If you have known anyone suffering from a substance use disorder, or have suffered from one yourself, then you know how difficult they are to treat. Addiction recovery is not always a simple one-shot deal. There is no magic bullet medication or therapy that delivers a 100% cure rate for all patients and unfortunately, relapse is a common occurrence. The National Institute on Drug Abuse states that drug addiction relapse rates are between 40-60%.
One reason for the difficulty in treating substance use disorders is that they don’t travel alone. Co-occurring disorders such as depression, anxiety, bipolar and PTSD are the norm, rather than the exception. “According to SAMHSA’s 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB), approximately 7.9 million adults in the United States had co-occurring disorders in 2014.” http://www.samhsa.gov/disorders/co-occurring
When one struggles with substances and a co-occurring condition (also known as a “Dual Diagnosis“), both are harder to treat. Each condition can, and usually will, exacerbate the other.
Co-occurring trauma (i.e. PTSD) and substance use disorder are especially difficult to treat if both are not addressed at the same time. Psychological trauma can come in many forms from childhood neglect or abuse, to full blown PTSD from extreme traumatic events such as rape or combat. These traumas have a profound effect on the human brain. The significant effects of trauma have been found in three primary neuronal systems– the hypothalamic-pituitary-adrenal axis, the locus coeruleus-noradrenegic system, and neurocircuitry interconnecting the limbic system and frontal cortex.
The consequence of these is a state of over-arousal, irritability, anxiety; poor sleep and increased frustration are often seen in victims of trauma. Frequently, those suffering these symptoms turn to substances to numb their pain, escape anxiety and induce sleep. While substance use alleviates symptoms temporarily, the brain actually increases the stress and arousal response to overcome the sedative effects of the substance. This creates a vicious cycle that continues to worsen symptoms and require greater quantities of substances to ease the pain. Furthermore, the consequences of using the substance actually lead to more psychological trauma due to impaired cognition and behavioral inhibition (i.e. drunk driving, promiscuous sex).
Substance use and psychological trauma must be addressed simultaneously to decrease the rate of drug relapses and to decrease the burden of trauma. Luckily, the recovery community has realized the importance of treating co-occurring disorders. Addiction specialists are increasingly trained not only in treating substances but also in treating trauma and treatment is most effective when individualized. The psyche of a substance user is complex and layered, as unique to an individual as a fingerprint. Although, there are commonalities like ridges, grooves and scars; each scar reveals its own story. Medical professionals have placed great focus on those scars and how to heal the trauma associated with them. Research is showing that effective trauma therapy is key to recovery.
If you or a loved one has suffered trauma and is struggling with an addiction, there is help available. Reaching out to a recovery center that integrates trauma and addiction therapy may be the best move you ever make.