Talking about traumatic events has been considered dangerous territory when treating addiction. Some people believe that cognitive behavioral therapy – the gold standard in treating trauma – resurfaces painful memories that people don’t have the tools to cope with, putting them at higher risk of drug relapse.
This assumption is incorrect, according to a June 2020 study from Johns Hopkins University. Treating post-traumatic stress disorder (PTSD) at the same time as addiction didn’t cause drug relapse, and it started reducing PTSD severity after just one therapy session.
For the study, the researchers asked participants about drug cravings, number of drug-using days, and other signs of distress. They found no increase in drug use or stress after PTSD therapy sessions. After nine therapy sessions, the severity of PTSD was reduced by 54% on average, compared to the first session.
“Now that we have evidence that treating PTSD won’t impact recovery, patients can request therapy, and mental health providers have a duty to make it available to their patients,” said Jessica Peirce, PhD, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.
The Link Between Substance Abuse and Trauma
Substance abuse and trauma often go together. About 25 percent of people with substance use disorders also suffer from PTSD. Trauma can lead to substance abuse and substance use disorder (addiction), often in an attempt to cope with depression, low self-worth and other PTSD symptoms. Substance abuse can also lead to trauma. In these cases, using drugs or alcohol leads to risky behaviors like driving under the influence, which can increase the risk of trauma.
The link between drug use and trauma is also strong in young people. Research shows:
- Teens who have experienced physical or sexual abuse are three times more likely to report abusing drugs or alcohol than those without a history of trauma.
- More than 70% of adolescents receiving treatment for substance abuse had a history of trauma.
- In a study of severely traumatized people, participants reported high rates of dependence on several drugs (39% alcohol, 34% cocaine and 44% marijuana). They also started using earlier than peers who didn’t have trauma.
At first, drugs and alcohol may seem like a solution to trauma symptoms, but over time they make the problem worse. Recovery is harder after a traumatic event, and some teens develop a second diagnosis – substance use disorder – that also requires treatment. Although these teens need specialized treatment, many don’t receive it.
What Type of Treatment to Look for if You Have PTSD and Addiction
The Johns Hopkins study underscores the importance of integrated dual diagnosis treatment for PTSD and substance abuse, which is care for both issues at the same time. In most cases – you get either trauma treatment or substance abuse treatment, not both. This type of treatment doesn’t address the underlying issues, which prevents long-term healing and increases the risk of relapse. So, you’ll need to do your research to find the most effective care.
Trauma-informed dual diagnosis treatment is unique in several ways:
- It’s delivered by clinicians who have training and experience in treating both trauma and addiction.
- It includes comprehensive assessments that consider trauma history and its relationship to the client’s current methods of coping, like substance abuse.
- It includes evidence-based interventions such as cognitive behavioral therapy to replace negative patterns of thinking and behaving with healthier ones.
- Early on in treatment, there is a focus on developing a sense of safety and avoiding re-traumatization, often using experiential and nonverbal approaches.
- Clients practice developing healthy coping mechanisms to replace substance abuse.
- Clients develop tools to enhance emotional and behavioral regulation.
- Relapse prevention planning takes into account trauma triggers as well as drug relapse triggers.
With dual diagnosis treatment, people can learn to process their sadness, anger and fear in healthy ways and develop coping strategies so they can move forward. Teens can focus on what really matters during this stage of life – figuring out who they are and having confidence-building experiences – without relying on drugs or alcohol to cope.