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Medically Reviewed by Dr. Mohammed Saeed, MD.

The number of Americans living with substance use disorders is daunting, with a 2018 national survey conducted by the National Survey on Drug Use and Health finding that 20.3 million people ages 12 or older had a substance use disorder within the previous year. Even more tragically, the National Council for Behavioral Health reported that more than 222 million Americans, or 70% of adults, had experienced some form of psychological trauma in their lives.

Extensive research over a period of decades has concluded that trauma plays a role in almost every substance use disorder. Why does this connection exist and what can be done about it?

Explaining the Link Between Trauma and Substance Abuse

woman reaching for pills to deal with past traumaResearchers who explore trauma’s impact on our behavior have suggested several theories to explain the link between substance use and trauma.

One well-known theory is the self-medication hypothesis, which suggests that substance abuse is a means to cope with or counteract the brain’s reaction to trauma. In this case, individuals would turn to substance use as a way to cope with the experience of living with trauma and traumatic memories.

Another theory, known as the shared vulnerability hypothesis, states that trauma and addiction are connected because they share the same risk factors, whether environmental or genetic. For example, individuals who live in high-risk households where violence or crime are present may be more likely to experience trauma and engage in substance use because they experience risk factors for both conditions.

Another theory called the high-risk hypothesis connects the lifestyle choices that substance abusers may make under the influence with their increased risk of suffering a traumatic event. In this case, researchers believe that individuals who struggle with addiction may be at higher risk for experiencing trauma such as assault, crime, and emotional and physical abuse.

Researchers also know that trauma that occurs in childhood may be particularly problematic and is more likely to lead to later substance use. In addition, childhood trauma can encompass a variety of events from physical or sexual abuse to traumatic grief to natural disasters.

Finally, the susceptibility hypothesis proposes that the use of addictive substances puts an individual at a higher risk for developing mental health issues such as PTSD after experiencing a trauma. In this hypothesis, researchers believe that individuals who struggle with addiction may be more likely to develop psychological complications from the trauma they experience in their lives.

It’s important to note that we don’t fully know why trauma makes addiction more likely or vice versa. Everyone’s life experiences are unique, so there may be no one-size-fits-all answer to this question. But we do know that there is a strong connection between experiencing trauma and engaging in substance use, which is why reputable treatment programs emphasize trauma therapy as part of their recovery program.

Signs of PTSD

PTSD, or post-traumatic stress disorder/syndrome, is an anxiety disorder that up to 8 out of every 100 Americans experience after a traumatic event. Military combat, sexual assault, or a car accident can all result in PTSD for some individuals. Symptoms of PTSD include:

  • Experiencing attitude and behavioral changes, such as being easily irritated and angered
  • Having difficulty sleeping and concentrating
  • Feeling numb and avoiding people, places, or activities
  • Reliving the trauma, experiencing flashbacks, and having nightmares

While PTSD is a serious mental health disorder, individuals don’t have to experience PTSD in order to feel the after-effects of trauma. Whether you are struggling with PTSD or not, your present behavior is likely shaped in some way by past traumatic experiences in your life.

Treating Trauma and Addiction

While there is no program that can “cure” trauma or addiction, recent research on dual diagnosis indicates that treating these conditions separately is not successful. Instead, researchers recommend an integrated plan which addresses both the trauma and the substance abuse in order to achieve the best possible outcome.

Such a treatment plan will usually involve both medical and therapeutic care. This enables the individual to manage the symptoms of their trauma without drugs or alcohol while they detox and learn aftercare steps to help them stay sober.

At Into Action Recovery Centers, we understand the importance of treating trauma alongside addiction. That’s why we incorporate individual and group therapy into our treatment program, allowing our clients space, support, and stability they need to address past traumatic experiences. When searching for a treatment program to meet your needs, we strongly encourage you to look for a program that addresses trauma as part of the recovery process.


Dr. Mohammed Saeed, MD.

Dr. Saeed is a psychiatry specialist with over 40 years of experience in the medical field. He received training in General Psychiatry at the University of Texas Medical Branch, where he was selected as the Medical Director of the Division of Child and Adolescent Psychiatry. He currently serves as the medical director at Into Action Recovery Centers. Full Bio

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