Alcohol and Trauma: Drinking as a Way to Cope with the Past

Black-and-white photo of person sitting in window with glass and bottle of wine, hand pressed to headDid you know one of the main predictors for having a substance use disorder is experiencing trauma?

A quick internet search yields many definitions of trauma. I think the simplest definition is this: an emotional response to a terrible event.

Note I did not specify what type of event or what type of response. These are all individualized. What might be traumatic for me could have little or no impact on you. A person experiencing trauma is in the best position to define their experience based on what they are thinking, feeling, and going through.

In one survey of adolescents receiving treatment for substance use, more than 70% had a history of trauma exposure. Teens who experienced physical or sexual abuse were three times as likely to use substances than those who had not. And 59% of young people with posttraumatic stress (PTSD) develop substance use disorders.

Another study found 60% to 80% of Vietnam veterans seeking PTSD treatment have alcohol use issues. They tend to binge drink in response to memories of trauma. Of further concern, veterans over the age of 65 who have PTSD are at a higher risk of attempting suicide if they also have an alcohol use disorder and/or depression.

People who experience trauma and PTSD often turn to alcohol and other substances to manage the intense flood of emotions and traumatic reminders. They may also use it to try to numb themselves. Drugs and alcohol may initially dull the effects of trauma and help manage associated distress, but a dangerous cycle may begin.

After a traumatic event, a person may drink to deal with anxiety, depression, and irritability. Typically, alcohol initially seems to relieve these symptoms. When we experience a traumatic event, the brain releases endorphins that help numb the physical and emotional pain of the event. This is our body naturally helping us cope.

However, this interrupts the natural protective function the body was already doing. As a result, we create a type of emotional withdrawal that can set us up to deal with increased and prolonged distress that could lead to the development of posttraumatic stress.

Drinking may have been the “solution” you turned to, but it is likely making things worse. We will not take that coping skill away until we teach you new ones.

Drinking often can contribute to PTSD symptoms and increase irritability, depression, and feeling off guard. Some drink to deal with insomnia that results from anxiety, anticipating nightmares, and circular thinking. Drinking actually impairs the quality of your sleep, however, setting up a destructive cycle. Trying to avoid memories of trauma can make them emerge in your sleep. Drinking also can make therapy less effective because you are not allowing yourself to effectively deal with trauma in a safe, healthy setting with a trained professional.

People who use substances may be less able to cope with a traumatic event. They may have increased difficulty with emotional and behavioral regulation. When chemical use starts, development gets significantly impaired. As a result, the person may be more likely to engage in risky behaviors that can lead to additional trauma.

The combination of trauma and drinking can increase challenges related to getting close to people and having conflicts with the people you do have a relationship with. Heavy drinking often leads to a confused and disorderly life. The very thing a person needs is support and connection, yet those are often damaged as a result of drinking consequences and behaviors.

A good therapist knows drinking is generally not THE problem. It is usually a symptom of another problem. Often, the problem is trauma. In such cases, drinking is not generally about having fun. It is about managing the pain of what you are dealing with.

Effective treatment of trauma does not mean you have to talk about what happened. We don’t want you to reexperience it. That probably happens enough. We focus more on how it is affecting you today. Drinking may have been the “solution” you turned to, but it is likely making things worse. We will not take that coping skill away until we teach you new ones. There are many other, more effective ways to deal with the past than drinking.

References:

  1. Bombardier, C.H., & Turner, A. (2009). Alcohol and Traumatic Disability. In R. Frank & T. Elliott (Eds.), The Handbook of Rehabilitation Psychology, Second Edition (pp. 241–258). Washington, DC: American Psychological Association Press.
  2. Khooury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance Use, Childhood Traumatic Experience, and Post Traumatic Stress Disorder in an Urban Civilian Population. Depression and Anxiety. 27(12): 1077–1086.
  3. National Child Traumatic Stress Network. (2008). Understanding Links Between Adolescent Trauma and Substance Abuse: A Toolkit for Providers, Second Edition. United States of America.
  4. Trauma and Violence. (2015). Retrieved from https://www.samhsa.gov/trauma-violence
  5. Volpicelli, J., Balaraman, G., Hahn, J., Wallace, H., & Bux, D. (1999). The Role of Uncontrollable Trauma in the Development of PTSD and Alcohol Addiction. Alcohol Research and Health, 23(4), 256-262.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Cynthia Turner, LCSW, LSATP, MAC, therapist in Ashburn, Virginia

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • charla

    charla

    June 3rd, 2017 at 7:01 AM

    I was raped in college and never told anyone or reported it and there were so many feelings that I had inside, anger and rage really, that I would drink as a way to push those feelings aside. Nothing felt quite as bad when I would have a few drinks. Actually I couldn’t really remember too much of it so you know, I could block it all out for a while. I eventually had to come to terms with the fact that not only did I have unresolved issues with the traumatic event that I either had to come to terms with and get help for or I would suffocate from the pressure, I also had to accept that I had developed a drinking problem as a result.
    The last few years have been a chore for me, dealing with the things I didn’t ever want to have to cope with and doing it sober… but things have slowly gotten better and now I just take it one day at a time.

  • Cyndi Turner

    Cyndi Turner

    June 3rd, 2017 at 8:35 PM

    Charla- I am so sorry to hear that you had to go through that and then suffered in silence for so long. You sounds like a strong person who is now founding your way in life.

  • charla

    charla

    June 5th, 2017 at 8:25 AM

    Thanks for the support Cyndi. It has been a long hard road, but yes I finally feel like I am making it back through to the light.

  • Matthew

    Matthew

    June 7th, 2017 at 8:18 AM

    I suffered from a back injury a few years ago and turned to drinking to help deal with that pain. Unfortunately now I am addicted to both the alcohol and the pain medication. Not a great combo for a life to be lived healthy.

  • Cyndi Turner

    Cyndi Turner

    June 8th, 2017 at 12:54 PM

    Matthew- please reach out for help!!! Look for a therapist who understands both mental health and substance abuse issues. He or she can help you find other ways to cope that are not damaging to your health. I know it probably seems like nothing will work, but I have seen thousands of people come through all kinds of physical and emotional trauma and be healthier and happier than they work before.

  • reese

    reese

    June 12th, 2017 at 11:26 AM

    I think that for many people the drinking begins innocently enough and then turns into something more sinister before they even know that it is happening.

  • Bryan

    Bryan

    September 16th, 2017 at 4:39 PM

    I suffer from Ulcerative Colitis and being recently diagnosed with PSC(primary sclerosing Cholangitis) a rare uncurable liver disease from having Colitis for so long, I am in a bad flare with my Colitis currently and use to drink to escape the everday struggles of living with Colitis and PSC, I would drown myself with alcohol on Friday and Saturday evenings to the point where I would black out and not remember most nights. For the time when I was at the bar drinking I felt like a new person, I didn’t have to deal with my illnesses. I have decided to quit drinking for good after an incident I had with a good friend of mine, I got a little to rough with her and don’t remember any of that night until she told me a few days later when I was sober and I was surprised that she still wanted to talk to me, but shes a good friend and knows I am going through a lot in life right now and has said many times she is here for me. I have had UC for over 10 years now and suffer from depression on and off from having the illness and now being recently diagnosed earlier this year with PSC things just went out of control with drinking, I lost a sigh of who I was a person and isolated myself. Its not like we can talk about Colitis and having to go to the bathroom all the time because its a touchy subject that no one wants to hear about your bathroom issues. I seeked help a little while ago and saw a therapist for these issues. Just going to 1 visit with the therapist helped me a lot, I don’t plan on seeking further help because just getting my emotions and struggles out helped me that day so much. Its been a long roller coaster and will continue to be a long one with twists and turns but I just have to take it 1 day at a time. I have a newly born niece that I want to see grow up one day and cherish the memories as she grows up. I had to come face to face with the fact that I was becoming a raging alcoholic and I would drink to numb the pain away and escape life.

  • Ned

    Ned

    August 28th, 2018 at 4:22 PM

    I had a car accident nearly 20 years ago resulting in the death of another person, the cause was determined as not my fault but I have been plagued with guilt ever since. I started drinking to close out these feelings but never really heavily, I just became a regular drinker. Then about 10 years ago I suffered a massive trauma causing me life changing injuries and as a result I now live with chronic pain, but muddle through life using drink to soften my emotions. I don’t take pain killers as they make my emotions worse and I am unable to work while on them. I am now middle aged and desperately looking for help, but don’t know where to start. I worry if I tell my GP everything it will affect my future of getting life cover or a mortgage renewal. My fear is I am spiraling out of control with only pain killers and anti depressants as an option.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    August 29th, 2018 at 8:02 AM

    Hi, Ned. Thank you for sharing your story. If you would like to consult with a mental health professional, please feel free to return to our homepage, http://www.goodtherapy.org/, and enter your zip code into the search field to find therapists in your area. If you’re looking for a counselor that practices a specific type of therapy, or who deals with specific concerns, you can make an advanced search by clicking here: http://www.goodtherapy.org/advanced-search.html

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