Author: Claudia M. Elsig, MD
Childhood trauma can have devastating consequences for its victims and for society. Addiction, a complex psychiatric disorder, is one such outcome. While there are several underlying causes for addiction, early trauma exposure is well known to be the most significant risk.
Numerous studies demonstrate a clear and distinct correlation between childhood trauma and drug and alcohol addiction.
This blog explains how exposure to traumatic experiences in childhood can lead to addictive behaviours.
What is childhood trauma?
Trauma is an event (or a series of events) that has lasting effects on a person’s mental, emotional, physical, social, and spiritual wellbeing.
The most common causes of childhood trauma include physical or psychological abuse, rape/sexual abuse, bullying, child abuse or neglect, domestic violence, grief following the death of a loved one, parental divorce, or any form of conflict. Witnessing violence, natural disaster, or death, or having a near death experience are also experiences that can leave an indelible mark.
Trauma can be experienced directly or by witnessing, indirectly. For example, a child witnessing violence between parents, or receiving a threat, can be traumatised in the same way as a child who is abused physically.
Even subtle levels of abuse, such as a parent/carer withdrawing affection, mocking, or ignoring a child, can cause psychological damage.
These experiences have lasting effects on the individual’s wellbeing.
The link between childhood trauma and addiction: research
Numerous studies show a concrete link between childhood trauma and addiction.
One study examining childhood trauma among individuals with co-morbid substance use and post-traumatic stress disorder (PTSD) found the vast majority (77%) had experienced at least one trauma before the age of 16.1
Another study using a large population-based twin sample concluded that early onset alcoholism is strongly association with childhood trauma.2
Research into PTSD concluded that those diagnosed with the condition are 3 times more likely to abuse substances.3
And in research testing the relationship between substance abuse and childhood traumatic experience, it was found that the level of substance use, particularly cocaine, strongly correlated with levels of childhood physical, sexual, and emotional abuse, as well as current PTSD symptoms.4
Why trauma can lead to addiction
Any childhood trauma can cause maladaptive and damaging behaviours because children lack the frame of reference that adults use later in life to process experiences. Traumatic experiences initiate strong emotions and physical reactions that can persist long after the event. They can change a person’s perspective and make it difficult for them to cope with life.
This emotional dysregulation gets expressed in a range of symptoms and behaviours that can include PTSD symptoms, substance and/or alcohol abuse, and other risky behaviours.
Alcoholism or drug abuse are avoidance symptoms – the individual uses drugs or alcohol to numb fear or avoid memories. It is common for the victims of trauma to turn to alcohol or drugs to manage PTSD symptoms and to escape. But this type of addictive behaviour is a vicious cycle, as alcohol and drugs worsen depression and anxiety and interfere with normal sleep patterns.
Going deeper: the biology of trauma
In recent decades, the development of brain imaging techniques and new biochemical approaches has increased our understanding of the biological effects of psychological trauma. Exposure to a traumatic event, or series of chronic traumatic events, activates the body’s biological stress response systems. We now know that psychological trauma disrupts homeostasis, causing short and long-term effects on many organs and systems in the body.5
The physiological consequences to trauma include the shift of metabolic resources away from homeostasis and towards a “fight or flight” reaction. This is a normal body response when we are in dangerous situations. But when activated regularly it can cause harm.
The limbic system (parts of our brain) is involved in emotions, feelings of motivation and reward, learning, memory, the fight or flight response, hunger, thirst, and production of hormones that help regulate the autonomic nervous system.
Repeatedly existing in ‘fight or flight’ mode means the body has persistently abnormal hormone concentrations. High levels of the stress hormone, cortisol, for example, can damage neurons in the brain. Abnormal concentrations of adrenaline (the hormone that prepares the body for “fight or flight”) depresses the immune system and activates hyperarousal (or hypervigilance).
The pathways leading to addiction are complex. They include “differences in molecular and genetic expression, altered brain sensitivities to reward- and stress-related cues, and behavioural patterns that include risk taking, social isolation, and/or stress dysregulation.”6
Three distinct but interrelated neurobiological systems are modified by early experience and patterns of maternal caregiving: These are the dopamine system (DA), the oxytocin system (OT), and the glucocorticoid (GC) system. Early-life trauma appears to modify aspects of these systems. Research shows that long-term alterations in the DA, OT, and GC systems increase a person’s susceptibility to addiction.6
Studies of the brains of human and animal subjects who have been victims of traumatic stress reveal differences in their brains when compared with control subjects who have not experienced trauma.5
Normally memories are processed and filed away but memories of traumatic events overwhelm the processing part of the brain. This has a direct effect on the hard wiring of neural circuits in the developing brain. Children who are severely neglected experience chronic traumatic stress that compromises right brain development.
This adverse neurobiological development can translate into behavioural patterns that increase susceptibility to addiction.
Treating childhood trauma and addiction
Addiction is a genetically and stress-induced disorder of the dopamine-glutamate interaction. A comprehensive addiction treatment plan, including trauma-informed therapy, offers the greatest hope for treatment success. It is important to address both the trauma and the addiction. Unfortunately, many treatment centers focus on one area without the other. Both must be addressed together because they are so strongly linked.
In treatment it is important for the person to understand how the addiction has helped them to survive. At the CALDA Clinic, coping strategies are taught to prevent relapse and to manage PTSD symptoms.
As traumatic experience is also somatic, effective treatment must also address the body. Talking therapy alone will not make trauma ‘go away’.
At the CALDA Clinic we work using targeted, addiction-specific therapy. We help individuals to identify and tolerate feelings. CBT (cognitive behavioral therapy), clinical hypnosis and EMDR (eye movement desensitisation and reprocessing) are directly implemented.
If you would like to know more about our addiction treatment programmes, please get in touch. Our clients are self-payers, which is the basis to enabling absolute discretion and privacy.
- Farrugia P L et al, Nov 2011, Childhood trauma among individuals with co-morbid substance use and post traumatic stress disorder
- Magnusson Å et al, 29Jul2011, Familial influence and childhood trauma in female alcoholism
- Gielen N et al, 8Aug2012, Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is
- Khoury L et al, 27Dec2010, Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population
- Solomon E P & Heide K M, Jan 2005, The biology of trauma: implications for treatment
- Sohye K et al, Apr 2017, Early adverse experience and substance addiction: dopamine, oxytocin, and glucocorticoid pathways