Trauma and Addiction: Signs, Symptoms, and Recovery

Trauma can occur from a single frightening event or prolonged exposure to scary or distressing situations. Without treatment, trauma can develop into post-traumatic stress disorder (PTSD), a mental health condition that causes persistent anxiety, intrusive thoughts, hypervigilance, and nightmares.

For people with trauma, it’s not uncommon to self-medicate with substances like drugs and alcohol. These conditions can co-occur, complicating treatment and making it more difficult to find healing. Dual diagnosis treatment, which addresses both disorders concurrently and how they affect each other, can promote better outcomes and lasting recovery.

Updated On: Feb 15, 2025
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Written by:

Amanda Stevens, B.S.

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    What you will learn
    • Trauma refers to distressing experiences that can cause ongoing stress and fear, and may develop into mental disorders like PTSD.
    • There are different types of trauma, including physical or sexual abuse, witnessing violence, experiencing terrorism or combat violence, and natural disasters.
    • People who experience trauma may turn to substances to relieve anxiety and intrusive thoughts possibly leading to addiction.
    • Treating trauma and addiction can be challenging, but dual diagnosis treatment addresses both conditions concurrently and how they influence each other.

    What Is Trauma?

    Trauma is a persistent emotional response to an event, series of events, or situations that someone perceives as harmful or threatening.[1] It can cause increased stress and other lasting impacts on well-being and daily function.

    Traumatic experiences can be shocking, scary, or dangerous, such as natural disasters, assaults, terrorist attacks, mass shootings, car accidents, or abuse. In some cases, the emotional response to a traumatic event or circumstance continues for long periods of time and interferes with everyday life, which is known as post-traumatic stress disorder (PTSD).

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    Types of Trauma

    What may be traumatic to one person may not be to another, but most people experience some type of trauma at some point. It can be a single event or ongoing experience, such as child abuse or living in a combat zone.

    Trauma is categorized as overt or covert. Overt trauma is a clear, definable event that’s considered generally traumatic, such as physical abuse, sexual assault, war, or natural disasters.[3] Covert trauma, also known as relational trauma, is subtle and may go on for long periods, such as emotional neglect from a parent, bullying, or experiencing racism.[4] Both types of trauma can have a significant impact on health and well-being.

    Some types of trauma have an increased risk of addiction, such as:[5]

    • Physical and sexual abuse: In a survey of over 600 people with substance use disorder, nearly half reported physical or sexual abuse. Women have much higher rates of both, but abuse in children has a higher risk of addiction at a rate of 74% for physical abuse and 73% for sexual abuse.
    • Violence: Victims of violent crimes or witnesses to violent crimes are more likely to engage in substance use and misuse. Exposure to domestic violence is also associated with a higher risk of substance use and addiction, particularly for women.
    • Military service: Military personnel who have had multiple deployments, combat exposure, and combat-related injuries are at a higher risk of developing an addiction. Studies also show an increase in alcohol or drug use after experiencing acts of terrorism.
    • Family conflict: Divorce and parental conflict, the loss of a parent, and poor family relationships can contribute to severe, chronic stress that can lead to addiction.
    • Racism and discrimination: Experiencing racism and systemic discrimination can cause chronic stress, increasing the risk of substance use and misuse. The same is true of discrimination based on gender identity.
    • Physical injury: A serious head injury, particularly in children, can increase the risk of addiction. This can be common in children and adults who are victims of abuse or violent crimes.

    The Link Between Trauma and Addiction

    People often engage in substance use to get the immediate psychological effects, such as a high or being “buzzed.” Alcohol and other drugs change the way you feel by causing pleasure and reducing negative feelings.

    However, for people with dysregulated stress systems that come from trauma, drugs and alcohol can offer a break from the constant state of arousal and anxiety. Alcohol, opioids, and benzodiazepines have a relaxing effect to relieve anxiety.

    Someone with trauma may be more vulnerable to addiction as a way to regulate their mood, shut off intrusive thoughts, and suppress the heightened state of arousal caused by stress hormones. They may feel numb from drug use, giving them temporary relief.

    Conversely, some people experience the ongoing effects of trauma as disengagement and a chronic feeling of numbness instead of a heightened state of arousal. In this case, they may turn to stimulants like cocaine or amphetamines to increase alertness and energy that snaps them out of their numbness.

    Because of this complex relationship, treatment for trauma and addiction requires a trauma-informed perspective and dual diagnosis treatment that addresses the experience and ongoing effects of trauma and addictive behaviors simultaneously.

    The Effects of Trauma and Addiction on the Body

    Trauma and addiction have some similar effects on the brain. They both have an impact on neurotransmitters that increase stress hormones and cortisol.[6] In fact, urine samples may reveal elevated stress hormones, which take a toll on the central nervous system over time.[7]

    Left untreated, trauma and addiction can cause chronic health problems, a higher risk of suicide, an increase in violence and legal issues, and a difficult treatment experience.[8]

    Treatment for Trauma and Addiction

    Trauma therapy is a type of psychotherapy that helps with processing and overcoming traumatic experiences. Trauma-informed care can address the impact of trauma on your mental and emotional well-being while avoiding re-traumatization.

    Other therapies can be beneficial in treating trauma and addiction with a dual diagnosis approach, including:

    • Cognitive behavioral therapy (CBT): CBT works to identify unhealthy thoughts and feelings that lead to your actions, helping you create healthier habits and understand what motivates you.
    • Family therapy: Depending on your individual needs, family therapy can be beneficial to create a safe space for everyone to share their experiences and gain support.
    • Holistic therapies: Holistic therapies take a “whole-person” approach to care that addresses the mind, body, emotions, and spirit.
    • Medication-assisted therapy (MAT): MAT is a medical intervention that uses medications to reduce substance cravings, alleviate withdrawal symptoms, and promote comfort to ensure you can focus on your treatment.
    • Gender-specific treatment: Men and women have unique needs and challenges with both trauma and addiction. Gender-specific treatment takes this into account to create a safe space for healing.
    • Experiential therapy: Experiential therapy is an interactive approach to treatment that involves musical or artistic activities, nature activities, or other experiential therapies that can help you create new associations with past experiences.
    • Eye movement desensitization and reprocessing (EMDR): EMDR is an essential part of treating trauma by helping you process past trauma and develop new thoughts, emotions, and behaviors associated with the experience.
    • Psychoeducation: Psychoeducation is a structured form of therapy to help you understand your disorder, treatment, and coping skills.

    Find Healing from Trauma and Addiction

    If you’re struggling with trauma and substance abuse or addiction, you don’t have to do it alone. Dual diagnosis treatment can help you address your past trauma, learn healthy coping skills, and learn to be present in your life while treating your addiction.

    Frequently Asked Questions about Trauma and Addiction

    What Is the Relationship Between Trauma and Addiction?
    Do You Treat Trauma or Addiction First?
    Can Addiction Be Caused by Childhood Trauma?
    Sources

    [1] What is trauma? – trauma-informed Care Implementation Resource Center. Trauma. (2022, July 8). Retrieved from https://www.traumainformedcare.chcs.org/what-is-trauma/ on 2025, January 22.

    [2] Mayo Foundation for Medical Education and Research. (2024, August 16). Post-traumatic stress disorder (PTSD). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967 on 2025, January 22.

    [3,4] Northwestern Medicine. (n.d.). Trauma: The root of substance use disorder? Retrieved from https://www.nm.org/healthbeat/healthy-tips/emotional-health/Trauma-the-Root-of-Substance-Use-Disorder on 2025, January 22.

    [5] U.S. Department of Health and Human Services. (2024, February 28). Trauma and stress. National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/trauma-and-stress#treatments on 2025, January 22.

    [6] Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in clinical neuroscience. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3181836/ on 2025, January 22.

    [7,8] Michaels, T. I., Stone, E., Singal, S., Novakovic, V., Barkin, R. L., & Barkin, S. (2021, June 19). Brain Reward Circuitry: The overlapping neurobiology of trauma and substance use disorders. World journal of psychiatry. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8209534/ on 2025, January 22.

    [9] U.S. Department of Health and Human Services. (2024, February 28). Trauma and stress. National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/trauma-and-stress#treatments on 2025, January 22.

    [10] Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010, December). Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depression and anxiety. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/pmc3051362/ on 2025, January 22.