Addiction

“How many mental health problems. From drug addiction to self-injurious behavior, start as attempts to cope with the unbearable physical pain of our emotions? If Darwin was right, the solution requires finding ways to help people alter the inner sensory landscape of their bodies. Until recently, this bidirectional communication between body and mind was largely ignored by Western science, even as it had long been central to traditional practices in many other parts of the world, notably India and China. Today it is transforming our understanding of trauma ad recovery.” Bessel Van der Kolk

Addiction is a chronic brain based medical health condition that is treatable. Early trauma and childhood adversity can make us susceptible and raise our risk for later substance abuse issues. The hallmark of all addictions is the feeling of having no control and the biochemical changes that occur within the brain as a result of the addiction. Dr. Daniel Sumrok, the Director of the Center for addiction services says it shouldn’t be called “addiction”, instead it should be called ritualized compulsive comfort seeking. The compulsive behaviors are our bodies attempt to feel better and relieve suffering and help us feel better.

Common Addictions or comfort seeking compulsive behaviors Include:

Food               Drugs              Alcohol           

Love                  Nicotine          Gambling

Shopping         Exercise           Caffeine

 

Understanding the role of trauma and adverse childhood experiences often at the root of addiction along with the interplay of genetic factors, brain based changes in the reward circuitry and the impact of the social determinants of health allow us to begin to address the intergeneration patterning of substance use disorders. Trauma and adversity in early childhood changes the brain and sets the stage for later substance use.

“We found that the compulsive use of nicotine, alcohol, and injected street drugs increases proportionally in a strong, graded, dose-response manner that closely parallels the intensity of adverse life experiences during childhood. “

-Vince Felliti (Adverse Childhood Experiences study)

Individuals who reported five or more ACES were three times more likely to misuse prescription pain medication and five times more likely to engage in injection drug use. Among the different forms of adverse childhood experiences sexual abuse and parental separation (women) and physical and emotional abuse (men) appear highly correlated with opioid abuse.

 

Adult survivors of trauma become increasingly responsive to relatively minor stimuli as a result of decreased frontal lobe functioning (learning and problem solving) and increased limbic system (amygdala sensitivity (impulsiveness).

-Streeck-fischer&van der kolk, 2000

In order to learn, problem solve and make healthy decisions we need to be in a non-hyper-arousal state to begin to activate the prefrontal cortex. This is why a trauma informed culture and trauma informed care is paramount to successfully working with families devastated by substance use, trauma and adversity. Part of effective addiction treatment is working with the body to learn alternate strategies to reduce chronic stress and activation of the nervous system. It is important to give yourself healthier and kinder ways to allow yourself relief from suffering and strategies to use to begin to feel better after we let go of our various addictions.

What can we do??

We understand trauma changes the brain and our approach to care accommodates these changes.

Principles of a Trauma Informed Approach

• Safety
• Trustworthiness and transparency
• Collaboration and mutuality
• Empowerment
• Voice and choice
• Fallot 2008, SAMHSA, 2012