” or find some sort of quick relief especially when our ability to implement healthy coping skills is compromised by the severity of the presenting symptoms. If you’re combating feelings of anxiety, guilt, shock, confusion, sadness, or any other of the wide range of symptoms that can arise following trauma, it is difficult to practice some popular practices like deep breathing or meditation and expect instant relief.

trauma differs between everyone

How trauma and addiction mix together?

Therefore, there is a strong correlation between people who have endured trauma and addiction. I’ve had clients describe how using drugs or alcohol numbs them and helps them to not think about their problems. At the time, it’s “fixing” the problem. It’s decreasing the internal pain. And it’s that feeling of relief that becomes strongly appealing and eventually a form of coping, of surviving.

A colleague of mine once gave me this metaphor-Imagine you’re walking along a filthy sidewalk and you fall and scrape your knee. The cut is filled with gravel and dirt. If you slap a band aid over it, what will happen? It will get infected. So, what’s the proper course of action? To clean it out with hydrogen peroxide, thoroughly clean the wound and then apply a band aid. Simply putting on a band aid might provide immediate relief, but it certainly will not help to heal the wound. Cleaning it out might sting and it might be uncomfortable but it will help the wound to heal. This is a great way to view and understand the work with mental health and addiction. We understand the desire to find instant relief.

We’re not saying addressing underlying issues head on will be easy or comfortable. It might sting and you’ll likely be uncomfortable. But you’re not alone through this process and ultimately the work you put in will lead to personal growth, a healthy life, and an opportunity to truly heal.

By: Hannah Croce-Reisman, LCSW

Excerpts taken from:,