This is part two of the three-part series, Trauma-Informed Addiction Treatment and Research-Based Interventions. Read part one, Post Traumatic Stress Disorder
Addiction almost always has underlying causes, and a history of trauma is one of the most common issues behind drug and alcohol addiction. Some groups of people are more likely to experience certain kinds of trauma than others, and the extent to which a trauma affects someone and leads to substance abuse can vary among these groups.
Exposure to trauma in childhood, which often includes sexual or physical abuse and violence in the household, changes the physical structures and chemical functions of the developing brain, according to a study published in the journal Depression and Anxiety. These changes often lead to cognitive problems and a higher risk of mental illnesses down the road, including schizophrenia, major depression and bipolar disorder.
The link between substance abuse and early exposure to trauma is well-established. The National Survey of Adolescents found that teens who have experienced physical or sexual abuse or assault are three times more likely than those without a history of trauma to report past or current substance abuse.
A study published in the American Journal of Psychiatry found that among adolescents aged 15 to 19 years who were in treatment for a substance use disorder, 24.3 percent of males and 45.3 percent of females had a lifetime history of PTSD—five times higher than a community sample of adolescents. Research shows that nearly 60 percent of young people with PTSD will develop a substance abuse problem.
Women and Trauma
A study published in the journal Psychiatric Services found that up to 80 percent of women being treated for a substance use disorder report a history of trauma, most commonly sexual or physical abuse.
According to an article in the McGill Journal of Medicine, the lifetime prevalence of PTSD among North Americans is 7.8 percent, compared to 50 percent among women who have been sexually assaulted. Sexual assault is the most common cause of PTSD among women, with one study finding that 94 percent of women experienced symptoms of PTSD within the first two weeks of a sexual assault.
Women with PTSD stemming from sexual violence encounter more difficulties recovering from an addiction than women without a history of sexual abuse, according to the National Institutes of Health. This may be due to the complex relationship between sexual trauma and substance abuse; the role drugs or alcohol play in helping to manage symptoms of PTSD; and the co-occurrence of other psychological problems, such as depression, anxiety or eating disorders, that result from the abuse.
Men and Trauma
Men are more likely than women to experience feelings of anger associated with trauma—particularly sexual trauma—and they’re likely to act out aggressively or violently as a result of the trauma, according to an article in Addiction Professional Magazine. Men are also less likely than women to seek help for PTSD due to cultural and societal pressures to be “strong.”
Often, men will believe that acknowledging the trauma is on par with admitting they’re not a “real” man. This may help account for the fact that while women are more likely than men to have a lifetime prevalence of PTSD, men are more likely than women to self-medicate their symptoms with drugs and alcohol, according to a study published in the journal Depression and Anxiety.
Once in treatment for PTSD, addiction or both, men often have a difficult time fully engaging in therapy, largely due to problems with expressing emotions and communicating honestly about experiences that cause feelings of shame or embarrassment.
Veterans and Trauma
Military veterans who have served in a combat zone have a high prevalence of PTSD. According to the U.S. Department of Veterans Affairs, around 12 percent of soldiers who served in the Gulf War, 20 percent of Operation Iraqi Freedom vets and 30 percent of Vietnam veterans have PTSD in any given year. Additionally, around 23 percent of female veterans report being the victim of a sexual assault while in the military, increasing their risk of PTSD. Up to 75 percent of all veterans who have experienced trauma from combat or sexual abuse report having problematic drinking patterns.
First Responders and Trauma
First responders, including police officers, firefighters and EMTs, are constantly exposed to trauma. According to the Trauma Center at the Justice Resource Institute, these individuals are at a particularly high risk of developing PTSD during the course of their career.
A number of studies on first responders and PTSD conducted after 9/11 found that incidents of PTSD increased among this population in the years after the terrorist attack, with one study finding that the prevalence increased from 12.1 percent two to three years post-9/11 to 19.5 percent five to six years post-9/11.
According to the U.S. Fire Administration, a number of studies conducted between 2013 and 2015 found that firefighters drink alcohol more frequently than the general male population, and twice as many binge drink. A 1993 study published in the Scandinavian Journal of Work, Environment, and Health found that between 33 and 41 percent of firefighters were experiencing psychological distress, and 29 percent had possible or probable problems with alcohol abuse.
Read part three, Trauma-Informed Treatment: Research-Based Interventions, or download the entire series as a beautifully designed eBook, Trauma-Informed Addiction Treatment and Research-Based Interventions