Childhood Trauma and Addiction

December 2023

Mental Health

"Research spanning 20 years has shown a strong link between adverse or traumatic experiences in childhood and addictive behaviours in adulthood."

 

Sam (not his real name) is in his 30's and is currently seeking support at WE CARE for recovery from long-term drug use. In recollecting his childhood, Sam shared, "Growing up was hell. My siblings and I had to manage on our own. My parents were not home a lot. When they were, they were fighting. Shouting, hitting, throwing things - it was all normal for me."

Sam's childhood experiences echo the childhoods of many individuals who struggle with substance use. Adverse childhood experiences (ACEs) are defined as traumatic events experienced in the first 18 years of life, including, physical or emotional abuse or neglect, parental substance use and household violence. Research spanning 20 years has shown a strong link between adverse or traumatic experiences in childhood and addictive behaviours in adulthood. For example, individuals who report experiencing multiple adverse events in childhood are three times more likely to struggle with alcohol problems (Dube et al., 2002) and engage in problem gambling (Poole et al., 2017) in adulthood.

Exposure to traumatic childhood events has been established to be widespread both in developing and developed countries. Gomez and colleagues (2018) found that around 46.5% of the adolescents in their study sample from a national addiction treatment population in Singapore had experienced at least one ACE. Exposure to multiple ACEs was linked to drug-related substance use disorder, earlier drug initiation and more severe drug use.

Research on the relationship between traumatic childhood events and substance use highlights that addiction-related issues have much larger developmental and societal implications. It is so much more than the personal choice of one individual.

The Impact of Childhood Trauma

For survivors of childhood trauma, instability, danger, and the threat to one's safety is constant. The chronic stress from prolonged exposure to trauma leads to the excessive activation of the body's stress-response system. The experience would be like someone revving a car engine for months at a time. As a result of the 'stress alarm' constantly sounding, children who endure extended childhood adversity experience continuous arousal, anxiety, hypervigilance, and alertness.

In the longer term this stress system dysregulation during the critical years of a child's development, negatively impacts the development of an individual's immune system, emotion regulation skills and skills related to attention, concentration, and self-control.

The Link Between Trauma and Addiction

The main reason individuals use substance is for their immediate mood-altering effects. For example, opioids have calming intoxication effects as the nervous system is slowed down. Amphetamines have stimulating intoxication effects, producing energy and alertness. Additionally, activities such as sex and gaming may shift individuals out of numbness and allow them to feel some sensation in the short-term (van der Kolk, 2014).

Substance use is commonly stigmatised as a character weakness or personal failing of willpower. However, the association between adverse childhood events and substance use disorders suggests that substance use represents an individual's attempt to cope with the devastating biological and neurological impact of childhood trauma (van der Kolk, 2014). For example, an individual may use opioids to quiet intrusive thoughts or suppress the hyperarousal or anxiety due to elevated stress hormones.

Sam shared, "In my life, I never learnt to deal with emotions in a healthy way. I never received love or guidance about how to deal with things well. All I wanted was to escape. For my mind to have a break and stop worrying that something bad was going to happen. I did not know any other way. Friends who were also going through their own problems introduced me to how they coped. So, drugs became how I learnt to cope too."

Moving Forward

For longer term change to occur we need to move beyond blaming the individual, and to acknowledge the impact of adverse childhood events on health and wellbeing. Changes need to be made at every level in society. At a community level for example, important initiatives include public education campaigns promoting social norms against violence, mentoring programs that connect youth with caring adults and the early identification of at-risk families for family-centred treatment to reduce the impact of adverse childhood experiences.

 

By Laika