There is a growing problem in our society that nobody seems to talk about and everyone seems to bat an eye to. There is not one person to blame when our society promotes alcohol and other substances to “cure” mental health issues the way that they do. The collective consciousness is searching for answers, being blindly misguided by mainstream media and everything else around them. None of us were taught how to cope and this isn’t the way things are supposed to be. For centuries society told us to conform; denying ourselves the truth and freedom our innate beings seek. Everything is connected, but the root of the problem stems from the fact that trauma is the main cause of substance abuse. Trauma and substance abuse often intertwine in a very complex relationship. Two completely separate topics that are so deeply connected. Both paths lead to one another but they manifest in many different forms. Individuals may turn to substances as a coping mechanism to numb emotional pain stemming from traumatic experiences. Conversely, substance abuse can contribute to trauma, creating a cycle of dependence. Because of their interconnected nature emphasizing the importance of holistic therapeutic approaches while addressing both trauma and substance abuse simultaneously is crucial for effective treatment and recovery. There are so many different forms of healing that are available to society today. The goal is to change the stigma against addiction while promoting a safe space to learn about how to overcome these destructive behaviors and tendencies. The root of the problem is known, so now there needs to be viable solutions.
Trauma can occur on a spectrum and is defined as a deeply disturbing and/or distressing situation. There are many different ways an individual can experience trauma and the SAMHSA guide states, “The concept of traumatic stress emerged in the field of mental health at least four decades ago. Over the last 20 years, SAMHSA has been a leader in recognizing the need to address trauma as a fundamental obligation for public mental health and substance abuse service delivery and has supported the development and promulgation of trauma-informed systems of care” (Page 5) In the guide published by SAMHSA (substance abuse and mental health services administration) they break down the Three “E’s” of trauma as: event(s), experience of event(s), and effect. “Events and circumstances may include the actual or extreme threat of physical or psychological harm…” “How the individual labels, assigns meaning or to and is disrupted physically and psychologically by an event will contribute to whether or not it is experienced as traumatic.” “The long-lasting adverse effects of the event are a critical component of trauma. These adverse effects may occur immediately or may have a delayed onset.” (Page 8). The three E’s give insight into how trauma can form and develop over time. The events, experience and effect are what happened, how we processed it and how we’re handling it currently. The impact of trauma extends beyond the event itself and can affect an individual for years after the fact. In SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, it explains, “Traumatic experiences complicate a child’s or an adult’s capacity to make sense of their lives…” (Page 9). These lasting effects on an individual’s mental and emotional well-being often influence thoughts, behaviors, relationships, their worldview and coping mechanisms. These can all determine and shape how stress is handled, which in most cases is why individuals will turn to substances. In an article written by Alison Knopf, she mentioned a study conducted by NCS‐A who concluded, “Before the age of 11 years, 11% of participants had experienced interpersonal violence, 18% had had a traumatic accident, 15% had witnessed or heard about a traumatic event happening to a loved one, and 4% reported an unspecified event. For lifetime drug use, 22% had ever used marijuana, 2% cocaine, 5% prescription drugs not for medical reasons, 3% other drugs, and 6% multiple drugs.” There is no discrimination when it comes to witnessing or experiencing one of the situations listed above. Trauma can stem from various forms, such as: physical abuse, emotional neglect, natural disasters, accidents, or witnessing violence. It’s a deeply individual experience and what constitutes trauma can vary from person to person. The article Physical Health Burdens of Women With Trauma Histories and Co-occurring Substance Abuse and Mental Disorders, it claims, “Childhood abuse can lead to increased prevalence of substance abuse and of post-traumatic stress disorder, depression, anxiety, and other mental health conditions later in adulthood” (Page 129). Understanding these varying effects is crucial for developing strategies to support those who have experienced or are currently experiencing trauma. Once we understand how trauma forms, we can take a closer look at why those with a history of traumatic events turn to substances.
Substance abuse, like trauma, can be defined on a spectrum and each experience with substance use is individual as well. There are requirements listed on the DSM-5 explaining how to determine if someone qualifies for a substance abuse/ use disorder (SAD/SUD). The article states, “Consuming the substance in larger amounts and for a longer amount of time than intended. Persistent desire to cut down or regulate use. The individual may have unsuccessfully attempted to stop in the past. Spending a great deal of time obtaining, using, or recovering from the effects of substance use. Experiencing craving, a pressing desire to use the substance.” (McNeely J, Adam A). Trauma is the leading cause of substance abuse. The addiction crisis remains a pressing issue in America, with a concerning upward trend. Factors such as stress, social isolation, and economic challenges contribute to its growth but the main reason is that we don’t know how to treat trauma effectively. These circumstances go hand in hand with how we respond to dealing with trauma. The impact extends beyond an individual’s physical or mental health. It affects our communities and straining healthcare systems, highlighting the need for comprehensive approaches to prevention and treatment. In a newspaper article titled Substance Abuse Treatment: What Are the Options? It states, “Because substance abuse is complex, your treatment should address both the drug abuse and your social, psychological, medical, employment and legal needs, according to the National Institute on Drug Abuse (NIDA). You may be treated with one or more of the following treatments.” (Ganobsik, Kirstie). Including but not limited to: medications, outpatient and inpatient therapy. Traditionally, these are the three most common forms of therapy in America. In order to properly determine the best approach to treatment we can look at success stories in the past. Newspaper article Substance Abuse Treatment: What Are The Options? Writes, “SUD therapy itself is multifaceted, says NIDA and the Cleveland Clinic. For example, addiction specialists might use cognitive behavioral therapy to help people identify their triggers and learn strategies to take control of them so they’re less likely to turn to alcohol or drugs again.” (Ganobsik, Kirstie). For many, these traditional forms of therapy can work wonders, but that isn’t always the case. Adding in holistic approaches to treating substance abuse could be as simple as promoting movement and meditation which also helps alleviate symptoms of PTSD (post-traumatic stress disorder). When we take the approach of treating both simultaneously it allows for researchers and mental health professionals to recognize the interplay between addiction and emotional distress.
When someone seeks traditional therapy one of the first ways professionals start treatment is by prescribing medication. Unsurprisingly, it’s one of the first resorts because it suppresses the patient’s problems. In extreme cases medication can be crucial, but for PTSD and SUD there are many other solutions to try before resorting to prescription drugs. In an article posted by the American Psychological Association titled Inappropriate Prescribing the author starts with, “Writing a prescription to treat a mental health disorder is easy, but it may not always be the safest or most effective route for patients, according to some recent studies and a growing chorus of voices concerned about the rapid rise in the prescription of psychotropic drugs.” (Brendan L. Smith). Treatment plans that are individually designed for each patient are needed because of the spectrum that both trauma and substance abuse lie on. Each case is very unique and treating these cases should be unique as well. Developing separate plans of action for each patient while including multiple forms of therapy is key. In the same article written by Brendan L. Smith, he continues with, “Most antidepressants are prescribed by primary-care physicians who may have limited training in treating mental health disorders. In the United States, almost four out of five prescriptions for psychotropic drugs are written by physicians who aren’t psychiatrists (Psychiatric Services, 2009).” To know how easily prescriptions can be handed out is heartbreaking. Medication can sometimes only work as a band-aid and further promote using substances to numb. There are many health professionals out there who see this growing problem with this. Later in the article listed above it states, “Today, patients often receive psychotropic medications without being evaluated by a mental health professional, according to a study last year by the Centers for Disease Control and Prevention (CDC).” This shows that these prescriptions are being filled by those without proper education, further enabling the cycle of addiction to “treat” trauma. The first step in addressing a problem is having awareness, and with growing awareness we can enforce stricter rules on passing out medication to treat mental health issues/ disorders.
In realizing that trauma leads to Substance Use Disorder and those without proper background push medication onto patients, we can further research if this is due to the way substances and western medicine are advertised in America. Physical Health Burdens of Women With Trauma Histories and Co-occurring Substance Abuse and Mental Disorders it claims that, “Childhood abuse can lead to increased prevalence of substance abuse and of post-traumatic stress disorder, depression, anxiety, and other mental health conditions later in adulthood. Prior research also links the experience of physical and sexual abuse in childhood and adulthood to poorer health, more medical symptoms, chronic pain and increased rates of disability. Childhood abuse is also associated with poorer health habits in adulthood, such as smoking, risky sexual behaviors and other high-risk behaviors.” (Page 129). This proves that pre-existing conditions due to trauma develop overtime and turn into substance abuse. After proving this, the article titled A Social-Attributional Analysis of Alcohol Response goes on to suggest that alcohol has always been a part of community tradition and dates back centuries. “In ancient Greece, members of the elite classes consumed large quantities of wine in the company of friends and acquaintances during parties known as symposia—a word that translates from the Greek as “to drink together.” During these symposia, guests drank and conversed on couches, occasionally debating philosophical issues and enjoying musical and theatrical entertainment provided by their hosts” (Fairbairn CE, Sayette MA). Alcohol has been around for centuries and has always been used and promoted as a “feel good” drug when it is literally a depressant. Society’s promotion of alcohol can contribute to normalized drinking behavior. Raising awareness about responsible alcohol consumption, promoting alternatives, and encouraging open discussions can help shift cultural attitudes toward a more balanced perspective on alcohol.
The next step is breaking the stigma society holds towards those with trauma, PTSD, and SUD. Breaking the stigma surrounding substance use and trauma requires open conversations, education, and empathy to foster understanding that these struggles are complex, often rooted in personal challenges, and that seeking help is a sign of strength, not weakness. Building a supportive community, encouraging empathy and providing accessible resources for prevention and treatment can help unite efforts in addressing these challenges collectively. Substance Abuse Treatment: What are the Options? Suggests, “Therapeutic communities. Therapeutic communities include supportive peers and sometimes trained specialists who provide a healing community. NAMI and NIDA say they may be: Sober houses, Group counseling programs, Self-help support groups…” “To be effective, NIDA recommends at least three months of treatment and notes that many inpatient treatment programs last 6 to 12 months.” (Ganobsik, Kirstie). The more we open up to one another and reach out for help, the more common we will see that these issues are prevalent. It is time to take a stand and educate those willing on forms of advocacy and promoting the resources we have available.
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