Today we know that there are various reasons and factors that can contribute to a substance use disorder. However, between 1995 and 1997 one of the largest ever studies of its kind was undertaken looking at Adverse Childhood Experiences and consequential health and social problems. This defining study was a collaboration between the Centres for Disease Control and Prevention (CDC) and Kaiser Permanente’s Health Appraisal Clinic in San Diego. Over 17,000 people took part in the study and they were asked to fill out a questionnaire that looked at various different types of childhood trauma.
The study was aimed at the middle class demographic – over three quarters of them had attended college and they all had jobs and good health care. Within this cohort of people, the average number of ACEs experienced by each individual was 2. The study was able to demonstrate a strong link between childhood trauma and adult health problems, including addiction. Of the people it observed who were in treatment for addictive behaviours at the time of taking the questionaire, it showed them generally to have been been exposed to 3 times more ACEs than the average in the cohort. Addicts therefore scored on average 6 ACEs. In a paper written by Vincent J Felitti, MD called “The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead”, which explored the results of the ACE’s study, he observed that the number of ACEs experienced ‘had a powerful correlation to adult health a half-century later.[1]’ He also explained that those people who scored 6 or more ACEs on the questionnaire were 4600% more likely to use intravenous drugs later in life.
Felitti’s observations were extremely powerful and raise the question that perhaps intravenous drug use, along with any other drug use, is a way to numb recurring pain that began in childhood. Are drugs simply ‘the best coping device a person can find?[2]’ This theory is reiterated by Janina Fisher in her paper “Addictions and Trauma Recovery,” where she proposes that addiction is simply a dysfunctional survival mechanism used by victims of trauma in an attempt to re-regulate a dysregulated nervous system. Trauma ‘interferes with the body’s ability to self-regulate both psychologically and somatically.[3]’
Trauma severely impairs an individual’s ability to function normally. Therefore in order to cope with a life that otherwise can seem too overwhelming for adult survivors of trauma, they often need to find strategies that help them self regulate. These strategies could be behaviours that they learned when they were young such as cutting, under or over eating or other forms of self harm. They could also be re-enacting the trauma that they themselves experienced. Anything that can help them disassociate from the recurring pain of the childhood trauma. When struggling with any trauma related symptom disassociation is a way to remove yourself from these experiences. Essentially detaching from your own mind and body. One of the fastest ways to detach from emotion and feelings is through high risk, addictive behaviours such as alcohol abuse, sex, drug abuse, gambling or anything else that releases adrenaline or endorphins into the system to give a temporary release from negative feelings associated with trauma. It therefore stands to reason that when trauma survivors use any of these high risk or addictive behaviours or substances, they are doing so simply to try to feel normal and relieved from pain. It could even be said that ‘addictive behaviors are ingenious ways of altering consciousness and changing psychophysiological experience.[4]’
The link between childhood trauma and drug misuse and abuse is fairly clear. It starts off as a means for survival, albeit a destructive one. However, due to the nature of addictive behaviours and substances and the reactions in our brains when we use them, what starts off as a tool to make life more bearable will develop into an addiction as the individual builds a tolerance to the substance or starts craving a bigger and bigger dopamine hit in order to numb the pain of the past. Eventually the addiction will become more dangerous and painful than the memories and symptoms of the original trauma.
[1] Felitti VJ. The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead. Perm J. 2002;6(1):44–47.
[2] ibid.
[3] Fisher J. Addictions and Trauma Recovery. Paper presented at the International Society for the Study of Dissociation, November 13, 2000. San Antonio, Texas
[4] Fisher J. Addictions and Trauma Recovery. Paper presented at the International Society for the Study of Dissociation, November 13, 2000. San Antonio, Texas
