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How Trauma Affects Substance Use Disorder (SUD)

There is a well-known connection between trauma and substance use disorder (SUD). As all individuals are at risk of experiencing trauma throughout their lives, it is essential to address the influence of trauma on SUD. Moreover, as untreated trauma can inform relapse, even well into long-term sobriety, discussing the need for trauma-informed treatment for SUD recovery is crucial. 

Understanding SUD and Addiction

Before understanding the link that connects trauma with SUD, it is important to define SUD and its relationship with addiction. The National Insititute of Mental Health (NIMH) explains:

Substance use disorder (SUD) is a treatable mental disorder that affects a person’s brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD.

Thus, when people discuss addiction, they are referring to the most severe form of SUD. In other words, not everyone with SUD has an addiction. 

A publication by Johns Hopkins University provides a detailed list of diagnostic criteria for SUD, coined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In this publication, 11 criteria are listed, from increased tolerance to using substances in unsafe environments. The publication states, “SUDs are classified as mild, moderate, or severe based on how many of the 11 criteria are fulfilled: mild, any 2 or 3 criteria; moderate, any 4 or 5 criteria; severe, any 6 or more criteria.” Moreover, fulfilling six or more criteria indicates an addiction. 

Regardless of how many criteria are met, it is only a matter of time before SUD develops into an addiction. Nonetheless, untreated trauma is often the culprit of recurring substance abuse and addiction relapse.

Trauma as a Risk Factor for SUD

There are several ways that trauma affects both SUD and addiction. First, untreated trauma serves as a risk factor for substance abuse and, therefore, informs the development of SUD. According to Depression and Anxiety, “Ample evidence has shown that childhood trauma compromises neural structure and function, rendering an individual susceptible to later cognitive deficits and psychiatric illnesses, including schizophrenia, major depression, bipolar disorder, Posttraumatic Stress Disorder (PTSD), and substance abuse.”

It is important to understand that the effects of childhood trauma are long-lasting, as such an event occurs during primal developmental stages. Nonetheless, traumatic experiences beyond adolescence well into adulthood still increase an individual’s risk of SUD, especially due to self-medication. 

Understanding Self-Medicating Practices

Self-medicating is the use of alcohol and other drugs to treat, manage, or relieve otherwise distressing symptoms of trauma or another mental health disorder. Although self-medicating may provide temporary relief, it does nothing to treat underlying trauma. In reality, it only masks the underlying problem and informs worsening SUD symptoms, such as cravings and withdrawal. 

Trauma Perpetuates Substance Abuse

Another way that trauma affects SUD is by perpetuating maladaptive behaviors, including substance abuse. Traumatic experiences of all kinds can inevitably complicate an individual’s well-being, including their physical, mental, and emotional wellness. 

For example, following trauma, a person may experience unmanageable feelings of guilt or shame, thinking that they could have done something to avoid the traumatic event. Similarly, following trauma, a person may experience rumination and existential dread that interferes with their ability to function in daily life. 

Simply put, trauma deeply affects a person’s brain, which can cause them to engage in risk-taking, self-destructive, or otherwise maladaptive behaviors. Substance use is one of many behaviors that an individual may turn to in an attempt to cope with their complex thoughts and emotions. Once self-medicating practices are established, an individual’s brain will begin to rely on those substances to feel normal or to seemingly function normally in their lives. In this way, unresolved trauma perpetuates substance abuse. 

The Complexities of Relapse

When a person participates in a treatment program for addiction recovery, they may not yet understand how their past traumas have played a role in their recurrent substance abuse. Likewise, they may not recognize that they will need to address and overcome untreated trauma to effectively establish and maintain sobriety. Truth be told, underlying trauma must be addressed in treatment and recovery to minimize the potential for relapse. 

If trauma is left untreated or unresolved, a person is more likely to relapse in response to future stress or trauma that may occur in their life. Addressing trauma in treatment allows individuals to better overcome personal triggers from their past that may otherwise hinder their recovery if left unchecked. 

Treating SUD and Trauma at Malibu Wellness Ranch

At Malibu Wellness Ranch, we understand the complex challenges that addiction treatment can pose, especially in regard to unresolved trauma. Within our treatment philosophy, we acknowledge the necessity of proper diagnosis to ensure that every person has the best chance at securing lasting sobriety and recovery. A proper diagnosis allows staff members and clients alike to address the root causes of substance abuse symptoms that may have been fostered by unresolved trauma. 

Moreover, we are an experiential recovery facility that offers an abundance of opportunities for clients to heal, learn, and have fun in sobriety. We utilize a whole-person approach to care, fostering whole-person healing through a wide range of programmatic offerings and recreational activities. Additionally, we offer a specialized veterans program for those seeking recovery from trauma and SUD that may have manifested as a result of active duty. 

Healing from SUD involves more than ceasing substance abuse; it demands proper addressing and processing of underlying trauma and associated symptoms to best prevent future relapse. 


There is an undeniable link between trauma and substance use, particularly the development of SUD. To effectively heal from SUD and its effects, you must properly address your past trauma with the help of a professional treatment program. This will minimize any potential for relapse while allowing you to become aware of your triggers. Malibu Wellness Ranch is a substance abuse and addiction treatment facility that offers experiential treatment programming for those looking to achieve and maintain sobriety. Through a wide range of diverse therapeutic approaches and programs, you can achieve whole-person healing of the mind, body, and spirit. If you or a loved one is in need of treatment, call us today at (800) 862-5428.