“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper, and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain.” ― Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction
When it comes to substance abuse and addiction, having an understanding of some of the most commonplace childhood traumas is extremely helpful, giving a foundation to more easily navigate the studies and statistics related to addiction. This foundation and the research surrounding it offer insight into the correlation between environmental or experiential trauma and the increased likelihood of addiction, for purposes of preventative and/or post-trauma addiction treatment.
Below is a list of the most common types of trauma children and teenagers can experience.
”[C]ausing or attempting to cause physical pain or injury.” –NCTSN
Types of physical abuse include, but are not limited to, hitting, punching, kicking, and burning. In extreme cases, physical abuse can lead to death. This type of abuse is marked by several physical indicators including bruising, swelling, lacerations on various parts of a child’s body. While play and curiosity lead to injury in many children, it’s important to note frequency, severity, and location of suspicious marks.
Also known as psychological abuse, this type of abuse can prove more difficult to identify and measure.
“Unlike physical or sexual abuse, where a single incident constitutes abuse, emotional abuse is made up of a series of incidents, or a pattern of behavior that occurs over time.” – Kali Munro
Emotional abuse includes insults, threats, criticisms, and humiliation that allow one person to gain power and control over another. Over time, victims can suffer from a wide range of health repercussions ranging from mental illness to substance abuse.
The American Psychological Association defines sexual abuse as, “[U]unwanted sexual activity, with perpetrators using force, making threats, or taking advantage of victims not able to give consent.” The shame associated with unsolicited sexual contact prevents many victims from disclosing their abuse, eliminating the prospect of early trauma intervention.
Self-medication, through substance use or other negative behaviors, is often the most viable option for victims as it allows them to maintain secrecy in regards to the abuse while numbing the emotional pain it continues to cause. According to AlcoholRehab.com, “Sexual abuse victims are…13 times more likely to abuse alcohol and 26 times more likely to abuse drugs than those who have not been sexually abused.”
ChildWelfare.gov defines neglect as, “The failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm.”
It comes as no surprise that substance abusing parents are often guilty of neglectful behaviors. Not only are the children subjected to early exposure to drugs and alcohol, but they are often charged with hiding their parents’ behaviors while attending to their own personal health and safety needs. Narcanon attests that, “[T]he most saddening byproduct of substance abuse is the neglect, abuse and maltreatment of children whose parents are addicted to drugs.”
Childhood trauma is by no means limited to physical, sexual, emotional abuse, and neglect. The National Child Traumatic Stress Network details other types of adverse childhood events that can impact one’s emotional and physical development.
The Adverse Childhood Experiences Study
The Adverse Childhood Experiences Study (ACES), conducted through a partnership between Kaiser Permanente and the Centers for Disease Control and Prevention, provides comprehensive, long-term data linking childhood trauma to alcohol and drug abuse as well as other chronic diseases and mental illnesses. According to the study, the more categories of trauma experienced in childhood, the greater the likelihood of alcohol abuse and illicit drug use later in life.
“[A]t least half [of addicts] have suffered at least one form of severe childhood stress and many have experiences multiple exposures. Among people with the most severe addictions, trauma histories are ubiquitous. And emotional sensitivity, which varies widely with genetics, may make experiences that would not be traumatic for most children intensely traumatic for some. Though all addiction is certainly not caused by trauma, it is becoming increasingly clear that it can be a big part of the disorder.’’ – Maia Szalavitz
Since 1998, ACE has published more than 70 research papers and continues to actively survey participants. As the data pool grows, the link between adverse childhood experiences and later emotional and physical health issues compounds. There are 10 factors accounted for in the original ACE questionnaire, meaning some types of childhood trauma remain unaccounted for. Some clinics have added items to the inventory to account for other adverse childhood events. The long-term study, however, includes the following:
- Physical, sexual, and verbal abuse
- Physical and emotional neglect
- A family member who is:
- depressed or diagnosed with other mental illness;
- addicted to alcohol or another substance;
- in prison.
- Witnessing a mother being abused
- Losing a parent to separation, divorce or other reason
Understanding Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) is a diagnosis that can present in those who have experienced a scary, dangerous, or life-threatening event. Whether the trauma is an isolated incident (accidents, natural disasters) or a prolonged event (repeated sexual, physical, emotional abuse, and neglect) the symptoms tend to surface quickly and often include hyperarousal/alertness, a re-experiencing of the event through nightmares and flashbacks, and avoidance of people, places, and things that the victim associates with the event.
PTSD and Substance Abuse
Without proper diagnosis and intervention, victims of adverse childhood events are likely to seek relief in other forms. For many, that manifests as drug and alcohol abuse. According to research, “…22%-43% of people living with PTSD have a lifetime prevalence rate of substance use disorders and the rate for veterans is as high as 75%.”
Knowledge is Power
While statistics like these are shocking, understanding some of the root causes that lead to drug and alcohol addiction is critical in the development of effective treatment programs. Studies like ACE have led many facilities to steer away from “tough love” interventions to embrace more compassionate, trauma-based treatment.
For addicts and their loved ones, this trauma/substance abuse research might come as a relief. A disease that is so often stigmatized can, in many cases, be attributed to uncontrollable factors that occurred in early childhood and adolescence. Treatment not only affords the addict with an opportunity to eliminate drugs and alcohol, but also to process these adverse childhood events in a safe and supportive environment.
Jen Anderson is a Licensed Clinical Social Worker (LCSW), sobriety coach, writer, and former alcohol enthusiast living in Florida with her husband and son.
Jen Anderson is a Licensed Clinical Social Worker (LCSW), Sobriety Coach, and former alcohol enthusiast living in Florida with her husband and son.