Substance Dependence? / It's Not Your Fault / Start Healing

Substance dependence has been around for a very long time. Humans have used psychoactive substances to relieve their emotional pain since our earliest recorded history. Homer's Odyssey, written in the 8th century BC, tells us that Helen of Troy used a potion to treat Greek warriors, “presently she cast a drug into the wine of which they drank to lull all pain and anger and bring forgetfulness of every sorrow.” Experts believe this drug was most likely opium. The use of drugs to help comfort ancient warriors should not surprise us, but what makes substance dependence so common in our society?

Today, one-third or more of us depend on substances for emotional comfort, from prescription drugs for depression, anxiety, and ADHD, for example, to the use of cigarettes, alcohol, and marijuana to manage our stress, to the illegal use of opioids and other drugs to seek moments of joy and relieve our pain. Our current need for substances to soothe our emotional pain, and the devastating human consequences that often arise from them, seem greater now than ever before. Why is this so?

Research tells us that like the warriors of Homer’s Odyssey, difficult human experiences or trauma are what cause our emotional pain. And our need for substances to relieve our pain, whether prescribed, legal or illegal, is directly related to the amount of adversity we’ve experienced (see Adverse Childhood Experience (ACEs) study). The U.S. Substance Abuse and Mental Health Services Administration states that, “Trauma is a widespread, harmful and costly public health problem … It is an almost universal experience of people with mental and substance use disorders.”

The inescapable truth is that the harmful, costly and growing problem of substance dependence is just a symptom of a larger social problem of increasing human suffering and adversity. When this adversity begins in childhood, as so often is the case, the resulting harm is even more severe. Dr. Gabor Maté, a best-selling author and leading authority on addiction writes in his book, In the Realm of Hungry Ghosts: Close Encounters with Addiction: “It’s just as many substance addicts say: they self-medicate to soothe their emotional pain—but more than that, their brain development was sabotaged by their traumatic experiences.”

That is, childhood adversity stunts normal brain development. The reason that opioids are so powerful for those who have experienced childhood adversity is because they stimulate the love/pleasure/pain relief centers of the brain that were underdeveloped as a child. Recovery from their opioid addiction is also more difficult because they developed less capacity for self-regulation and intentional decision making during childhood, through no fault of their own. But this is not how we treat those who struggle with substance dependence.

Addicts are not normally treated with the kindness, care, and understanding needed to heal from their emotional wounds. They are told that their addiction is the problem, not the psychic pain from their life experiences that they’re trying to relieve. This only reinforces the stigma and shame that they already feel. The failure to acknowledge and address their underlying emotional pain likely explains why treatments for addiction most often fail, despite the rush to invest more resources in them. If you doubt there is a problem with current addiction treatment methods, here are some data points:

• Results from Project MATCH, "... the largest and most expensive alcoholism treatment trial ever conducted ... suggest that current psychosocial treatments for alcoholism are not particularly effective ... Overall, a median of only 3% of the drinking outcome at follow-up could be attributed to treatment."

• Dr. Gabor Maté writes in his aforementioned book, “In the United States opiate relapse rates of 80 percent to more than 90 percent have been recorded among addicts who try to quit their habit. Even after hospital treatment the readdiction rates are over 70 percent.”

• An article in The Atlantic states, “Peer reviewed studies peg the success rate of AA [Alcoholics Anonymous] somewhere between five and 10 percent.”

That current approaches to addiction treatment are largely ineffective may also explain why most people who struggle with substance dependence avoid treatment (SAMHSA estimates that 89 percent of people who needed substance use treatment in 2015 did not receive it). People not only avoid substance use treatment, but also fail to receive help for their underlying trauma. Per SAMHSA, “Unaddressed trauma significantly increases the risk of mental and substance use disorders ... However, most people go without the services and supports needed to overcome traumatic experiences.”

This leads to another important question. Because of their failure to address the underlying problem, could current addiction treatment approaches be causing harm? The Project Match study cited above states, “Exaggerated claims of treatment effectiveness can have undesirable consequences for patients, for therapists, and for science. Patients who fail an ‘effective’ treatment may feel even more hopeless. This increased despair may be extremely deleterious in people with such life-threatening habits.”

One does not need to speak with many addicts to understand these sober truths about their failed attempts to get help. Those who repeatedly fail treatment end up feeling like they’re broken and can’t be fixed. We know that as addiction treatment has expanded, so has the incidence of overdoses. What if these increases are related? We also know that many overdoses are not accidental. When a person overdoses to put an end to their suffering and hopelessness, the correct term is suicide. These are hard questions/truths, but we need to better understand the problem before we can hope to solve it.

It’s time for a different approach to helping those who struggle with substance dependence, one that recognizes the effects of childhood and adult adversity/trauma and seeks to facilitate healing of the underlying emotional wounds. Research on trauma recovery tells us that healing requires safety, connection, understanding, and empowerment. In the past year, we’ve offered workshops based on these healing principles for those looking to overcome substance dependence. One participant who had struggled with addiction throughout her adult life, experiencing multiple overdoses and relapses, said after the workshop, “I feel joy again, I feel love again, I feel worthy again ... and feel that I am no longer at risk of losing my sobriety ... I know I have the resources inside to heal and create a life worth living.”

If you’ve struggled with substance dependence and you’re looking for help, please visit our website, Katlyn’s Healing Center, where we offer free healing resources and an online Healing Support Program to assist those affected by trauma or other difficult life experiences. You may want to start with the presentation on Substance Dependence.

Our healing approach is based on five core beliefs that are offered here to give you hope:

• You’re not alone (we’re here for you).

• It’s not your fault. You’re a good person.

• What you feel is normal, given what you have experienced.

• You can learn skills to help yourself feel better

• Healing is also normal, with understanding, support, and practice.

That is, with sufficient understanding, support and effort, healing comes naturally. But your healing, like any journey, begins with a first step. So please take a step to help yourself and check out our healing resources. And if our approach to healing resonates with you, please encourage your peers and those looking to support your recovery to review the information as well. Then we can all make the healing journey together.