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Trauma and Addiction

Cause & Symptom

 

One way to think about addiction is the acknowledgement that most if not all addiction has developed due to trauma. This might be a traumatic event or how one person has treated another. The feelings associated with trauma often vary from one individual to another. It could be that someone has a sense of feelings being unbearable, or a sense of not feeling anything at all. Before thinking a bit more about how trauma causes addictive behaviours, it’s worth considering what can be traumatic.

All human beings and animals require consistency and stability in order to survive. Anything that interferes with attachment; home; safety; can cause disruption. If disruption is sudden or continues for a while; it can cause trauma. Abandonment. Separation. Abuse. Hurt. Bereavement. It is clear these five states can lead to traumatic responses that potentially lead to shut-down and an inability to cope with everyday life. The definition of trauma is an emotional shock or injury or wound. An animal gets a fright and will cower or withdraw, or stop feeling hungry or sleep more than usual. Humans are no different. If anything, trauma can be described as the trigger and addiction the reaction.

Everyone has an addiction

Everyone has an addiction, whether that is through substances, behaviours, spending, how we treat people, personal care, health and fitness, gambling, general lifestyle, to name just a few. To carry out a particular task in a repetitive and compulsive way to the point of being out of control is an addiction. It is a coping mechanism to try and deal with what is happening; something to counteract fear and loss; both being traumatic. These components correspond with the five states of abandonment, separation, abuse, hurt and bereavement.

One of the challenges around trauma and addiction – particularly in a family unit/setting; is recognition of trauma and non-judgement of any subsequent addiction. Open and honest conversations are required – even though they are painful and difficult. It can be so hard to address the obsessive compulsive actions of a significant other, especially if their seeing it is too threatening, too distressing. When you apply an understanding of trauma into the interaction, this can help. Now the really challenging bit might be the need for a significant other to become aware of where they are in relation to the traumatised person struggling with an addiction. Judgement and prejudice are unhelpful responses that can ultimately prolong a trauma.

What to say to a traumatised person

So practical steps beyond openness and honesty around addiction is to ask a traumatised person what they need. It might sound like a strange question, but bearing in mind that trauma and addiction rocks the sense of self from a physiological axis; or as I like to think of it, each and every one of us walking across the map of life. When trauma comes it jolts consciousness and throws a person into chaos. When chaos is present then nurture and kindness need to come to the fore. It is just being with someone that is traumatised in a non-judgemental way that can change outcomes that may lead to addictive behaviours. With this in mind and considering children of parents that are struggling with addiction; it is important to note that a child’s role is never to look after a parent struggling with addiction; that mantle must be managed the other way round. However recognition and non-judgement are paramount. Complexity arises out of subsequent negative behaviours from parent to child born out of trauma and because of their addiction that may result in the five factors mentioned. When this happens then the cycle of trauma continues. This is why nurture and kindness are the key factors at key intervals. When we consider children that are struggling with addiction; then the power has always been with the parent, therefore recognition and non-judgement needs to balance with sensitivity and patience. If a parent struggles with holding these attributes, then they should seek support. If a child/young person is with a parent struggling with addiction, they should seek support. The experience of trauma is part of being human; how engaged we are with the healing process is a choice; but not a choice dependant on our own interpretation of experience with the five named factors.

These words are an invitation for a new conversation about family and therapy around trauma and addiction and the absolute link between the two. An individual struggling with addiction in a home is no different to someone living on the street. The only difference is primal; attachment, home, safety. It is warmth and consistency. It is family connection, in whatever form that may be. So much has been written about attachment, trauma and addiction; particularly around what is perceived to constitute a family. There are millions of people in the world that have lost family and friends, and do not have a secure base or home that they feel a sense of belonging to. The irony is the judgement. Trauma is not a weakness or fault. Probably the biggest secret and unhappiest betrayal of people is that we are all traumatised. If that is not addressed it will repeat – that is for certain. The reason why there are so many sectors of society working with trauma is because of its prevalence. It needs to be thought of in that context. When people are not supported, nurtured or filtered, trauma leaks. It is important to highlight that nobody wants to be addicted to anything. For many people it is about finding ways to live their life as free from addiction as possible. Addiction for many is to relinquish control of self.

When people live with addiction they are not selfish, or less than anyone else. They are trying to cope with unbearable feelings. Their window of tolerance is half-closed. They are traumatised.

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    Detoxification (detox) is the medical intervention required for someone who is physically dependent to drugs or alcohol. If required, medical detoxification would be the first step taken in residential rehab. Detox is used to prevent uncomfortable and dangerous (even fatal) withdrawals symptoms resulting in suddenly becoming abstinent from alcohol/certain drugs.

    The goal of a medical detox is to aid in the physical healing required following long term addiction and rid the body of all together of substance whilst providing a cushion for unpleasant symptoms of withdrawals. Detox is not considered the whole treatment for drug/alcohol addiction and it is always recommended that a comprehensive rehabilitation program is used along side to help maintain long term abstinence.

    Medication is often required for alcohol detox. If you are dependent on alcohol and experiencing withdrawal symptoms it is vitally important to seek medical advice prior to stopping. There is a long list of medications used when treating alcohol addiction and the exact medication given to an individual will depend on their needs/medical history. Some of these include;

    • Chlordiazepoxide (Librium)
    • Lorazepam (Ativan)
    • Diazapam (vailium)


    Librium and Valium are the most commonly used detox medication in the UK. All medication used to help with alcohol detox have been proven to help reduce the effects of withdrawal symptoms.

    There are also a number of drugs recombined by the NHS to help treat alcohol misuse. Some of these include:

    • Naltrexone
    • Disulfiram (Antabuse)
    • Nalmefene
    • Acamprosate (campral)

    Medication is always required for heroin detox. For someone suffering from heroin addiction, the thought of detoxification (detox) can be exceptionally daunting. Withdrawal symptoms from opiates, such as heroin, can be severe and include pain, vomiting, nausea and shaking.

    There are different ways that heroin detox can be carried out, most usually either ‘maintenance therapy’ or ‘full medical detox’.

    Attempting to switch from heroin to a heroin substitute, usually on a controlled prescription, is known as Maintenance therapy. Subsites used are most often methadone or buprenorphine.

    A full medical detox from heroin will always be carried out in a residential rehab setting and will allow the individual to switch form heroin to a substitute and slowly withdraw completing treatment free of all substances. Someone using a heroin substitute can choose to have a full medical detox at any time, however detoxing substances such a methadone can often add to the length of detox required. Drugs most commonly used to fully detox from heroin are, Subutex, Suboxone and Methadone. Much like alcohol, the exact drugs used will be dependent on the individuals needs/medical history.

    Once detoxed from heroin the risk of overdose is much higher following relapse due to tolerance following withdrawal.

    The length of treatment in a residential rehab depends on a number of elements. Some substances require longer periods of detox than others.

    Private paying patients will also often choose a length of stay that suites their therapeutic and financial needs. As a rule, a full treatment program in a rehab is considered to be 28 days (often referred to as a month), however, treatment is offered in several different ways and lengths starting at 7 days.

    Treating alcohol addiction will always require a minimum of 7-10 days, this would be considered the detoxification (detox) faze. The length required for treating drug addiction can vary drastically depending on the substance being used. Detox for Heroin addiction is generally around 14 days minimum, with more time required if substances such a methadone are being used. Treating prescription drug addiction can often take the longest. The time required for treating gambling addiction, eating disorders and sex addiction will be based on the individuals needs.

    Rehab programs can be as long as an individual requires but primary treatment is normally caped at 12 weeks, with the offering for further secondary and tertiary treatment thereafter.

    *based on average rehab stays, everyone will vary dependant on needs and medical requirement/history.

    There is no need for your employer to know that you are seeking help for trauma and addiction unless you choose to involve them with the process. All employers should have a policy that explains what you do if you cannot come to work due to illness – illness to include treating alcohol addiction/treating drug addiction.

    If your work absence extends over 7 days your employer is likely to require an official statement of fitness to work which would be obtained from your GP. This would need to supply evidence of your illness as well as any adjustments required for returning to work, fazed return or reduced hours, but does not need to specify in detail the reason why you have been absent.

    If you are absent from work for 7 days of less, for example entering rehab for a detoxification (detox) on a Saturday for 7-10 days taking a full week away from work, you can self-certify your illness by letting your employer work you will not be attending work for that period of time. Exactly how an individual would do this would be dependent on a specific companies’ policies on taking sick leave.

    Any time longer than 7 days it is likely an employer will require a note from the individuals GP certifying their sickness and a fit note on return. Most companies have a clearly outlined policy on sickness and receiving sick pay so the exact requirement can vary. A rehab will always be willing to advise on time off work.

    How much does rehab cost is a very frequently asked question. The cost of treatment can range from £1,000 per week upwards depending on the place, with luxury rehab being the most expensive.

    There are free options available on the NHS but the waitlist of those looking for free treatment is longer than that for privately paying patients. Some private health insurance policies will cover treatment in some rehabs around the country.

    Choosing the right rehab centre will often be based on priced but it is important to follow guidance on the most suitable treatment centre for an individual’s needs which our expert team of advisers are on hand to offer.

    There are certainly pro’s for both treatment near by and traveling for treatment with one of the most asked question being should I get rehab near me? There are rehabs all over the UK and around the world that all offer expert programs, let’s look at how to choose a rehab.

    Local treatment

    Being close to home gives certainly has benefits. Visitors are normally permitted in rehab following the first 7 days stay, therefore if an individual is in treatment for a length of time longer than that being local will make it easier for loved ones to visit.

    Most rehab centres will also provide a full aftercare plan for someone following treatment, this will include ongoing aftercare in the specific treatment centre. Living close by can make it easy to take full advantage of ongoing aftercare. There can also often be the option for ongoing care with an individual therapist, again being close by will allow that treatment to be carried out face to face.

    Some individuals wish to be local but are willing to look broader, for instance the greater city of residence (London, Manchester, Liverpool, etc)

    Treatment Away

    Getting treatment away from home can be very appealing to some. Being out of the local area makes it a lot harder to just walk out of treatment as resources locally are unknown. Some also take comfort in knowing that they are not near home and focus more on treatment.

    As the price for treatment can vary so much from one residential treatment centre to another, private paying patients often would rather travel to keep the cost down. Those using private health insurance may also have to travel to find a treatment centre covered in their policy.

    When opting for treatment away from home this can be anywhere in the UK and also abroad. Aftercare can still be carried out and very successful using tools such as The Online Rehab.

    There is no right or wrong when choosing where to go to residential rehab, but our expert advisors are always on hand to help provide information on all possible options.

    Whilst millions of people in the UK have taken recreational drugs (amphetamine, cannabis, cocaine, crack, crystal meth, GHB, heron, ketamine, methadone, and prescription drugs) and drank alcohol not all become ‘addicted’. Most recent reports show that 279,793 individuals were in contact with drug and alcohol misuse services in the last year with over half of that being from opiate addiction and a quarter for alcohol.

    There are several risk factors invoiced in addiction and those using drugs and alcohol socially, simply take the risk. These risks are as follows;

    Tolerance – basically, if a substance is used repeatedly an individual’s tolerance to it will build. This will result in more of the same substance being required to get the same effect. In the long run this can easily lead to addiction and physical dependencies.

    Environmental risks – these can include influences such a peer pressure and stress as well as physical or mental abuse of an individual (particularly as a child). Overall, those who live with frequent pressures and stress are more likely to reach for a substance to cope and are therefore at higher risk of becoming addicted.

    Drug type – it is very well known that certain drugs are simply more addictive than others. Using substances such as heroin increases the risk of becoming addicted for need to ‘chase’ a high as well as physical dependency.

    Drug administration – how a drug is administered can affect its addictive qualities. A drug injected rather than smoked or snorted will release a quicker and more intense high thus making it psychologically (and in many cases physically) more addictive.

    Biological factors – it is now widely reported that being an addict is not only psychological but also biological. This includes your genetic makeup, mental health, sex and age. It is also reported to be 8 times more likely for the child of an addict to become an addict themselves.

    Its believed that addiction is approximately half genetics and therefore some are 50% more likely to become addicted than others.

    How do you help a loved one trapped in addiction?

    The first step is to help and encourage the individual to become willing to accept help. They do not need to be shouting this off the rooftops, but they do need to be willing to go into treatment. There are ways to help someone become willing to get treatment for alcohol or treatment for drugs.

    Set boundaries – set boundaries and stick to them. Once you have laid them out follow through with whatever consequences you have set however hard it is.

    Stop finances – if you are financially supporting someone stopping these finances can be the quickest way for the addict needing to ask for help. With no money to acquire a substance an addict’s options become very limited.

    Intervention – getting together with other family members/friends/colleagues and staging an intervention is often very successful in the fist stage of acceptance and gaining an admission to residential rehab.

    You can’t make them quit, this can lead to dangerous withdrawal. Boundaries are very important in helping someone become willing to get help. Unfortunately you cannot do someone’s recovery for them and without self-motivation it is very hard to make it work.

    The next step is to call our highly trained advisers 0203 955 7700.

    There is a huge range of rehab options available and where to start can be completely over whelming so let us help.