Trauma-Informed Addiction Treatment

People who struggle with addiction often have experienced some type of trauma in the past. Treatment of the addiction in these people must take the trauma and the needs of the individual into consideration in order to achieve a successful outcome.

What Is Trauma?

Trauma is an overwhelmingly distressing event in someone’s life that has long lasting effects on their emotional well-being. It often causes shock and even denial, meaning that the person does not process their feelings about the event. This can cause ongoing negative emotions such fear, anxiety, anger, sadness, hopelessness, or guilt. Some people go on to develop post traumatic stress disorder (PTSD), which can cause physical symptoms as well, which may include headaches, dizziness, gastrointestinal issues, and flashbacks.

Traumatic events can occur in war or natural disasters, or they can be accidents, rape, witnessing death, physical or emotional abuse, whether as a child or in a domestic violence situation, or any other distressing occurrence. Some people, such as first responders, may experience traumatic situations on a regular basis.

The Connection Between Trauma and Addiction

It’s estimated that about 75% of people who struggle with a substance use disorder have experienced trauma of some kind. These people turned to drugs or alcohol in order to treat the negative emotions and other symptoms that stem from the trauma. They are essentially self-medicating their mental health issues.

This is why groups of people who regularly encounter traumatic situations, like first responders, have high substance abuse rates. They are medicating the negative effect of the horrible situations that they see on a daily basis.

What Is Trauma-Informed Addiction Treatment?

Trauma-informed addiction treatment is treatment that considers the past trauma when treating the substance abuse disorder. It recognizes that that the addiction cannot be treated without also addressing the traumatic event(s) and its effects. Essentially, both the trauma symptoms and the substance abuse disorder are treated at the same time.

 

Treatment Methods Used in Trauma-Informed Addiction Treatment

Several types of evidence-based treatments are used in trauma-informed addiction treatment.

• Eye Movement Desensitization and Reprocessing (EMDR): This is a therapy designed to change the way the participant perceives the memories of a traumatic event using guided eye movements and audio stimulation. The end goal is to change the response to the memory into something positive. For example, instead of feeling guilt or shame about the event, the person will feel proud of themselves for surviving.
• Dialectical Behavioral Therapy (DBT): DBT teaches the participant skills to cope with and manage the negative emotions that stem from the trauma. They learn to cope in healthy ways rather than turning to drugs and alcohol.
• Seeking Safety: Seeking safety also teaches healthy coping skills and emotion management. It can be an individual or group therapy.
• Cognitive Processing Therapy (CPT): In CPT, the participant confronts their traumatic memories and learns to think about them differently with the help of the therapist.
• Prolonged Exposure Therapy: In a safe, therapeutic environment, the participant is exposed to things that trigger their traumatic memories and practices coping strategies to deal with these triggers and the associated memories.

 

Key Principles of Trauma-Informed Addiction Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) has defined certain principles that should guide trauma-informed addiction treatment.

• Safety: The treatment environment should be one in which both participants and facility staff feel physically and mentally safe.
• Peer support: Peers in treatment should form mutually supportive relationships, which can help them feel less isolated. They can begin to feel safe and hopeful by sharing experiences and emotions with people who are going through similar struggles.
• Trustworthiness and transparency: Trust must be established between staff and participants through transparency.
• Collaboration and mutuality: The treatment should be a collaborative process in which both staff and participants have input into the treatment process. They work together to meet treatment goals.
• Cultural, historical, and gender issues: Treatment takes these issues into account without bias or stereotyping.
• Empowerment, Voice, and Choice: Participants should feel empowered to make choices about their treatment.

The Structure of a Trauma-Informed Addiction Treatment Program

Because it’s recognized that so many people who struggle with addiction have experienced trauma, many substance abuse treatment programs incorporate trauma-informed treatment into all of their treatment programs. These programs generally have three structures that may be standalone programs or parts of a comprehensive treatment program.

1. Inpatient Treatment

A 30 to 90 day inpatient treatment program includes a period of detox and therapy, both individually and in groups. Group therapy is an important part of the treatment process, giving you the opportunity to share your feelings, experiences, and challenges with peers. You’ll likely form mutually supportive relationships with some of these peers which may last beyond treatment. This follows the SAMHSA principle of peer support.

2. Partial Hospitalization Program (PHP)

A partial hospitalization program (PHP) allows you to live at home while attending treatment four to six hours per day, five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

Often, a PHP program is a transitional step that occurs after inpatient treatment, although it can be a standalone treatment option.

3. Intensive Outpatient Program (IOP)

An intensive outpatient program (IOP) consists of two to three hours of therapy three days a week for six to twelve weeks. In many programs, sessions are held in the evenings so that you can still go to work or school.

IOPs can be standalone treatments, or they can be attended after inpatient treatment, PHPs, or both.

For severe addictions, the ideal treatment is an inpatient program followed by a PHP and an IOP. After the treatment program, many people find it helpful to attend support group meetings, both for their addiction and the trauma. Recovery is a lifelong process, and having this kind of ongoing peer support can be invaluable.

In Closing

Addiction often comes when substance abuse is a reaction to past trauma. It’s critical that the trauma be addressed in order for addiction to be successfully treated. Bridges of Hope offers programs that can help you with both. We are dedicated to providing comprehensive, compassionate, individualized care. Give us a call today to take the first step.