Trauma Q&A

The importance of taking an integrated approach to co-occurring addiction and trauma disorders.

An integrated approach to co-occurring addiction and trauma disorders

Hazelden Betty Ford Foundation specializes in helping women and men find freedom from addiction and co-occurring trauma disorders. 

How common is it for addiction and trauma disorders to occur together?

The two conditions are closely linked and intertwined. We know that nearly two-thirds of women and men who seek treatment for alcohol or other drug addiction have a history of trauma.
Many trauma survivors turn to alcohol or other drugs to manage painful memories and other negative symptoms associated with trauma. The converse is also true: Individuals who abuse alcohol or other drugs may put themselves in dangerous or unsafe situations where they experience traumatic events or situations. For women, trauma commonly involves sexual assault or domestic abuse. For men, trauma is more often related to military combat or serious injury.

What prevents people from getting the help they need for co-occurring addiction and trauma disorders?

Stigma is a major barrier. Women—especially mothers—have a difficult time admitting they need help with what might be addiction. They identify with being the caregiver, not the person needing help and support. Rather than seeking treatment for addiction, many women get into treatment as the result of receiving medical or mental health care for anxiety, depression, irritability, or sleep problems.

Men experience the stigma, too. It's not easy for anyone to admit they might have a substance abuse or mental health problem, especially men who think they would let down their colleagues or appear incompetent or unreliable by seeking treatment. Even men who realize they need substance abuse treatment may not make the connection to trauma—that their angry outbursts or sleeplessness or severe anxiety might be related to post-traumatic stress.

Are there unique treatment challenges for people with both addiction and a trauma disorder?

Definitely. Because the two conditions are entwined in complex and multiple ways, the most-effective treatment addresses both disorders through a carefully integrated and calibrated approach. And it's important to provide services in ways that avoid re-traumatization while facilitating full participation in treatment.

That's why we focus on helping patients manage their emotional and physical symptoms of traumatic stress. Patients work on developing greater self-awareness and new skills around how to feel safe. This often involves learning to define and set personal boundaries, developing greater compassion for oneself and others, practicing honest communication, and building healthy relationships. It's an approach built on the values of safety, trustworthiness, and empowerment.

What advice do you have for women and men who are struggling with both substance abuse and a history trauma?

People can and do get well. We see it every day in the work we do. The self-awareness and new skills you develop as a trauma survivor will strengthen and support your recovery from addiction.

When you're in the midst of traumatic stress and addiction, the distress can feel overwhelming and unmanageable. But know that there is hope. Treatment does work. And life gets better.


Read More
Young girl in yellow dress running through field at sunset with large bouquet of balloons.

A Long Overdue Letter to "My Child Within"

An adult child of an addicted parent reaches in Read More >

Read More
Signs of addiction

7 Ways to Tell If Your Loved One Has an Addiction

Identifying addiction in a loved one and talking about it with them. Read More >

Read More
Ask your treatment provider important questions before signing an authorization for treatment

12 Questions to Ask Every Treatment Provider

A checklist for each alcohol and drug treatment program. Read More >