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Addiction & Trauma Therapy: Getting Help for Trauma & Substance Use

Experiencing trauma can impact you in many ways. Some people can deal with a traumatic experience without having it significantly impact their lives. Others may find it more difficult to cope with the trauma and may turn to drugs and alcohol. Trauma and substance use are often connected, and many addiction programs include trauma therapy.

In this article, you will be able to better understand trauma, the connection between trauma and substance abuse, the importance of trauma-informed addiction treatment, and how to find help for addiction and trauma.

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Understanding Trauma

A trauma or traumatic event is a scary, dangerous, or shocking experience that can significantly impact you physically and/or emotionally. Responses to the traumatic event can be delayed or immediate.1 Examples of traumatic events can include:1,2

  • Car accidents.
  • Natural disasters such as tornadoes, hurricanes, and floods.
  • Violent acts such as terrorist attacks and mass shootings.
  • Abuse or assault.
  • Combat.
  • Being a witness to injury or death.

Statistics show that roughly 50% of women and 60% of men experience at least 1 trauma throughout their lives.2 Symptoms of trauma can range in intensity and impact your functioning in many ways. Common symptoms associated with trauma can include:1

  • Feeling angry, sad, or anxious.
  • Chronically thinking about the experience.
  • Difficulty sleeping.
  • Trouble focusing.

More intense and severe signs of trauma include:1

  • Frequently crying.
  • Excessive feelings of sadness, fear, or anxiety.
  • Socially isolating.
  • Problems sleeping and/or nightmares.
  • Frightening thoughts or flashbacks.
  • Problems concentrating and thinking clearly.
  • Avoiding people and places that remind you of the trauma.
  • Headaches.
  • Racing heart.
  • Fatigue.
  • Digestive issues including stomach pain.
  • Being easily started.

The Connection Between Trauma & Substance Abuse

Post-traumatic stress disorder (PTSD) is a diagnosable mental health condition that occurs after you experience a traumatic event.3 PTSD and substance use disorder (SUD) are common co-occurring disorders. Research shows that PTSD co-occurs with SUD in nearly 40% of the U.S. population.4 A co-occurring disorder refers to the presence of a mental health issue and SUD simultaneously.5

The presence of both doesn’t mean that one caused the other. However, there is bidirectionality between the two as both disorders can mutually influence and exacerbate one another.6 There are many theories that have tried to explain the connection between mental illness and SUDs. A prominent theory is the self-medication theory, which states that individuals with PTSD may use substances to help manage and tolerate the symptoms of PTSD.4

Additional factors that can influence the development of both PTSD and SUD include:7

  • Genetic vulnerabilities. Your genetics can increase your vulnerability to developing a substance use and mental health disorder.
  • Environmental factors. This can include experiencing chronic trauma and stress.
  • Family history. Having a family history of mental health and substance use disorders can increase your vulnerability to developing a co-occurring disorder.

Research has shown that individuals with PTSD may be more likely to use specific substances. For example, individuals with PTSD are more likely to use serious substances like opioids and cocaine, however, the misuse of cannabis, alcohol, and prescription medications is also common.8

The Importance of Trauma-Informed Addiction Treatment

The presence of a co-occurring disorder can complicate the treatment process as individuals with them are less likely to engage, sustain, and complete treatment and are at an increased risk of experiencing negative health conditions and life outcomes (like homelessness, trauma, and self-harm).8 Therefore, it is recommended and encouraged that both disorders be treated simultaneously in an effort to treat the “whole” person and tailor treatment specific to you and your overall needs.7

Comprehensive treatment that addresses a co-occurring disorder is important in preventing relapse. Continuing care and relapse prevention services are essential because substance misuse is a chronic disorder that is subject to relapse along with the fact that mental health disorders can be cyclical and reoccurring.When you’re looking for a treatment program, make sure to look for one that focuses on treating addiction and mental illness.

Getting Help for Trauma & Addiction Recovery

Many addiction treatment centers have trauma-specific programs. A PTSD recovery program may be suitable for you if you are experiencing an SUD and have experienced trauma in the past. Trauma-focused therapy and trauma-informed care aim to identify people who have experienced trauma and associated traumatic stress symptoms, help individuals develop insight regarding how their trauma experience has impacted them, and identify an appropriate course of action in a safe environment.9 This can be accomplished through a variety of interventions such as developing coping skills and psychoeducation.9

It is important that your treatment plan integrate services to address all your needs and that treatment is individualized to you. Additional objectives that may be included as part of your integrated trauma-informed care include prevention strategies to avoid re-traumatization, prevention of trauma-related disorders, and strengthening resiliency may be included objectives in your co-occurring disorder treatment plan.9


  1. National Institute of Mental Health. (2020). Coping with traumatic events.
  2. U.S. Department of Veteran Affairs. (n.d.). How common is PTSD in adults?
  3. U.S. Department of Veteran Affairs. (n.d.). PTSD basics.
  4. Back, S.E., Flanagan, J.C., Killeen, T.K., & Korte, K.J. (2017). Concurrent treatment of substance use and PTSD. Current Psychiatry Reports, 18(8), p. 70.
  5. Substance Abuse and Mental Health Services Administration. (2022). Co-occurring disorders and other health conditions.
  6. National Institute on Drug Abuse. (n.d.). Comorbidity: Substance use and other mental disorders.
  7. National Institute of Mental Health. (2021). Substance use and co-occurring mental disorders.
  8. Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders.
  9. Substance Abuse and Mental Health Services Administration. (2014). Treatment improvement protocol (TIP)-Trauma-informed care in behavioral health services: Chapter 5.

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