Blog
Adolescent Substance Abuse and Trauma
Monday, August 29th, 2011 in Addiction, Adolescents and Families, Trauma
Adolescent Substance Abuse is America’s #1 Public Health Problem, according to the June 2011 study by the National Center for Addiction and Substance Abuse (CASA) at Columbia University (www.casacolumbia.org/upload/2011/20110629adolescentsubstanceuse.pdf). The CASA report states that childhood trauma, including: abuse; neglect; and household dysfunction are significant risk factors for adolescent substance abuse. The CASA study also states that a lack of education and training on this topic leads to failure in addressing it with adolescents. Only 6.4% of adolescents in need of treatment receive it and we all know the impact of untreated substance abuse disorders in our clients.
Substance abuse, like any other self-harming behavior, begins as a survival strategy. It starts out as a way to regulate dysregulated arousal states that may develop as a result of: disorganized attachment issues; emotional, physical and sexual abuse; neglect; co-occurring mental health disorders (e.g., depression, anxiety); and grief and loss. Initially drug and alcohol use seem to alleviate stress, either through the increase in pleasurable sensations and emotions or the avoidance of intense, trauma related emotions and sensations. In the long run, substance abuse takes on a life of its own because more of the psychoactive substance is required to achieve the same effect and, eventually, adolescents need to use psychoactive substances to deal with the symptoms of physical and emotional withdrawal. They do not use to “feel good”; they use to “feel less bad” on so many levels. Substance abuse also puts adolescents at risk for additional trauma (e.g., sexual and physical assault, injury).
Trauma, and its impact on mental health and substance abuse issues, must be addressed concurrently in treatment. We need to validate the adolescents’ creative, albeit maladaptive strategies to self-regulate their arousal system and develop compassion and acceptance to counteract the shame and guilt that is the inevitable result of addiction and trauma. When treating this population, we must address how the use of psychoactive substances has helped the adolescent to cope. We should explore the thoughts, emotions and sensations that are being managed by substance abuse in order to identify the symptoms that will be exacerbated as substance abuse decreases. We should identify interventions specifically targeted to increase the range of coping strategies for adolescents as they begin to “crowd out” substance use as their primary coping strategy. I have had the wonderful opportunity to complete Level 1 of Sensorimotor Psychotherapy training as developed by Pat Ogden and I am currently studying Level 2. It is so important to help adolescents recognize sensations in their bodies. Once they are tuned in to these sensations we can teach them to regulate and manage them so they can remain grounded and centered in their bodies. When this is accomplished, they don’t need to use alcohol and other drugs to regulate these experiences in a maladaptive way.
Join us on Monday, September 19 for the workshop, Making the Connection: Adolescent Substance Abuse & Trauma to learn about assessment and treatment strategies for adolescents impacted by traumatic stress and substance abuse. In this training, we will explore how to provide trauma-specific, integrated treatment strategies and interventions for working with adolescents with substance abuse disorders. All of the aforementioned issues will be explored in the training. Please join us for an opportunity to share your knowledge, expand your education, and to learn trauma-specific approaches to address adolescent substance abuse that you can use with your clients the NEXT DAY!
