The Relationship Between Interpersonal Trauma and Substance Use
By Gabrielle McCarthy
BA, BSN (non-practicing RN), MEd (Candidate)Traumatic events leave a lasting impact, shaping how one perceives the world, ourselves and others. Whether the trauma stems from childhood experiences or challenges faced in adulthood, it can profoundly alter your sense of safety and stability, leading to unhelpful coping strategies like substance misuse or other addictive behaviours to manage overwhelming emotions and stress.
Some of the impacts of trauma include anxiety, flashbacks, numbness, dissociation, shame and self-blame, anger, and difficulties sleeping.
Different types of trauma affect people in various ways. However, research highlights that interpersonal trauma, such as abuse or betrayal by trusted individuals, is particularly harmful. Research suggests that a history of interpersonal trauma was found to be associated with a higher risk of lifetime use of all drug types compared to non-interpersonal trauma.
Furthermore, research strongly links childhood trauma to addictive behaviours in adulthood, highlighted by the landmark Adverse Childhood Experiences (ACEs) study by Felitti et al. (1998). ACEs include early-life traumas like abuse, neglect, parental loss, witnessing violence and living with a parent experiencing mental health concerns.
When people experience trauma, particularly in their formative childhood years, it can leave lasting impacts. For example, a common consequence of trauma is the dysregulation of the nervous system.
Individuals use substances primarily because of their immediate psychological and physiological effects. Alcohol and drugs change the way individuals feel by producing pleasurable sensations and reducing negative sensations.
Individuals with trauma histories are often more vulnerable to addiction, using substances or behaviours as a way to manage their mood, silence intrusive thoughts, and dampen the heightened nervous system arousal caused by elevated stress hormones. For individuals dealing with trauma-induced nervous dysregulation, substances like alcohol, benzodiazepines, opioids, and cannabis may offer temporary relief by calming the nervous system and quieting the constant state of alertness or anxiety that often comes with trauma.
On the other hand, others, particularly those exposed to prolonged trauma, may experience feelings of dissociation or feel detached from themselves. This can lead to feeling chronically numb and emotionless. For these individuals, substances like cocaine, amphetamines and nicotine, which are known for their stimulating effects, can temporarily restore energy and alertness. Similarly, behaviours like nonsuicidal self-injury, sex, and gaming may provide a jolt of sensation, helping people escape their feelings of numbness and allowing them to feel some sensations, even if only for a short period of time.
Trauma and substance use are deeply intertwined, often creating a cycle that feels impossible to break. But you don’t have to face this alone. Therapy offers a safe space to explore your experiences, understand the connections between your trauma and coping strategies, and develop healthier ways to manage stress and emotions.
Citations:Levin Y, Lev Bar-Or R, Forer R, Vaserman M, Kor A, Lev-Ran S. The association between type of trauma, level of exposure and addiction. Addict Behav. 2021 Jul;118:106889. doi: 10.1016/j.addbeh.2021.106889. Epub 2021 Mar 9. PMID: 33735776.Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245-258.