Pathways to Addiction: Trauma and Substance Abuse

Substance abuse develops for a range of reasons. Three common experiences can contribute to the development of addiction: trauma, stigma, and poverty. Over the next few months, I want to explore the role that each of these factors plays in the pathways to developing and maintaining addiction.

Pathways To Addiction: Poverty and Substance Abuse

Pathways To Addiction: Stigma and Substance Abuse

People do not develop drug addiction for no reason.

Most individuals with happy lives do not seek solace in substances. Those who turn to drugs or alcohol typically have an explanation for choosing to use drugs and alcohol. They tend to hide behind the haze of substance abuse to avoid dealing with some circumstance or situation.

Current research suggests that biological and environmental factors are about equally responsible for substance use disorders. Someone who struggles with addiction likely has a genetic predisposition or experienced difficulties during their life. There are many pathways to addiction but most of those share some commonalities. 

Trauma is one of the primary pathways to addiction. It is one of the most shared experiences among people who deal with drug and alcohol abuse. Traumatic experiences are life-altering and can lead to effects that last long after the event occurs. Unfortunately, drugs and alcohol are one way that people cope with their trauma.

What is trauma? How are trauma and substance abuse related? Why do people who experience traumatic events lean on drugs and alcohol? And how can people find an alternative solution to their struggles?

What is Trauma?

Trauma is the emotional response experienced after an unexpected alarming event. These include things like:

  • Severe accidents
  • Physical or sexual assault
  • Natural disasters
  • Abuse
  • Neglect

Shock and denial are common short-term responses to trauma. Most people process the difficult experience, move on, and can function normally within a few weeks. However, ongoing exposure to trauma can cause serious and lasting effects. This is especially true when trauma occurs during developmental childhood years.

Childhood trauma is an unfortunately common experience. Research shows by the age of 16, over two-thirds of children experience at least one traumatic event. At least 1 in 7 children experience abuse or neglect every year.1 Trauma that occurs during childhood and goes untreated can cause developmental delays and behavioral problems.

Someone who experiences a traumatic event but doesn’t work through it can have lasting effects. Long-term symptoms of trauma include things like flashbacks, extreme mood swings, psychosomatic symptoms, strained relationships, and more.2

How Can Trauma Lead to Addiction?

In the mid-1990s, Dr. Vincent Felitti wondered whether clinicians were looking at addiction from the wrong direction. Medical communities viewed substances themselves as the primary source of the problem. Felitti, however, noticed that many obese patients he worked with had former problems with alcohol, illicit drugs, and tobacco.

Dr. Felitti took these observations and looked further back into his patients’ lives. He found that many of them experienced at least some form of childhood trauma. Dr. Felitti coined these events “Adverse Childhood Experiences” (ACEs) and pursued his findings with a study.

Dr. Felitti released his findings in 1998 in the Adverse Childhood Experiences Study.3 His study was monumental and provided a deeper look into the lasting effects of childhood trauma. His research showed that individuals who experienced ACEs were 4- to 12-times more likely to develop substance use disorder, depression, and suicidal ideation. 

Results from the Adverse Childhood Experiences Study are still relevant today, with researchers referencing it in current studies more than 20 years later.4 The clear relationship between trauma and addiction suggests that 

Healing Trauma and Substance Abuse

The close connection between trauma and addiction suggests that treatment must consider more than the substances themselves. Removing drugs and alcohol without diving deeper ignores the root causes of these behaviors. As Dr. Felitti observed, people will likely look for another target to soothe the pain of those past experiences.

In a 2003 follow-up study, Dr. Felitti wrote, “Our findings are disturbing to some because they imply that the basic causes of addiction lie within us and the way we treat each other, not in drug dealers or dangerous chemicals.”5 He insists that treatment must incorporate the healing of trauma if addiction is to truly be treated.

Bessel Van Der Kolk is another author who unpacks the impact of trauma and its lasting effects. In his book The Body Keeps Score, he writes, “Being traumatized means continuing to organize your life as if the trauma were still going on – unchanged and immutable – as every new encounter or event is contaminated by the past. After trauma, the world is experienced with a different nervous system.”

Emerge Recovery is founded on the understanding that addiction will not go away unless those deeper wounds are healed. Treatment that doesn’t address the lasting impact of trauma only contributes to the revolving door of recovery.

We’re here to help people dive into those darker parts of their lives and heal those things left unhealed. Only by working through trauma can we come to a place of true healing. To learn more about our approach to treatment and recovery, schedule a No-Fee Recovery Activation Call today. We’re here for you every step of the way – you never need to struggle alone again.


1. Substance Abuse and Mental Health Services Administration. (2022). Understanding Child Trauma.

2. American Psychological Association. (2022). Trauma.

3. National Library of Medicine. (1998). The Adverse Childhood Experiences Study.

4. National Library of Medicine. (2021). The importance of adverse childhood experiences during the prenatal period.

5. Kaiser Permanente Department of Preventive Medicine. (2003). The Origins of Addiction.

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I’m here to help you get sober and stay sober. We’ll uncover what’s keeping you sick and why you’re stuck in the same cycle. Parts of you are begging to be healed but you can’t do it alone. Emerge Recovery is the first step toward learning to navigate and thrive in a life free from substances.

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