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A renowned addiction doctor believes trauma is the underlying cause of drug abuse. Dr. Daniel Sumrok and others don’t consider reliance on drugs or alcohol to be addictions.

Instead, they say that drug and alcohol use is really ritualized compulsive comfort-seeking. It’s an attempt to relieve the pain of what he calls adverse childhood experiences (ACEs). You can read more about his findings on ACEs Too High.

According to Sumrok, an early traumatic experience changes the composition of a child’s developing brain. The child suffers damaging toxic stress as a result. Unless the person learns healthy methods to deal with it, the pain is constant until he or she finds a solution.

Without a safe means of finding relief, the method to ease the trauma may become drug or alcohol use. The individual seeks to self-medicate to relieve the pain of the traumatic experience. Alcohol and drugs may bring the individual relief and pleasure. These sensations may mask the enduring pain of the adverse childhood experience.

The Hidden ACE

Dr. Sumrok believes the traditional drug abuse treatment is wrong. It subjects people to shame and pain instead of healing. To end drug and alcohol usage as a form of self-medication, finding a safe and healthy alternative is necessary.

Addressing the ACE is an early step in the healing process. In some cases, the client is aware of the traumatic experience. But, in others, it is unknown and the client may not have been aware an experience was traumatic. There are several reasons why a client may not know that an event was traumatic:

    • The child may have viewed an abusive situation as normal. He or she didn’t register the situation as traumatic.
    • Other siblings who experienced the same situation did not react to it in the same way as the client. This can cause him or her to believe that their reaction, rather than the actual event, was the problem.
    • Other siblings may deny the trauma took place. There is sometimes an effort to protect the dysfunctional home environment or abuser. This causes the individual to believe that he or she is the problem.
    • The client didn’t identify an event as traumatic. He or she was unaware of how the event caused devastation.
    • All trauma doesn’t arise from a single, stand-alone event. The trauma may have occurred on a consistent basis and was hidden under a shroud of normalcy.

Health care professionals have worked to address trauma at the National Center of Excellence for Integrated Health Solutions. One discussion highlighted the importance of including ACEs in treatment plans. It included reasons why identifying ACEs may be difficult.

Professionals use a test to begin searching for ACEs. The test identifies the type of trauma the client experienced. Professionals often administer the test twice.

For example, Sumrok asks his colleagues to administer the first test before he has met or spoken with the client about trauma. The next test occurs after Sumrok and his client have talked.

There is often a marked difference in the responses the client gives before and after the meeting. There are various types of situations and events the clients may not realize are traumatic. National Public Radio describes a test used to identify ACEs.

Types of Adverse Childhood Experiences

Many events can cause childhood trauma. Some include:

    1. Poverty

    2. Racism

    3. Homelessness

    4. The incarceration of a family member

    5. Parental divorce or separation

    6. The death of a loved one

    7. Physical and emotional neglect

There are many studies addressing the impact of ACE in treatment. Several are online at the Centers of Disease Control and Prevention (CDC) website.

Self-Medicating

Untreated trauma has dire consequences, according to the Robert Wood Johnson Foundation. Unless a child has therapy following the trauma, the pain from the trauma can last a lifetime. If he or she doesn’t find a way to cope with the experience, it creates a painful and damaging aftermath.

Enduring trauma at an early age changes the chemical makeup of the brain and can stunt a child’s emotional growth. The mind urges the individual to find a way comfort to their pain. These comforting tactics may be healthy or self-destructive.

Some people suffering from trauma begin to abuse substances at an early age. The drug may become the only coping mechanism the individual knows. The more drugs people consume, the more damage they may do to their brains and bodies.

Once the self-medication brings them pleasure by numbing their pain, dependence may begin. The individual rejoices at something that feels good and brings comfort. In response, the person’s brain releases dopamine. This pleasure-giving chemical prompts the user to continue using substances to sustain this feeling.

Drugs and alcohol alter the chemical functions of the brain. They can cause an overproduction of dopamine. This can soothe pain and create pleasure.

Thus, the body and brain may increasingly become more dependent on alcohol or drugs to produce positive feelings. People may then find it increasingly difficult to stop using the substances, because it becomes painful not to use drugs or alcohol. According the ACE perspective, this is not an addiction. It is a normal response to pain caused by trauma from negative childhood experiences.

The Dangers of Untreated ACE

Coupled with an untreated adverse childhood experience (ACE), dependency on drugs can be difficult or impossible to end. In this perspective, drugs are an attempt by individuals to self-medicate. The drugs themselves are not the cause of the problem.

Drugs are a coping mechanism. Their use should be viewed as a symptom of the problem, not the problem itself. The root cause of the problem is the ACE.

Using shame to stop drug or alcohol use is useless. Unless professionals discover an effective way to address and help the client understand and face the trauma they are experiencing, long-term recovery efforts are bleak.

Successful Treatment of Substance Abuse

An article on Train.org explains the role of ACEs in substance abuse and calls for changes in drug treatment methodology. Drugs and alcohol are not the individual’s main problems. Drugs and alcohol are his or her misguided attempt to relieve the pain of an underlying ACE.

For such individuals, drug use is an effort to numb the pain of their trauma. Without healthy methods to deal with their ACEs, they only know how to cope using negative solutions. To end drug dependence, they need to uncover their underlying trauma.

One way to address their trauma is to attend rehab for dual diagnosis treatment, treatment that addresses trauma as well as addiction. Inpatient rehab centers can help people heal from both conditions and find lasting recovery.

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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