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Science Trauma

mr peabody

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Dr. Daniel Sumrok


Is childhood trauma the root cause of addiction?*

by Jane Ellen

"When you’re a child, you can’t control the people who abuse and assault you, who create hostile environments. If a child can’t control their environment, because of these things they grow up thinking they’re bad, different, horrible people. This new approach helps them feel like they’re not drowning anymore."

Introducing Dr. Daniel Sumrok, director of the Center for Addiction Sciences at University of Tennessee’s College of Medicine. The center is the first to receive the Center of Excellence designation from the Addiction Medicine Foundation, a national organization that accredits physician training in addiction medicine. Sumrok is also one of the first 106 physicians in the U.S. to become board-certified in addiction medicine by the American Board of Medical Specialties.

"Addiction shouldn’t be called “addiction,”it should be called “ritualized compulsive comfort-seeking,” says Dr. Sumrok. "Ritualized compulsive comfort-seeking is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed."

"The solution to changing ritualized compulsive comfort-seeking behavior to address a person’s adverse childhood experiences (ACE) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail. My patients seem to respond really well to this,” he says.


Sumrok, a family physician and former U.S. Army Green Beret who’s served the rural area around McKenzie, TN, for the last 28 years, combines the latest science of addiction and applies it to his patients, most of whom are addicted to opioids. He sees them in the center’s two outpatient clinics: his clinic, which the Center for Addiction Science has taken over as its rural clinic, and another that opened recently in downtown Memphis.

Since he first sat down in the early 1980s to write a research paper (“Public Health Legacy of the Vietnam War: Post-Traumatic Stress Disorder and Implications for Appalachians”) to describe the symptoms of the newly named post-traumatic stress disorder in Vietnam veterans – “problems with the law, having trouble sleeping, anxiety, divorce, sleep troubles, substance use disorders, depression, anxiety, cognitive and chronic pain issues” — Sumrok has pieced together the ingredients for a revolutionary approach to addiction. It’s an approach that’s advocated by many of the leading thinkers in addiction and trauma, including Drs. Gabor Maté, Lance Dodes and Bessel van der Kolk. Surprisingly, it’s a fairly simple formula: Treat people with respect instead of blaming or shaming them. Listen intently to what they have to say. Integrate the healing traditions of the culture in which they live. Use prescription drugs, if necessary. And integrate adverse childhood experiences science: ACE.

ACE understanding changes practice

Learning about ACE more than two years ago was a big turning point for his understanding of addictions, explains Sumrok. “I was working in an eating disorders clinic and someone told me ‘90 percent of these folks have sexual trauma’. I remember thinking: That can’t be right. But that was exactly right. Since I’ve learned about ACE, I talk about it every day.”

He also practices it every day, by integrating ACE assessments for all patients in his clinics. He currently has about 200 patients who are addicted, most to opioids (heroin and prescription pain relievers, including oxycodone, hydrocodone, codeine, morphine, and fentanyl). “I’ve seen about 1,200 patients who are addicted,” he says. “Of those, more than 1,100 have an ACE score of 3 or more.”

Sumrok knows that score says a lot about their health and ability to cope: ACE comes from the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), groundbreaking research that looked at how 10 types of childhood trauma affect long-term health. They include: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused. Subsequent ACE surveys include racism, witnessing violence outside the home, bullying, losing a parent to deportation, living in an unsafe neighborhood, and involvement with the foster care system. Other types of childhood adversity can also include being homeless, living in a war zone, being an immigrant, moving many times, witnessing a sibling being abused, witnessing a father or other caregiver or extended family member being abused, involvement with the criminal justice system, attending a school that enforces a zero-tolerance discipline policy, etc.

The ACE Study is one of five parts of ACE science, which also includes how toxic stress from ACE damage children’s developing brains; how toxic stress from ACE affects health; and how it can affect our genes and be passed from one generation to another (epigenetics); and resilience research, which shows the brain is plastic and the body wants to heal. Resilience research focuses on what happens when individuals, organizations and systems integrate trauma-informed and resilience-building practices, for example in education and in the family court system.

The ACE Study found that the higher someone’s ACE score – the more types of childhood adversity a person experienced – the higher their risk of chronic disease, mental illness, violence, being a victim of violence and a bunch of other consequences. The study found that most people (64 ercent have at least one ACE; 12% of the population has an ACE score of 4. Having an ACE score of 4 nearly doubles the risk of heart disease and cancer. It increases the likelihood of becoming an alcoholic by 700 percent and the risk of attempted suicide by 1200 percent. (For more information, go to ACE Science 101. To calculate your ACE and resilience scores, go to: Got Your ACE Score?)

High ACE scores also relate to addiction: Compared with people who have zero ACE, people with ACE scores are two to four times more likely to use alcohol or other drugs and to start using drugs at an earlier age. People with an ACE score of 5 or higher are seven to 10 times more likely to use illegal drugs, to report addiction and to inject illegal drugs.

The ACE Study also found that it didn’t matter what the types of ACE were. An ACE score of 4 that includes divorce, physical abuse, an incarcerated family member and a depressed family member has the same statistical health consequences as an ACE score of 4 that includes living with an alcoholic, verbal abuse, emotional neglect and physical neglect.

Subsequent research on the link between childhood adversity and addiction corroborates the findings from the ACE Study, including studies that have found that people who’ve experienced childhood trauma have more chronic pain and use more prescription drugs; people who experienced five or more traumatic events are three times more likely to misuse prescription pain medications.


Dr. Dan Sumrok with group therapy members at McKenzie, TN, clinic.

“ACE doesn’t just predict substance abuse disorders,”
says Sumrok. “Major chronic diseases are so often linked to substance abuse, this is too big to ignore.”

Whether you’re talking about obesity, addiction to cigarettes, alcohol or opioids, the cause is the same, he says: “It’s the trauma of childhood that causes neurobiological changes.” And the symptoms he saw 40 years ago in soldiers returning from Vietnam are the same in the people he sees today who are addicted to opioids or other substances or behaviors that help them cope with the anxiety, depression, hopelessness, fear, anger, and/or frustration that continues to be generated from the trauma they experienced as children.

Learning about ACE helped him understand that the original definition of PTSD, which many people still cling to, is not accurate. In the 1980s, PTSD was defined as a result of trauma that was outside the realm of normal experience.

“That was just wrong,” says Sumrok. “Divorce, living with depressed or addicted family members are very common events for kids. My efforts are around helping people to see the connections, and that their experiences are predictable and normal. And the longer the experiences last, the bigger the effect.”

He also says, “Drop the ‘D’, because PTSD is not a disorder.” It’s what he learned from van der Kolk, who wrote The Body Keeps the Score. “Bessel says we’ve named this thing wrong. Post-traumatic stress is a brain adaptation. It’s not an imagined fear. If one of your feet was bitten off by a lion, you’re going to be on guard for lions,” explains Sumrok. “Hypervigilance is not an imagined fear, if you’ve had one foot bitten off by a lion. It’s a real fear, and you’re going to be on the lookout for that lion. I tell my patients that they’ve had real trauma that’s not imagined. They’re not crazy.”

Patients who learn about their ACE understand that they can heal

This is what happens when a person sees Sumrok for the first time: They fill out the 10-question ACE survey (Got Your ACE Score?) in the waiting room. “Then when I see them, I go through each question and ask them again,” says Sumrok, who also does a normal physical exam. “Frequently, there’s a difference between the two. For example, this morning, I saw a woman and she reported an ACE score of 1 on the survey. Then, when I asked her the questions, she reported nine out of 10.”

That’s just how I grew up, she told Sumrok. She didn’t think being beaten, humiliated or seeing her mother smoking crack every day was harmful or unusual, especially since most kids she knew were experiencing the same thing.

Sumrok normalizes their addiction, which he explains is the coping behavior they adopted because they weren’t provided with a healthy alternative when they were young. He explains the science of adverse childhood experiences to them, and how their addictions are a normal – and a predictable – result of their childhood trauma. He explains "what happens in the brain when they experience toxic stress, how their amygdala is their emotional fuse box. How the thinking part of their brain didn’t develop the way it should have. How it goes offline at the first sign of danger, even if they’re not connecting the trigger with the experience. Drugs like Zoloft don’t really help much," he tells them. "Zoloft and other anti-depressants don’t remove the memory triggered by the odor of after shave that was worn by your uncle who sexually abused you when you were eight, or the memory triggered by a voice that sounds just like your mother who used to beat you with a belt, or by a face of a man who looks like your father who used to scream at you about how worthless you were…" The examples are infinite. That’s why van der Kolk says, “’The body keeps the score’,” Sumrok says.

“After I explain all this to them, many of them stare at me and say: ‘You mean I’m not crazy?’” says Sumrok. “I tell them, ‘No, you’re not crazy’.” Sometimes he yells out the door to his nurse: "Patsy! Where’s my not-crazy stamp? I need to stamp this person’s chart.”

For people who are addicted to opioids, he prescribes buprenorphine (one of the brand names: Suboxone), which helps them to withdraw from opioids and to keep their job, or return to work. For most people, the drug is less addictive than other opioids. Sometimes if people are young, healthy and haven’t been addicted long, they can withdraw from opioids without buprenorphine.

“There’s no buzz associated with buprenorphine,” says Sumrok. “They can concentrate and think. Once they’re free of the continuous distraction of the acquisition and use of substances, they become pretty valuable employees.”

For people who are addicted to alcohol, he prescribes naltrexone (one of the brand names: Revia), because alcoholics have a high risk of death if they aren’t provided medication. And in this current national attention on opioids, Sumrok is careful to point out that although 33,000 people died from opioid overdose in 2015, 88,000 people die annually from alcohol-related causes, and 480,000 from cigarette smoking. The complicating factor — and why policies don’t work when they chase the eradication of one drug, only to focus on eradicating the next popular drug of choice for “ritualized compulsive comfort-seeking” — is that many people use opioids and alcohol and cigarettes. And if they receive no help to get at why they’re using legal or illegal substances, they will move on to another, more easily accessible drug when the current drug they’re using becomes more difficult to find.



All patients sign a contract agreeing that they won’t drink alcohol or take other drugs. “We don’t mess around with that,” says Sumrok. “We can’t deal with them being deceptive, because if they drink or do other drugs, it can kill them. If their drug screens aren’t consistent, we ask them to find another doctor. Just about everybody stays," he says.

They also participate in group therapy. For physicians who prescribe buprenorphine, it’s now required, but Sumrok had seen the research about the effectiveness of group therapy, and had started 12-step groups for his patients about 10 years ago. Talking with others who have the same experiences helps each person normalize their own experiences. Sumrok and the others in the group help each other find “ritualized compulsive comfort-seeking behaviors” that won’t kill them or put them in jail, such as coaching their kid’s soccer team or volunteering at a food bank. Sumrok encourages them to integrate other rituals into their lives, such as walking 30 minutes a day or other exercise, joining a 12-step group or finding a path to encourage a spiritual awakening.

“Six months into this,” says Sumrok, “they start saying things like, ‘My wife and I are back together,’ or they’re hanging out with their kids. It’s pretty cool to see how people get their lives back. My favorite word is ‘normal’. When they tell me they feel normal, I know they’re doing okay.”

So, how long does it take before they’re cured? “How long should you take insulin if you have diabetes?” responds Sumrok, making the point that this is a chronic disease, that people should be in treatment for as long as it is necessary, and that some may relapse. His goal is for them to not have to use buprenorphine, but he knows that because of the number and duration of their ACE, and the paucity of resilience factors provided to them when they were children, many will need continual support. He helps them learn how to integrate that support into their lives.

“When a diabetes patient comes in with a blood sugar level of 300, we don’t say: ‘Give me back that insulin.’ We intensify the treatment to get them back in balance,” explains Sumrok. “Only in addictions do we shame people. We tell them they can’t be part of this recovery anymore. We create a teeny hoop that’s called abstinence, and not too many people can jump through that hoop. If every time we saw a diabetic, we told them that their kidneys were going to fail, they would be blind and we would amputate their extremities, there wouldn’t be many diabetics who got help. I have patients who drop out, and then return a couple of months later, and say, ‘Doc, Christmas came, I saw some of my buddies, and I started using again.’ I tell them, ‘Come on in. Let’s work with you.’ And I remind myself that I’m not saving souls, I’m saving their asses. It’s about getting them so they can function at work, at home, at play. It’s not about making them perfect human beings."

“It has been abundantly clear to me and reinforced over a 40-year career,”
continues Sumrok, “that patients desire, and respond better to, sensitive and informed care. From the Navajo Nation, to Appalachia, to Memphis, to the mountains of Honduras, to the jungles of Amazonia - people regard respect as the sine qua non of quality care.”

Stories AND data drive solutions

Although Sumrok thinks his approach benefits his patients, he knows he needs data to prove it. When he saw a recent study that said 43% of people on buprenorphine were using other opioids, he did his own analysis of a sample of his patients, and found that only 8% were using other opioids. After tracking down those who were, most had good reasons, such as a man whose arm and shoulder were in a new cast after surgery repairing an injury, and he was taking a narcotic. Only one did not, and when shown his drug test, he said, "'You know what? I slipped.' He talked about it in group," says Sumrok, and everyone in his group hovered around him to make sure he’d continue the program.


Dr. Karen Derefinko

Because Sumrok has kept fastidious records of the patients who have done their ACE scores, Dr. Karen Derefinko, a clinical psychologist and assistant professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center, is starting a research project to examine all 1,200 records in Sumrok’s clinic in McKenzie to look at the relationship between people’s ACE scores and their adherence to treatment and their relapses.

“We think that people with high ACE scores are likely to have more relapses,” she says. “And that may be because people with higher scores have fewer resources and more difficulty associated with adhering to their treatment plans.”

She and her research assistant will de-identify the records, so that all information is anonymous, and then collect the data. Once that data is analyzed — probably within two months — Derefinko and her assistant will conduct focus groups of some of Sumrok’s patients. She’s already been sitting in some of the groups.

“Dan encourages this participatory nature of his groups,” she says. “People are very willing to talk. After the group sessions, they’re often not done talking about why they came to Sumrok and why other programs didn’t work for them.”

Through the records and the focus groups, Derefinko hopes to identify barriers to care, which include basics such as how people can find good care easily (most of Sumrok’s patients find out about him through word of mouth), being wary of the treatment because it isn’t explained to them, or — what Sumrok hears a lot — being judged or talked down to instead of given understanding and respect.

“In Shelby County, people complain about barriers to care, which many people think is because of economics,” she says. “But it may not be just economics that is keeping people from accessing treatment; it may be more about being judged, and not knowing what the treatment looks like.”

Being treated with respect builds trust, trust builds health

One of Sumrok’s patients – I’ll call him John, which is not his real name – has been driving 140 miles from Southeast Missouri to see Sumrok for the last five years. He began using drugs off and on during his 20s. When he was in his 30s, he injured his back, was sent to a worker’s comp physician, who prescribed stronger doses of pain killers until his back stopped hurting.

“I was taking pain pills like candy,” says the 46-year-old, who is married and has a son. “All of a sudden, the pills are gone, and you’re very sick, and I start looking for them everywhere – on the street, taking them from family members without asking – just to keep me from getting sick. I thought I had to have them to function. If I didn’t have six or seven pain pills, I wasn’t going to be able to get out of bed. If I didn’t get them, I’d be sick, puking… I’d do almost anything to have those pills.”

After he spent his and his wife’s life savings, and the money they’d put away to buy a home, and his retirement fund from a previous job; after he saw friends die from overdosing; and after he realized that he was risking losing his wife and son, he told his wife he needed help, and they found Sumrok.

“It’s been a miracle, for sure,” says John. As the Suboxone took effect, “after two or three weeks, I began to feel normal again.”

About two years ago, Sumrok asked him to fill out the ACE survey. “It really did make a difference,” says John. He had never connected experiences in his childhood with using drugs as an adult.

“When I was just a baby,” recalls John, “my grandpa took me from my mother, and told my parents: ‘When you guys are stable, I’ll let you have him back.’ Up until I was 10 or 11, I called them ‘Mom’ and ‘Dad’.’” His older sisters were sent to live with his other set of grandparents. He didn’t live with his parents again until he was 15 years old. His sisters were adults and out on their own by then.

Until he did the ACE survey and talked with Sumrok about his childhood, it didn’t dawn on him that losing his mother, father and his sisters at a young age could have affected him in ways he didn’t realize. “I knew I was loved by my grandfather and grandmother, but being a young kid and seeing other kids going out with their parents was frustrating,” he says. “I lived with old people who never left the house, while my parents were out running around. I maybe thought my mom and dad didn’t care about me enough to change. I might have always felt like I wasn’t important enough to my mom and dad for them to change the way they were living and acting.”

But now he has a better understanding of what it was like to be a 19-year-old in the late 1960s and involved in the drug and party scene then, as his parents were. He understands them better, and why they weren’t able to care for him. He and his family members have “had our discussions,” says John. “My family life is a whole lot better. I didn’t have relationships with my parents or sisters. We only live seven miles apart, and I barely saw them twice a year, if that. But now I have my wife back. I’ve got my son back. And I see my parents and sisters all the time. We’re a tight-knit family.” He’s also able to hold a job, and is a reliable employee.

John sees Sumrok once a month now. He participates in group therapy, where they can safely talk about their ACE scores without having to get into specifics. He checks in with Sumrok, who renews his prescription.

“I like group therapy with Dr. Sumrok,” says John. “He talks to us with respect. We feel very comfortable with him. Dr. Sumrok never lies. I trust him fully. And he trusts me. It took five or six months to build that trust. The more I met with him, the more I realized that he was really concerned about me. He wants to help people. Let him train more doctors in the procedures he uses. You can’t treat people like they’re nobodies.”

A 29-year-old patient, who chose to be called “Mr. Big” since I’m not using his real name, has been seeing Sumrok for the last six months. He had been in a methadone treatment program, and found Sumrok after he couldn’t pay for treatment any longer. Sumrok was the only physician who would take his insurance. Mr. Big filled out the ACE survey in the waiting room, but reported his score as a two. Then Sumrok went through the survey with him, and Mr. Big’s score climbed to an 8.

“It does help me understand my addiction better,” says Mr. Big, who is a single father of two children, five and six years old. “For one, my trauma in my childhood was very dramatic. I thought everyone’s parents did what they were doing. I could see why I related to narcotics and stuff. It was the only place I had to turn. I started taking opiates when I was 11 or 12 years old. I was playing football, and broke my ankle. They gave me painkillers that made me feel like Superman. I couldn’t get enough, because I wasn’t feeling like Superman without it.”

The Suboxone helps him feel “normal — probably the way everybody else feels,” says Mr. Big. “Nothing I took ever gave me that feeling before. I’m a better person, father, and a better brother” to his sister, whom he convinced to also get help from Sumrok.

The first time he went for help, to a methadone clinic, he didn’t like it for two reasons: Methadone made him nod off or feel high, and the people at the clinic treated him as if he was a number, or just there for the drugs. “That’s just unprofessional, in my opinion,” he says. “Sumrok actually sits down and talks to you like a human being.”

Mr. Big wants to work with Sumrok to develop a 'game plan so that I can live without my medicine,' he says. He just wants to live a normal life. What does a normal life mean?

“It means that I’m home overnight with my children,” he says. “I don’t have to rob, lie, steal, or cheat to find drugs. I can fit in with society and not be high off my mind. I can wake up every day and do stuff. My children — they know Daddy’s not in bed sick any more. It’s wonderful. I’m wore out. I never knew that first grade and kindergarten had homework that was so complicated.”

With addictions and deaths on upswing, how to increase addiction docs?

Prescription and illicit opioids are the “main driver of drug overdose deaths,” according to the CDC, with 33,091 deaths in 2015. That’s four times more than 1999. And between 2014 and 2015, Tennessee saw a 13.8 percent increase in opioid deaths. More than 1,000 people died from opioid overdoses in 2014, and tens of thousands of people lead desperate lives, most of them unknowingly fueled by their childhood experiences. "Only 10% of these are getting the help they need," says Sumrok.

Dan Sumrok is just one doctor, in one part of the country. How can what he does be scaled up to thousands of physicians who can treat addiction — all types of addiction — successfully in all parts of the U.S.? By doing what Dr. David Stern, Robert Kaplan executive dean and vice-chancellor for clinical affairs for the University of Tennessee’s College of Medicine and the University of Tennessee Health Sciences Center, did: launch the Center for Addiction Science.

“This really starts with Dr. Altha Stewart, who’s the director of the Center for Health in Justice-Involved Youth,” says Stern. “She’s the one who showed me that kids with high ACE scores end up in trouble. When I developed the Center for Addiction Science, it had to be like a cancer center, it had to be multi-disciplinary. In the old days, we thought people who had addictions were weak in the moral department. You really needed someone to straighten you out, because your mother didn’t do a good enough job.”

But that approach doesn’t work. Neither does criminalizing addictions. "Stigma drives problems underground," says Stern, "instead of driving them to a solution." The center is taking an integrated approach to using research and education to help people in all possible ways, from physiology to genetics to counseling.

Stern believes that every physician should know about ACE science, which is one of the reasons he chose Sumrok to lead the center, along with his willingness to be creative and seek solutions across disciplines. “Two of the most prevalent things in acute care are depression and addiction,” says Stern. “I think it’s important to be able to understand what ACE mean to patients, what addiction is all about, how to recognize it, how to treat it.” He’s in the process of finding an associate dean for medical education, and is looking for someone who will integrate ACE and other social determinants of health into the school’s curriculum.

“I think a medical school should provide for the community it serves,” says Stern. “This medical school should be the medical school for Memphis. We should develop solutions that are scalable.”

Dr. Altha Stewart, associate professor of psychiatry in the University of Tennessee College of Medicine, learned about ACE in 2009 when a group in Shelby County began educating people about ACE science. They brought Dr. Vincent Felitti, co-founder of the ACE Study, and Robin Karr Morse, who wrote Ghosts from the Nursery: Tracing the Roots of Violence, which was published in 2007, to give a presentation.


Dr. Altha Stewart

“It’s become a core part of what I do now in my professional work,” says Stewart, who was recently named president-elect of the American Psychiatric Association. She’s working with the Shelby County community and the local criminal justice system to integrate trauma-informed and resilience-building practices to find ways to help youth who enter the justice system — all of whom have likely experienced ACE — instead of shaming, blaming or punishing them.

The things that have happened to kids — as well as to many people who come into the health care system — are out of their control, says Stewart. “When you’re a child, you don’t control the people who abuse and assault you, who create hostile environments, who don’t provide you with clean clothes,” she says. “If a child can’t control their environment, because of these things they grow up thinking they’re bad, different, horrible people. This new approach (integrating trauma-informed and resilient-building practices based on ACE science) helps them feel like they’re not drowning anymore. When they can pop their head out of the water and get a breath, and see outstretched hands, a life preserver, a life boat, that changes their entire perspective.”

"When Sumrok began integrating ACE into addiction treatment, that was innovative,"
says Stewart. “If you don’t ask these questions, people tend not to tell you,” she says. Sumrok’s approach is part of a shift in patient engagement and involvement. “The trend in health care is that patients are partners in their treatment.”

"This new knowledge about why and how humans behave the way they do also speaks to how we have trained the medical profession,”
says Stewart. "The traditional approach is that physicians “know everything. The people whom we treat know nothing. We tell them what to do, and if they don’t get better or do what we say, it’s their own fault."

“That’s simply not true,”
she emphasizes. “Some of us have come to understand that there’s more expertise in the community and our patients than we’ve understood. That takes a bit of humility on the part of a physician, and an understanding that we are partners in helping a person heal.”

Sumrok’s experience with the young fellows at the Center for Addiction Science is giving him some real hope that the medical profession can change. When he’s explained to them how important it is to ask patients about ACE and other aspects of their lives — such as food availability, safe housing, transportation, jobs (in the medical profession vernacular: social determinants of health) — “they say ‘isn’t that just taking a patient history?’”

He and others at the University of Tennessee Health Sciences Center have an opportunity to educate young physicians outside the state, too. Derefinko is also director of the newly created National Center for Research of the Addiction Medicine Foundation. The foundation oversees the 130 addiction medicine fellowships at 46 medical schools across the country.

“We want metrics to understand the impact they’re having when they go out in the world," says Derefinko: "where they go, whom they’re treating, how they’re practicing, whether they’re integrating ACE science. In addition, the foundation will be developing some accreditation guidelines, so that all fellows receive the latest and best education in addiction medicine."

"One of those elements,"
says Sumrok, "has to be empathy, which physicians can practice by listening, acknowledging and understanding how the experiences in a person’s childhood and adulthood have shaped their lives and health."

“Can you teach empathy?”
he asks. “Can people learn to be empathetic providers? I think you can. I think so.”

*From the article here:

 
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mr peabody

Moderator: PM
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Childhood trauma and addiction*

by Johann Hari | OpenDemocracy.net

One of my earliest memories is of trying to wake up one of my relatives, and not being able to. As I got older, I understood why. We had addiction in my family. And as I watched some of my other close relatives become addicts, I asked myself several questions, but one in particular seemed haunting and insistent: why does addiction so often run in families? Why does it seem to pass from mother to daughter, from father to son, as though it were some dark genetic twist?

I went on a long journey to find the answers to these questions – I describe it in my book ‘Chasing The Scream: The First and Last Days of the War on Drugs.’ My research was book-ended by two events that remind us why we need to urgently understand this.

This question is no longer a mystery. We know the major reason why addiction is transmitted through families – and it is not what most of us think. There is a genetic factor; but there is another explanation that is even more significant – and that we can do something about. A major study by the Center for Disease Control (CDC) and the healthcare provider Kaiser Permanente of 17,000 people has unlocked this – and its results have subsequently been replicated by over 20 studies funded by individual US states.

It was discovered quite by accident – in part of a study of a totally different subject. A distinguished doctor in San Diego called Vincent Felitti was trying to find out the underlying causes of obesity, and he was overseeing the treatment of over 30,000 people. He spent long sessions talking with his patients about when they had started to over-eat – and what events had taken place at that point in their lives, at the apparent trigger-moment.

Dr. Felliti noticed something striking. His patients seemed to have been sexually abused at a higher rate than the general population. Far higher. One woman explained that she gained 105 pounds after being raped. “Overweight is overlooked,” she said, “and that’s the way I need to be.”

Intrigued, Dr. Felitti launched a major and detailed study to find out what role – if any – traumatic childhood events played in obesity. It became known as the Adverse Childhood Experiences (ACE) Survey. They questioned 17,000 people in San Diego, mostly middle class and professional, to find out if they had gone through any of ten traumatic experiences that can happen to a child – from neglect to violence to rape. They then followed them to see if they suffered any other problems later in life. At the same time as they looked to see if there was any correlation with obesity, they also included other factors – like drug addiction.

What they discovered seemed, at first, to be an error.

“A person who experienced any six or more of the categories” of childhood trauma, Dr. Felitti tells me, “was 4600 percent more likely to become an IV drug user later in life than a person who experienced none of them.” He adds: “I remember the epidemologists at the CDC told me those were numbers a magnitude of which they see once in a career. You read the latest cancer scare of the week in the newspaper and something causes an increase of 30 percent in breast or prostate cancer and everybody goes nuts – and here, we’re talking 4600 percent.”

The published research showed that for every category of trauma that happens to a child, they are two to four times more like to grow up to be an addict – and multiple traumas produced a massive risk. The correlation for addiction was startling. Nearly two-thirds of injecting drug use, they found, is the result of early childhood trauma.

But why would this be? Further research by the British psychoanalyst Dr. Sue Gerhardt advances an explanation. When you were a baby, what happened when you were upset? If your mother soothed and reassured you, in time, you will have learned to soothe and reassure yourself. If, however, your mother responded to your pain by being hostile or angry or distressed – as chaotic addicts like Whitney Houston often do – you will not have learned to regulate your own feelings. You would then be much more likely to need to seek external soothing – and nothing stuns internal grief quite like chemicals, for a while.

Just as Dr. Felitti’s obese patients tried to protect themselves from predatory sexual attention with layers of fat, his drug-addicted patients were often trying to protect themselves from the childhood storms in their own heads – by numbing themselves with chemicals. His obese patient didn’t feel so afraid of sexual assault if she had rendered herself conventionally ‘unattractive’. His addicted patients didn’t feel their own agony so keenly if they were drugged.

We know that Bobbi Kristina Brown, as a little girl, went through many of the traumas that were proven to massively increase addiction – her father violently attacking her mother, parental addiction, neglect. Survivors of this kind of childhood find it harder to trust people – so they are more likely to become isolated, another major driver of addiction. In another tragic twist, kids of addicts often think turning to the drug will bring them closer to their addicted parents. In my book I tell the story of Chino Hardin, a transsexual former crack dealer in Brownsville, Brooklyn who became my friend. His mother, Deborah, had a crack addiction, and died when Chino was twelve. He started using crack not long after. “I wanted to know,” he told me, “what she chose over me.”

Today, we have a criminal justice system that takes people who are addicted because they endured trauma, and we traumatize them more. We routinely put them in prison cells with no support, and where rape is a running punch-line in the popular culture. Dr. Gabor Mate, one of the leading experts on this question, told me: “If I had to design a system that was intended to keep people addicted, I’d design exactly the system that we have right now.”

Dr. Mate – after years of treating patients who became addicts after hellish abuse – has outlined an alternative. Imagine if we had taken the $1 trillion that has been spent so far on the failed drug war, and had spent it on the collapsing services designed to protect abused children instead. Every year here are 686,000 kids who have been identified as abused or neglected in the US – and the services for them are appalling. We are setting up a generation of new addicts – and then we will squander more money punishing them. There would, this evidence suggests, have been a genuine and substantial fall in addiction.

But the biggest change this evidence should trigger isn’t political – it is personal. In our everyday lives, we need to think about the addicts we work alongside, live alongside, and love. “When people are having problems,” Dr. Robert Anda, another author of the ACE study, tells me, “it’s time to stop asking what’s wrong with them, and start asking what happened to them.”

*From the article here:

 
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mr peabody

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Is addiction rooted in childhood trauma?*

by Rob Waters | Jan 10 2019

Dr. Gabor Maté, well-known addiction specialist and author, spent 12 years working in Vancouver’s Downtown Eastside, a neighborhood with a large concentration of hardcore drug users. The agency where he worked operates residential hotels for people with addictions, a detox center and a pioneering injection facility, where drug users are permitted to shoot up and can get clean needles, medical care and counseling.

Amid the severe opioid epidemic in the U.S., Dr. Maté recently visited Sacramento, where he conducted workshops with addiction specialists and families affected by addiction. California Healthline contributor Rob Waters caught up with him there. The following interview was condensed and edited for clarity.

Q: A big part of your book “In the Realm of Hungry Ghosts” is about how you came to see that childhood trauma and pain lie at the root of addiction. Tell me about your insights.

Downtown Eastside is North America’s most concentrated area of drug use. In 12 years, I worked with hundreds of female patients, and every one had been sexually abused as a child. Men were physically, sexually and emotionally abused, suffered neglect, were in foster care.

Thirty percent of people there are native Indians, what we call First Nations people. For generations, the government abducted their children and sent them to residential schools. Parents were barred from seeing kids. Kids were physically and sexually abused by teachers and priests. Tens of thousands died. Because of multigenerational trauma, native communities have high rates of sexual abuse, violence, addiction and suicide. It’s the most addicted population in Canada.

All addictions — alcohol or drugs, sex addiction or internet addiction, gambling or shopping — are attempts to regulate our internal emotional states because we’re not comfortable, and the discomfort originates in childhood. For me, there’s no distinction except in degree between one addiction and another: same brain circuits, same emotional dynamics, same pain and same behaviors of furtiveness, denial and lying.

Q: You write about your own addictions — being a workaholic and binge shopper of classical music, once spending $8,000 in a week on CDs.

I was not addicted to substances but I might as well have been. I couldn’t stop myself. I lied to my wife. I lied to my kids. It doesn’t matter which addiction you’re looking at; it’s the same dynamics.

Q: Last year in the U.S., an estimated 72,000 people died of drug overdoses, most from opioids. The U.S. penalizes drug use harshly and has the largest prison population in the world — 2.3 million people, almost 1 percent of the adult population. Meanwhile, 90 percent of people with substance use disorders in the U.S. are not getting treatment. What’s your take on this approach?

The more pain you cause people, the more you shame and isolate them, the worse they’ll feel about themselves. The more suffering you impose, the more you strengthen their need to escape. If you wanted to design a system to maintain drug use and enhance the profits of the illegal drug trade, I would design the system you have.

Q: Let’s talk about the science. How does trauma in the early years of life affect brain development and predisposition to addiction?

Studies show that early stress affects both the nerve cells in the brain and the immune systems of mice and humans and makes them more susceptible to cocaine as adults. If you look at brain circuits implicated in impulse regulation or stress regulation or emotional self-regulation, all are impaired in addicts.

Q: Why do you think the opioid epidemic exploded in the way it has in recent years?

On top of the childhood trauma and the profound social and economic dislocation so many people experience, most physicians are completely uninformed about trauma and don’t understand how to address chronic pain or treat addiction. Hence they have a propensity to prescribe opiates all too quickly without looking at root causes or alternatives. Most people introduced to opiates in recent years started on medical prescriptions. When these are stopped, they turn to illicit substances. All this is greatly exacerbated by pharmaceutical companies’ well-documented drive to induce doctors to prescribe.

Q: Critics like psychologist and addiction specialist Stanton Peele say you’re proposing a reductionist vision in which abuse history and biochemical changes to the brain inevitably lead to substance abuse.

Peele totally misconstrues my argument. Nobody’s saying that every traumatized person becomes addicted. I’m saying that every addicted person was traumatized. There are other outcomes of trauma including cancer, autoimmune disease, mental illness — addiction is only one of them.

Q: You write with compassion about the people you worked with. But you also write about them as broken people who rarely seem to recover. What good are you doing?

If somebody had cancer and pain and you couldn’t cure the cancer, what would you do? Would you say, “I’m not going to help you any more”? Or would you try to ameliorate their suffering? The essence of harm reduction is you reduce the harm. You don’t impose abstinence. If they choose that at some point, I provide whatever support they need.

*From the article here:

 
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Dealing with past trauma may be the key to breaking addiction

by Joanna Moorhead | The Guardian | 24 Nov 2018

What’s your poison, people sometimes ask, but Gabor Maté doesn’t want to ask what my poison is, he wants to ask how it makes me feel. Whatever it is I’m addicted to, or ever have been addicted to, it’s not what it is but what it does – to me, to you, to anyone. He believes that anything we’ve ever craved helped us escape emotional pain. It gave us peace of mind, a sense of control and a feeling of happiness.

And all of that, explains Maté, reveals a great deal about addiction, which he defines as any behaviour that gives a person temporary relief and pleasure, but also has negative consequences, and to which the individual will return time and again. At the heart of Maté’s philosophy is the belief that there’s no such thing as an “addictive personality.” Nor is addiction a “disease.” Instead, it originates in a person’s need to solve a problem: a deep-seated problem, often from our earliest years, that was to do with trauma or loss.

Maté, a wiry, energetic man in his mid-70s, has his own experience of both childhood trauma and addiction, more of which later. Well-known in Canada, where he lives, he gives some interesting reasons why Britain is “just waking up to me” and his bestselling book In the Realm of Hungry Ghosts. "There’s a generational conflict here," he says, "around being open about past trauma." He cites Princes William and Harry opening up about their mother’s death, and says it’s something the Queen’s generation would never have done. He applauds the new approach: “I think they [the princes] are right to be leading and validating that sense of enquiry, without which life is not worth living.”

The infamous British stiff upper lip is something Maté has watched with fascination over the years. Born of our imperial past, he says, it was maintained for as long as there was something to show for it. Boarding school culture and traumatic childhoods played out into dominance of other countries and cultures, giving the “buttoned-up” approach inherent value. But once the empire crumbled, lips quavered.

“With rising inequality and all the other problems there are right now,” he says, “people are having to question how they live their lives. People in Britain are beginning to realise they paid a huge price internally for all those suppressed emotions.”

"Part of that price was addiction – whether to alcohol or drugs, gambling or sex, overwork or porn, extreme sports or gaming – but essential to understanding it,"
says Maté, "is to realise that addiction is not in itself the problem but rather an attempt to solve a problem. Our birthright as human beings is to be happy, and the addict just wants to be a human being.”

And addictive behaviour, though damaging in the medium or long term, can save you in the short term. “The primary drive is to regulate your situation to something more bearable. So rather than some people having brains that are wired for addiction," Maté argues, "we all have brains that are wired for happiness. And if our happiness is threatened at a deep level, by traumas in our past that we’ve not resolved, we resort to addictions to restore the happiness we truly crave."

He speaks from experience: Maté is a physician who specialised in family practice, palliative care and, finally, addiction medicine. He became a workaholic and lived with ADHD and depression until, in his 40s and 50s, he began to unravel the root cause – and that took him all the way back to Budapest, where he was born in January 1944. Two months later, the Nazis occupied Hungary: his mother took him to the doctor because he wouldn’t stop crying. “Right now,” the doctor replied, “all the Jewish babies are crying.” This is because, explains Maté, what happens to the parent happens to the child: the mothers were terrified, the babies were suffering, but unlike their mothers they couldn’t understand what the suffering was about.

Later, Maté’s mother, fearing for his survival, left him for a month in the care of a stranger. All this, he explains, gave him a lifelong sense of abandonment and loss which had an impact on his psychological health. It affected his marriage and his own parenting experience. To compensate for his buried trauma, he had buried himself in work and neglected his family.

Opening up to the trauma, exploring it and investigating it, was incredibly difficult. “The problems for me showed up in the dichotomy between my success as a physician and my miseries as a husband and a father,” he recalls. “There was a big gap between them, and it’s taken me a long time to work through what I needed to work through.” As Oscar Wilde believed, pain is the path to perfection; and nearly five decades on from the day of their wedding, Maté says his marriage is better than ever.

“We’re happier, but it’s taken many years of work,” he says. In a few weeks it will be the couple’s 49th wedding anniversary. “We’ll go out for dinner and raise a glass to five happy years,” he quips. He’s already chosen his epitaph: “It’s going to say, this life is a lot more work than I anticipated. Because it takes a lot of work to wake up as a human being, and it’s a lot easier to stay asleep than to wake up.”

For Maté, self-awareness is the bottom line: when we wake up and become properly self-aware, we are able to address the traumatic childhood issues that leave us vulnerable to addiction. But because the process inevitably involves pain, we don’t address the issues until we absolutely have to – until something happens that forces us to face up to the fact that our lives aren’t working as they should. And as with the individual, so too with society: although all around us in politics and the wider world is mayhem and chaos, Maté holds on to the fact that this discomfort – which we are communally aware of – will force us to examine what’s gone wrong in our collective psyche, and to seek to correct it.

Unsurprisingly, given his central message, Maté is in favour of drug decriminalisation. He points to Portugal, where it is no longer illegal to possess a small amount of heroin or cocaine, and says the country has seen a reduction of drug-taking, less criminality and more people in treatment. In his view, it’s not really the drugs that are being decriminalised, it’s the people who are taking them – and given that they are, in his view, always victims of trauma, and never merely “bad” or “dangerous”, that’s entirely logical. But decriminalisation is only the beginning: reform must cut much deeper. “The whole legal system is based on the idea that people are making a choice,” he says. “This is false – because no one chooses to be an addict, or to be violent.”

Everything about Maté seems to be based on a workaday, efficient kindness: his message is about understanding, blue-sky thinking and common sense. However, with any philosophy that references retrospective experiences, there’s the inevitable tendency to parent-bash – the “they fuck you up” mentality. But read on in Larkin, and his approach is not so different from Maté’s: “They may not mean to, but they do. There’s no room for blame because," says Maté, "virtually all parents do their best, and the deepest love they have is for their child." One of the best things that ever happens to him, he says, is when a parent whose child has died of an overdose comes up to him and tells him that, through his book, they can understand why it happened. And when readers tell him – sometimes accusingly, sometimes gratefully – that his work humanises addicts, he can only answer: addicts are human. The only question for him is, why has it taken us so long to realise that?

 

mr peabody

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Does childhood trauma cause addiction?

Basic biology: children who were neglected or abused did not receive the proper conditions for their nervous systems to develop properly. Because of their volatile caregiver environment, they experience significantly higher volumes of the stress hormone cortisol on a day-to-day basis. If left unaddressed, this carries on into adulthood. In contrast, children who had proper developmental conditions (safe, secure connection to their caregiver) develop a healthy internal hormone regulatory system, and therefore don't experience stress to the same degree as abused or neglected individuals do. Addiction is simply the evolutionary act of seeking a tool to reduce that stress. All addictive substances release biophysically healing (cortisol reducing) neurochemicals called endorphins. The more stress is experienced by the body, the more endorphin activity is required to soothe the body. The more that cortisol levels skyrocket, the more the nervous system automates endorphin-seeking behaviours.

So why does abuse cause so much lasting stress? When a child is in those crucial developmental years that happen before the age of two, a child's brain and body are exceptionally vulnerable to external circumstances. This is evolutionary so that we adapt to our surroundings, learning to keep us safe from harm before anything else. We learn to fear what hurt us so that our bodies react faster to get us out of the way.

To understand this, picture a red-hot stove iron. If you touch it and it burns you - you feel excruciating pain. Your senses - like the sight of the red glow, the sound of the burner - are heightened. They get stored in your limbic system (part of your body's nervous system). So the next time you see your arm near the red hot stove iron, or hear the burner flick on when your hand is on it, your nervous system reacts more immediately than your mind can, in order to jerk your arm out of the way fast. The limbic system stores these sensory memories longer and more deeply than your conscious mind, so that your contemplative, reflective, calculating, longer-to-process, thought system (the brain) is bypassed. The limbic system can then assure that the body reacts faster just at the mere perception of the hot stove iron being close, without having to sit and reflect on whether or not the red stove is hot - your body just knows (before the brain does!)

So how does this relate to Trauma? While a child's nervous system is developing, if their parent of caregiver hits them every time they ask for something they need (like food or a hug), in response to that pain their limbic system stores the sight of a hand being raised, or the loud shout of an angry parent, within its limbic (central nervous) system so that the body can react fast to get out of harm's way. It does this by: releasing high dosages of the stress hormone cortisol and the panic/motivator chemical adrenaline, sending the blood from the brain to arms and legs so that the child can move out of the way as fast as it can. (This is often called "fight or flight" syndrome.) So then later on down the road in that child's life, if they have been struck repeatedly, their nervous system will be set up to alert the body to react even at the mere sight of an arm being raised, or the sound of an angry voice yelling near them. They are on high alert constantly due to an over-adaptation of this very basic survival mechanism.

Now when you bring in the effects that highly addictive substances (like heroin, cocaine, alcohol, cigarettes, high-fat, high-sugar foods) all have in common, it's understandable why so many children who were abused become compulsively fixated on obtaining and using them. The common thread in these addictive substances? The are all extremely efficient tools for the release of endorphins. Endorphins are biochemicals that upon release, activate the reward centre of the brain, soothe stress and anxiety (reduce cortisol levels), momentarily heal pain, and give humans that warm, cozy, "ahhh" feeling - similar to a hug from someone you love. So because children who were abused endure significantly higher levels of stress (the "fight or flight" response and spikes of cortisol are induced far more often) that individual has a tough time dealing with even the smallest of daily tasks and responsibilities that revolve around the emotions of others, and constantly need to reach for something to relieve that stress and the long-term physical pain that notoriously comes from it.

Q: But it happened so long ago, why can't they just get over it?

Again, it's a nervous system response, not a conscious thought response to that childhood trauma. In fact, most adults who were abused as children will tell you, "So what, I'm over it, who cares." while they emit a tough demeanour and a who cares attitude if ever asked about their childhoods. This is because we have been reprimanding sadness, vulnerability, and emotional individuals for centuries - they are deemed undesirables in society and the vulnerable are the first to pick up on that. No one wants to be the victim of abuse so they often block it out, and get tough. But it's their adaptive nature that responds regardless of what they tell themselves in their conscious minds, and to others around them. It takes a lot more than 'acting' tough to work out the limbic and central nervous system's autonomous response to the perception of pain. A lot of times they feel angry that they can't seem to control themselves in the face of whatever drug or drink that controls their lives, but they rarely want to talk about what happened to them as children because they've 'put that behind them'.

Even if a child who suffered through abuse in their developmental stages does find themselves in a position where they have done 'everything right' and avoided smoking, drinking, and drugs - all the things that we've always been told will ruin your life - they will still find themselves engaging over compulsively in other legal things that have the same effects of lighting up the reward center of the brain. Say they can't stop eating highly processed foods, having sex with too many people, overdoing some extreme sports, shopping out of control even when they are in extreme debt. The stress of their overexposure to pain in those developmental years will be too much to handle on their own and if not addressed they will constantly seek a reward to reduce the harm from so many environmental stressors.

To talk a bit more about environmental stressors, contrast the child who was abused, with the child who whenever they asked for a second helping of oatmeal, or an extra hug or blanket before bed, the parent responded with a warm, genuine smile and eye contact, and said, "Sure son, come with me to the kitchen for another scoop" or placed their newspaper down and said, "Of course you can, come in for a hug." The child will not have a built-in nervous system reaction to asking for something and will feel confident that their needs will always be met. This child will grow up into an adult who will be able to ask for a raise for the hard work they've done, while the child who has a maladapted nervous system will be shot with stress and anxiety when they even just think about asking for a raise. In fact, it will become easier for them to avoid an authoritative boss figure all-together. Or if they are in a position where they have to be under the pressure and perception of abuse that comes from a demanding boss, they will find themselves compulsively engaging in something to reduce that very visceral fear and over-reaction of the body's fight or flight syndrome after the perception of any reminder of that initial pain from the developmental years.

Q: I never hit or physically abused my child, so why are they addicted?

Unfortunately, before the science confirmed otherwise, parents thought they were doing a wonderful job if they were just making sure their children weren't physically harmed. But the research now shows that neglect is a silent killer. Most parents in the West don't understand how much their infants need physical touch, eye-contact, and a soothing voice. These things - once considered to be emotional luxuries - are in fact required for the infant's nervous system and biochemical regulation to develop properly. Psychologist John Bowlby called this developing a secure attachment bond. Secure attachment bonds assure that the child develops an armour against stress from rejection, loneliness, and other 'emotional' pain that physically harms the body in the same way that falling and being hit does - you just can't see it. In fact, so-called 'emotional' pain can be so harmful to the body, that Tylenol - a known pain killer - reacts on the same centres of the brain for both physical and emotional pain.

 
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The roots of addiction and lasting solutions*

by Tracy Giesz-Ramsay | This.org

In Aaron Goodman’s The Outcasts Project, the photojournalist captures opioid users from Vancouver’s Downtown Eastside in their day-to-day lives as they participate in North America’s first heroin-assisted treatment program. Above, subject Johnny is photographed as a nurse aids in self-injection at Vancouver’s Crosstown Clinic. “The reason I do the dope are different from why a lot of other people do it,” he says. “They do it to get high, I do it to help with some pain issues I have. I don’t want people thinking, ‘You know, these guys are going in there taking our tax dollars and doing heroin and getting high, look at them. You know, they’re nothing but detriments to society.’ Well, I’ll tell ya, it’s saving my life.”

Pacing frantically around her living room, Audrey yelled at herself in frustration: “Just put down the fucking phone!” It was mid-February and, having been sober since New Year’s Day, Audrey, 35, whose name has been changed to protect her privacy, decided to see a show with friends at Toronto’s Danforth Music Hall. After getting ready with the band’s album playing and “just one” drink in hand, she became consumed by an inner battle between the urge to dial her dealer for the drugs she usually took when going out with friends, and her long-term desire to kick the habit.

Audrey had been a heavy drinker since her early 20s. Over the past decade, she developed a compulsive drive toward cocaine, even knowing that it can sometimes be laced with fentanyl. “It scared me at first,” she says, “but I just don’t read those headlines anymore.”

Audrey was the lead programmer at a Toronto tech firm, yet her personal life was unravelling. Her husband wanted children on the condition that she stop taking drugs for at least a year, but she had struggled to pass a month. Some days, Audrey found herself sniffing cocaine before breakfast.

That night in Toronto she cracked and called her dealer, instantly easing her anxiety. But feelings of guilt and defeat returned the next day. “I was so mad at myself. I’d been sober for over a month,” she says. “It’s like another person takes over.”

Like millions of other Canadians, Audrey has an addiction. By definition, addiction is when we compulsively engage in rewarding acts, even when we understand the adverse consequences. One can become addicted to many things: alcohol, cigarettes, gambling, sexual activity, shopping, junk food, even work. In non-compulsive amounts, some of these can be good for you. It’s only when they’re incessantly sought out, despite knowing the negative repercussions, that use becomes addiction.

The current answer to addiction is based on outdated assumptions and disproven theories. If we believe that narcotics on their own cause addiction then it makes sense to criminalize drugs; but a four-decade-long War on Drugs has done little to curb the problem. More people have been jailed for possession and profiteering than ever before, though addiction is rising in lockstep with an epidemic of overdose deaths.

If we believe that genetics alone causes addiction, then it makes sense to prescribe the disease away with pharmaceutical responses. But no specific gene can be pointed to as the cause of addiction, and no pill can cure it. Current medical and public policy approaches largely believe addiction is a problem to prescribe or jail away. Yet the roots of why people become addicted must be tackled to find lasting solutions.

Dr. Gabor Maté, a Vancouver physician and renowned addictions author, has long advocated for deeper comprehension. “If we’re going to understand addiction,” he says, “we first have to understand what it is that the person gets out of it.”

Addictive acts and substances activate neurochemicals known as endorphins, our brain’s natural opiates. By acting on the brain’s reward centres, opiates—both natural and synthetic—calm the body and mind. After consistent repetition of the behaviour, stimuli such as smells, sights, and sounds associated with the endorphin-releasing act trigger dopamine in the brain.

Dopamine is a neurotransmitter responsible for increasing energy, heightening drive, and narrowing focus. For Audrey, stimuli that typically preceded taking drugs—drinking and listening to music before a concert—triggered dopamine that focused her drive to obtain cocaine.

“If I were to start using heroin, the first time I did it…I wouldn’t get high until the heroin hit my brain,” says Dr. Alexander Goumeniouk, emeritus pharmacology professor at the University of British Columbia. “But the fiftieth time, I’d be high before the heroin even got in my arm.” Repetition facilitates the release of these compounds, Goumeniouk says. “There definitely is a behavioural component to addiction.”

We weigh consequences in our brain’s prefrontal cortex, the place where Audrey tells herself to stop using coke. But the brain’s reward centre can easily overpower the prefrontal cortex’s commands if cued by external stimuli—even something like a song. Stress can also trigger the reward centre to overpower the rational prefrontal cortex.

Maté often tells audiences on his speaking tours that the real question is not “why the addiction” but “why the pain.” If we’ve experienced stressful life events, we are more likely to reach for substances that release feel-good endorphins. “The first time I did heroin,” a sex worker told Maté, “it felt like a warm, soft hug.”

An overreactive nervous system and its need for soothing both stem from trauma. During childhood, abuse and neglect affect the brain and nervous system’s development, amplifying stress responses in adulthood.

When asked about her upbringing, Audrey disclosed she had been neglected as a child. Her father left when she was very young. “The new man my mom married was verbally abusive; a pretty angry guy,” she says. This abuse frayed her nervous system. “I think that’s why I can’t connect with others without being high.”

While data suggests that 80 percent of those in rehab centres have some trauma, childhood or otherwise, Goumeniouk’s experience puts that figure at 100 percent. Despite his own field trying to solve addiction with pharmaceuticals, he’s quick to note the effects of trauma on addiction, calling it an “underappreciated component of addiction-ology.”

In addition to childhood trauma, isolation is another crucial factor in determining the chances of addiction. Social and economic exclusion leaves the brain in the absence of environmental conditions required for healthy neurochemical activity.

Maia Szalavitz, a neuroscience author and reporter for the New York Times, often writes about the importance of connection for brain health. “You could define addiction as falling in love with a drug rather than a person. The same kinds of brain systems and chemicals are involved,” she says. "The underlying message," Szalavitz notes, "is that if people are alienated, traumatized, and desperate for a solution, simply taking away a drug doesn’t solve the problem."

"But the way we’ve set up society works against making warm and reliable connections,”
she says, "which are crucial for relieving stress. When you have inequality, you have competition,” neither of which are useful in helping people get the social support they need.

“There’s a universal human desire to be included, to be social,” says Chris Arnade, addiction and poverty journalist with the Guardian. "Drugs perform many tasks," he says; "beyond numbing pain, they provide someone with a social network. It may not be the social network that you or I may approve of, but on the streets, they have family, often for the first time.”

If addictive substances soothe us, calming troubles stemming from childhood trauma or social isolation, then society must tackle addiction at those roots. To create more affection and inclusivity, we need a deeper awareness of the lasting effects of childhood abuse and the isolating effects of stigma and disenfranchisement left over from the drug war.

With so many advocating for an addiction approach focused on mental and physical health, rather than a punitive or strictly pharmaceutical response, it’s time we accept the research and activism that prove we must tackle addiction at its roots.

*From the article here:

 
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According to addiction expert Dr. Gabor Maté, trauma is at the root of all addiction*

by Lakshmi Narayan | Feb 7 2019

Addiction is a condition that impacts body, mind, and spirit. It comes from the Latin word addictus, meaning “a debt slave,” a person who has been bound as a slave to his creditor. Many people describe themselves as “enslaved” by their opioid addiction. Addiction cannot be healed by pills and/or detox alone because they do not address the underlying root cause, which, according to addiction expert Dr. Gabor Maté, is always trauma.

Ibogaine

Ibogaine is a natural medicine for addiction that comes from the root bark of the iboga tree. It not only can interrupt addiction and eliminate withdrawal, it can also repair brain tissue damaged by prolonged opioid use. On a human level, an ibogaine treatment, combined with an integration plan can bring back a sense of wholeness and purpose to a person suffering from opioid addiction, offering them a real second chance at reclaiming life. Plant medicines like ibogaine can act as chemical doorways to direct unitive experience. They can be instrumental in being able to deal with the shadows and traumas of life on the psychological and spiritual level, where the wound resides. The ibogaine experience is a return to the root, not just the root cause of one’s problems, but the root source of one’s strength. This makes it a gift to humanity, especially during an opioid epidemic.

What are the risk factors of ibogaine?

Ibogaine treatment is not for everybody. People with cardiac issues may be at risk of arrhythmia during the treatment. The best clinics will do rigorous pre-screenings, which may include blood tests, EKGs, and health intake data. During the treatment they will monitor the client’s heart rate and pulse throughout the procedure. They will recommend nutritional pre-care and integration aftercare. However, because of ibogaine’s illegal status, there are no medical regulations for its use, and there is a risk of fatality for those with certain cardiac issues or other contra-indications if not administered properly. That being said, the death rate from overdose is so much greater that even as it now stands, ibogaine treatments are our best hope. These risk factors would be greatly mitigated if people could have access to ibogaine in a safe, legal, therapeutic environment within the United States, and if medical research and best practices were freely available.

Tragically illegal where it is most needed

The tragedy of parents losing a child to overdose, rising levels of psychological distress, moral depravity, and cultural destruction can all be attributed to this one thing: lack of legal access to the plants that are organic chemical cocktails designed by nature to put you directly in touch with your subconscious and superconscious. Just like food gives you nutrition for your body, entheogenic plants can give you nutrition for your mind and spirit.

We are dealing with centuries of cultural prohibition, compounded by the Controlled Substances Act of 1970, which made no distinction between shamanic substances with a long history of religious and medicinal use like ibogaine and harmful narcotics like heroin, cocaine, and methamphetamine. They were thrown indiscriminately into a category defined by the DEA as a schedule I controlled substance, with “no currently accepted medical use and a high potential for abuse” and severe criminal consequences for their possession, ingestion, and sale. Ibogaine is clearly mistakenly classified in this category.

Powerful medicine for addiction and trauma - not a recreational drug

Evidence confirms that there is nothing recreational about an ibogaine treatment. The experience lasts up to 36 hours and requires an in-patient procedure, either in a clinic or in a retreat center. While ibogaine works on a physiological level to repair brain tissue and neurons, on a psycho-spiritual level, it commonly presents one with a starkly honest life review that allows one to understand the roots of one’s illness or situation. For a person struggling for years with opioid addiction, it’s as though they have become their own doctor and metaphysician, empowered to understand and instantly heal years of dysfunction.

*From the article here:


Dr. Bruno Chaves has performed over 1200 treatments with ibogaine in hospital without a single adverse event. 62% of those treated remain abstinent long term. Dr. Chaves is currently accepting new patients for treatment in hospital in São Paulo, Brazil. For more information, contact Dr. Chaves directly at : [email protected] -pb
 
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mr peabody

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Childhood trauma and its lasting scars on adult behavior and mental health*

by Arash Javanbakht | reset.me | Jun 3 2019

With the awakening in society of the importance of mental health, combined with advances in neuroscience and psychiatry, much needed attention to trauma and childhood trauma is slowly forming.

A child’s brain is a sponge for learning about how the world works and who they themselves are. We humans have an evolutionary advantage in having the ability to trust the older and learn from them about the world. That leads to cumulative knowledge and protection against adversity, about which only the experienced know. A child absorbs the patterns of perceiving the world, relating to others and to the self by learning from adults.

But when the initial environment is unusually tough and unfriendly, then a child’s perception of the world may form around violence, fear, lack of safety and sadness. Brains of adults who experience childhood adversity, or even poverty, are more prone to detecting danger, at the cost of ignoring the positive or neutral experiences.

Some who experience childhood adversity have to mature faster and become caretakers or provide emotional support for siblings or parents at an age they themselves need to be taken care of. They may end up carrying those patterns of relating to others throughout their adult life.

The child of trauma may also perceive himself or herself as unworthy of love, guilty or bad. The brain of an unknowing child may think: If they do this to me, there should be something wrong with me, I deserve it.

The little world people experience as children forms the way we perceive the real big world, its people and the people we are as adults. This will then form the way the world reacts to us based on our actions.

A world filled with trauma

Childhood trauma is more common than one would think: Up to two-thirds of children experience at least one traumatic event. These include serious medical illness or injury, firsthand experience of violence or sexual abuse or witnessing them, neglect, bullying and the newest addition to the list: mass shootings.

Unfortunately, when it comes to domestic violence and sexual abuse, it is often chronic, repetitive exposure, which can be even more detrimental to the child’s mental and physical health and behavior.

Ongoing civil wars and refugee crises also expose millions of children to extremely high levels of trauma, which is often ignored.

How do children react to trauma?

To understand the child’s reaction to trauma, one has to keep in mind their developmental level of emotional and cognitive maturity. Most of the time, confusion is the reaction: The child does not know what is happening or why it is happening.

I hear frequently from my adult patients that when they were molested by a relative as a five-year-old, they did not know what was happening or why a supposedly trusting caregiver was doing it to them. Fear and terror, coupled with a sense of lack of control, are often companions of this confusion.

There is also guilt, as the child may believe they did something wrong to deserve the abuse, and often the perpetrating adults claim they did something wrong to deserve the abuse. Sadly when it comes to sexual abuse, sometimes when the parents are told about it, they choose to deny or ignore the incident. This makes the feelings of guilt and helplessness worse. When the trauma is happening to parents, such as frequent battering of a mother by an alcoholic father, children are stuck between two people they are supposed to love. They may be angry with the father for violence, or angry at the mother for not being able to protect herself and themselves.

They may try to rise to protect mom from father or from her sadness. They may feel guilty for not being able to save her, or have to raise their siblings when parents fail to do so. They learn the world is a brutal and unsafe place, a place where one is abused and one is violent.

Adulthood scars of childhood trauma

There is a growing body of research suggesting longstanding impact of childhood trauma: not only that such childhood experiences can form the way the person perceives and reacts to the world, but also that there are lifelong academic, occupational, mental and physical health consequences. These children may have lower intellectual and school performance, higher anxiety, depression, substance use and a variety of physical health problems including autoimmune disease.

Adults who endured childhood trauma have a higher chance of developing post-traumatic stress disorder when exposed to new trauma and show higher rates of anxiety, depression, substance use and suicide. Physical health consequences of childhood trauma in adults include but are not limited to obesity, chronic fatigue, cardiovascular disease, autoimmune disease, metabolic syndrome and pain.

Not all who are exposed to childhood adversity are permanently scarred, and a front line in research of childhood adversity is the predictors of risk and resilience. For instance, there are genetic variations which may make the person more or less vulnerable to impact of trauma. I often see those who were lucky enough to transform their trauma to a meaningful cause, and with the help of a good mentor, therapist, grandparent or positive experiences rise and develop more strength.

This, however, does not mean those who sustain long-term impacts were weaker or tried less. There are a multitude of genetic, neurobiological, family, support, socioeconomic and environmental factors, besides the severity and how chronic the trauma is, that can lead to breaking of the strongest of people when exposed to trauma.

How to deal with childhood trauma

We as a society can do a lot: reduce poverty; educate and provide less privileged parents with support needed for raising their children (although childhood trauma happens also in privileged homes); take seriously children’s report of abuse; remove the source of trauma or remove the child from the traumatic environment; psychotherapy. When necessary, medications can also help.

Fortunately for all of us, recent advances in neuroscience, psychotherapy and psychiatry have provided us with strong tools to prevent the negative impact in the child and reduce a lot of the negative impact in the adults, if we choose to use them.

*From the article here:

 
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mr peabody

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The groundbreaking public health study that should change U.S. society—but won’t

by Bruce Levine | Counterpunch | Jul 19 2019

What variable is associated with a 12 times greater likelihood of a suicide attempt—and also doubles the likelihood of cancer, heart disease, or stroke?

In the late 1990s, the Adverse Childhood Experiences (ACE) Study revealed a stunningly powerful relationship between childhood trauma and later adult emotional difficulties and physical health problems. Two decades after the ACE Study was published, it has finally become politically correct for U.S. politicians to acknowledge its significance, and for Congress to respond with legislation. However, U.S. history tells us that even when politicians finally acknowledge an ignored truth, given their allegiance to the U.S. societal status quo, their reactions routinely neglect the most embarrassing implications of that truth—before getting to that, a summary of the ACE Study.

The ACE Study

The ACE Study compared current adult emotional and physical health status to research subjects’ childhood traumatic experiences. The study was triggered by the 1980s observations of physician and researcher Vincent Felitti (head of Kaiser Permanente’s Department of Preventive Medicine in San Diego) who found a strong relationship between childhood sexual abuse and adult obesity.

In the mid-1990s, Felitti and Robert Anda (at the Centers for Disease Control and Prevention) surveyed the adverse childhood experiences of 17,431 Kaiser Permanente patient volunteers. Since the average study participant was 57 years old and their adult health status was known, the ACE Study could correlate adverse childhood experiences with adult health status decades later. Of note, this was a middle-to-upper-middle-class population—74% had attended college, and all had higher-end medical insurance.

Subjects were given one point for each Yes answer to the following 10 categories of childhood household trauma, and so their ACE score ranged from 0 to 10:

1. Recurrent emotional abuse such as humiliation (Were you routinely insulted, for example, told by parent you are stupid?).

2. Recurrent physical abuse (Were you beaten with fists or objects, beaten to the point of injury?).

3. Sexual abuse by older family member (Were you fondled or was anal, oral, or vaginal intercourse attempted on you?).

4. Major emotional neglect (Did you feel that no one in your family thought you were important or special?).

5. Major physical neglect (Can you recall not having enough to eat or enough clothing to wear or not being taken to the doctor if you were sick?).

6. Parental absence (Were your parents separated or divorced?).

7. Exposure to domestic violence (Did you grow up in home with a mother who was physically violated?).

8. Household substance abuse (Did you grow up in home with a problem drinker or drug abuser?).

9. Household extreme emotional problems (Did you grow up in home with someone who was suicidal, severely depressed, or diagnosed with severe mental illness?).

10. Household member incarcerated (Did you grow up in home with household member who went to prison?).

ACE findings produced two areas of unexpected results for the researchers. The first area was the prevalence of adverse childhood experiences in a relatively well-off population in the United States. The second area was the strength of the relationship between adverse childhood experiences with adult emotional problems and physical health issues—while unsurprising for many ACE victims, this has been groundbreaking for medical authorities.

Prevalence. More than a quarter of subjects grew up in a household with an alcoholic or a drug user; 23% had experienced severe physical abuse; and 28% of women had been sexually abused as children (16% of men). More than half of the subjects reported at least one adverse childhood experience, and one-quarter reported two or more.

It is important to keep in mind that ACE examined middle-to-upper-middle-class subjects, and we know from other research that abuse and neglect is far higher for children from financially impoverished households (the National Incidence Study of Abuse and Neglect reported: “Children in low socioeconomic status households. . . . experienced some type of maltreatment at more than 5 times the rate of other children; they were more than 3 times as likely to be abused and about 7 times as likely to be neglected”).

The finding that abuse and neglect are so common in well-off U.S. households—where, for example, 28% of girls are sexually abused—is so unpleasant that some defenders of the U.S. societal status quo have attempted to marginalize the ACE study by arguing that it is unreliable because it relies on the memory and credibility of respondents. The reality, Felitti and Anda have responded, is that under-reporting of trauma is more likely than over-reporting. Common sense tells us that, for example, a woman would be reluctant to discuss her childhood sexual abuse; and my experience of more than 30 years of clinical practice validates Felitti, Anda, and common sense—that under-reporting is far more likely than over-reporting.

Correlations Between Adverse Childhood Experiences and Negative Adult Health. While apologists of the U.S. societal status quo are embarrassed by the prevalence of adverse childhood experiences for well-off American children, what has been groundbreaking for medical authorities is the finding of such a powerful relationship between childhood trauma and adult serious emotional problems and physical health problems.

Returning to the initial question: What variable is associated with 12 times greater likelihood we make a suicide attempt and which also doubles the likelihood we get cancer, heart disease, or have a stroke? That variable is an ACE score of 4 or more as compared to adults with an ACE score of 0. This same variable also is associated with: a 4 times greater likelihood we have emphysema or chronic bronchitis; more than 4 times greater likelihood we have had a depressive episode in the past year; 7 times greater likelihood we become an alcoholic; and 10 times greater likelihood to have injected illegal drugs.

Moreover, correlations followed a “dose-response” model, which means that the higher the ACE score, the worse the outcome. So for example, Felitti notes that an ACE score of 6 compared to an ACE score of 0 makes it 46 times more likely that a person will have injected illegal drugs.

ACE study implications

The more extensive our childhood abuse and neglect, the greater our lifelong chronic stress, and the more likely we, throughout our lives, “medicate” the emotional pain of unhealed trauma by smoking cigarettes, drinking alcohol, using dangerous illegal and psychiatric drugs, compulsively eating, and engaging in other destructive behaviors. Our physical health is damaged not only by toxins such as cigarettes, alcohol, and drugs; even for those with high ACE scores who don’t engage in these self-destructive behaviors, the chronic unrelieved stress of unhealed trauma increases the wear and tear on the body by, for example, overloading our bodies with adrenalin and cortisol which compromise our immune systems.

While ACE findings of the prevalence of household dysfunction in well-off American households is embarrassing for apologists of the U.S. societal status quo, even more taboo (and uncounted in the ACE Study) are adverse childhood experiences outside the household—traumatizing childhood experiences created by U.S. societal authorities and institutions. In my clinical experience, patients have often told me that their most painful adverse childhood experiences have been created by (1) schooling; (2) psychiatric treatment; and (3) state coercions.

In their schooling, my experience is that what has driven adolescents to feel stressed, hopeless, and suicidal even more often than peer bullying are school authorities’ coercions and threats of dire consequences for academic noncompliance and failure. Oppressive psychiatric treatment—e.g., the use of drugs to control bothersome behaviors instead of receiving caring for the emotional pain fueling such behaviors—is also a major adverse childhood experience. The adverse childhood experience that dominated my adolescence was the U.S. state terrorism of the Vietnam War and the draft, which filled me with a chronic fear that I was going to get maimed or killed in Vietnam unless I became a fugitive. Today, many adolescents are overwhelmed with anxiety owing to a range of societally generated terrors—e.g., they are all pressured to go to college but well aware that a college degree may result only in a low-paying job, crippling student-loan debt, and failure to avoid becoming one of life’s “losers.”

For a sane society, the most obvious implication of the ACE Study would be prioritizing the prevention of preventable adverse childhood experiences. A sane society would be asking questions about the very nature of a society and culture that creates so much trauma for children. However, we do not live in a sane society. We live in a society that prioritizes profits for large corporations and power for large institutions. We live in a society in which, for example, the cause of depression and suicide has been, for decades, falsely attributed by psychiatry and Big Pharma to a chemical imbalance theory long known to be untrue—an untruth that has made billions of dollars for drug companies and increased power for psychiatry through increased use of antidepressants which are known to actually increase suicide. This is just one of many examples that we do not live in a sane society.

U.S. Politicians’ response vs. a sane society’s response

Owing to the great efforts of Felitti, Anda, and others getting the word out on the ACE Study, twenty years after its publication, it is no longer possible for politicians to simply ignore its findings. In June of 2019, the RISE From Trauma Act was introduced with bipartisan support in the U.S. Senate, its stated purpose: “To improve the identification and support of children and families who experience trauma.” It allocates $50 million in grants, spread over 2020 to 2023, for institutions such as child welfare agencies, hospitals, and schools for research; to build awareness, and to assess, prevent, and treat youth and their families who have experienced trauma or at risk of experiencing it.

In her Mad in America article about the RISE From Trauma Act, Leah Harris provides examples of how states have created initiatives in schools to be more “trauma sensitive.” In response to the idea of creating more trauma sensitive schools, one young man I know with an ACE score of 8—but who feels as traumatized by his school experience as by his household ones—was cynical, rhetorically asking me: “Are schools going to include ACE screening day with lice screening day? Are they going to report ACE scores to parents—parents who will then abuse the kid even more for talking to authorities about their shit parents?”

In response to Harris’s article, there were many comments by Mad in America readers who had negatively experienced psychiatric treatment, and almost all were concerned that the legislation would result in more such treatment that would be re-traumatizing. Felliti himself has concerns about typical mental health services that primarily treat traumatized patients with drugs, noting, “Back when I was at Kaiser Permanente, I was afraid to send patients to psychiatrists.”

In a sane society, treatment for traumatized young people would be quite different than the treatment routinely provided. A sane society would not equate treatment with drugging the symptoms of trauma; and it would not be self-satisfied with quick-and-easy behavioral “trauma informed focused treatments” (such as “cognitive processing therapy” and “prolonged exposure”). A sane society would recognize that real healing involves providing safe, caring, and loving relationships, which may or may not be possible within a paid therapeutic relationship; and so all efforts would be made to re-make society so that safe, caring, and loving relationships could be found in daily life.

A sane society would also be asking this: What is it about U.S. society that creates so many abusive and neglectful adults? A sane society would acknowledge that such adults have themselves likely not only been traumatized as children but continue to be traumatized in their adult lives—e.g., alienated and humiliated in their jobs; and given the general message that they are simply objects and tools, and to the extent that they cannot be used to make some rich asshole even richer or some powerful institution more powerful, they will be discarded. A sane society would not be surprised that such adults often have little patience for the normal but sometimes frustrating behaviors of children, and react with abuse and neglect.

 
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PtahTek

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The title got me here... will probably be here a couple days reading.

I love the hell out of this:
“ritualized compulsive comfort-seeking,”
may be my morning mantra as i get "comfy" before work. :)
not trying to make light of any of this... think it has a bit to do with my behaviour: the childhood trauma.
 

mr peabody

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Is the key to breaking addiction dealing with past trauma?*

by Joanna Moorhead | The Guardian | 24 Nov 2018

What’s your poison, people sometimes ask, but Gabor Maté doesn’t want to ask what my poison is, he wants to ask how it makes me feel. Whatever it is I’m addicted to, or ever have been addicted to, it’s not what it is but what it does – to me, to you, to anyone. He believes that anything we’ve ever craved helped us escape emotional pain. It gave us peace of mind, a sense of control and a feeling of happiness.

And all of that, explains Maté, reveals a great deal about addiction, which he defines as any behaviour that gives a person temporary relief and pleasure, but also has negative consequences, and to which the individual will return time and again. At the heart of Maté’s philosophy is the belief that there’s no such thing as an “addictive personality.” And nor is addiction a “disease.” Instead, it originates in a person’s need to solve a problem: a deep-seated problem, often from our earliest years that was to do with trauma or loss.

Maté, a wiry, energetic man in his mid-70s, has his own experience of both childhood trauma and addiction, more of which later. Well-known in Canada, where he lives, he gives some interesting reasons why Britain is “just waking up to me” and his bestselling book In the Realm of Hungry Ghosts. There’s a generational conflict here, he says, around being open about past trauma: he cites Princes William and Harry opening up about their mother’s death, and says it’s something the Queen’s generation would never have done. He applauds the new approach: “I think the princes are right to be leading and validating that sense of enquiry, without which life is not worth living.”

The infamous British stiff upper lip is something Maté has watched with fascination over the years. Born of our imperial past, he says, it was maintained for as long as there was something to show for it. Boarding school culture and traumatic childhoods played out into dominance of other countries and cultures, giving the “buttoned-up” approach inherent value. But once the empire crumbled, lips quavered.

“With rising inequality and all the other problems there are right now,” he says, “people are having to question how they live their lives. People in Britain are beginning to realise they paid a huge price internally for all those suppressed emotions.”

"Part of that price was addiction – whether to alcohol or drugs, gambling or sex, overwork or porn, extreme sports or gaming – but essential to understanding it,"
says Maté, "is to realise that addiction is not in itself the problem but rather an attempt to solve a problem. Our birthright as human beings is to be happy, and the addict just wants to be a human being.”

And addictive behaviour, though damaging in the medium or long term, can save you in the short term. “The primary drive is to regulate your situation to something more bearable. So rather than some people having brains that are wired for addiction," Maté argues, "we all have brains that are wired for happiness. And if our happiness is threatened at a deep level, by traumas in our past that we’ve not resolved, we resort to addictions to restore the happiness we truly crave."

He speaks from experience: Maté is a physician who specialised in family practice, palliative care and, finally, addiction medicine. He became a workaholic and lived with ADHD and depression until, in his 40s and 50s, he began to unravel the root cause – and that took him all the way back to Budapest, where he was born in January 1944. Two months later, the Nazis occupied Hungary: his mother took him to the doctor because he wouldn’t stop crying.

“Right now,”
the doctor replied, “all the Jewish babies are crying. This is because," explains Maté, "what happens to the parent happens to the child: the mothers were terrified, the babies were suffering, but unlike their mothers they couldn’t understand what the suffering was about."

Later, Maté’s mother, fearing for his survival, left him for a month in the care of a stranger. All this, he explains, gave him a lifelong sense of abandonment and loss which had an impact on his psychological health. It affected his marriage and his own parenting experience. To compensate for his buried trauma, he had buried himself in work and neglected his family.

Opening up to the trauma, exploring it and investigating it, was incredibly difficult. “The problems for me showed up in the dichotomy between my success as a physician and my miseries as a husband and a father,” he recalls. “There was a big gap between them, and it’s taken me a long time to work through what I needed to work through.” As Oscar Wilde believed, pain is the path to perfection; and nearly five decades on from the day of their wedding, Maté says his marriage is better than ever.

“We’re happier, but it’s taken many years of work,” he says. In a few weeks it will be the couple’s 49th wedding anniversary. “We’ll go out for dinner and raise a glass to five happy years,” he quips. He’s already chosen his epitaph: “It’s going to say, this life is a lot more work than I anticipated. Because it takes a lot of work to wake up as a human being, and it’s a lot easier to stay asleep than to wake up.”

For Maté, self-awareness is the bottom line: when we wake up and become properly self-aware, we are able to address the traumatic childhood issues that leave us vulnerable to addiction. But because the process inevitably involves pain, we don’t address the issues until we absolutely have to – until something happens that forces us to face up to the fact that our lives aren’t working as they should. And as with the individual, so too with society: although all around us in politics and the wider world is mayhem and chaos, Maté holds on to the fact that this discomfort – which we are communally aware of – will force us to examine what’s gone wrong in our collective psyche, and to seek to correct it.

Unsurprisingly, given his central message, Maté is in favour of drug decriminalisation. He points to Portugal, where it is no longer illegal to possess a small amount of heroin or cocaine, and says the country has seen a reduction of drug-taking, less criminality and more people in treatment. In his view, it’s not really the drugs that are being decriminalised, it’s the people who are taking them – and given that they are, in his view, always victims of trauma, and never merely “bad” or “dangerous,” that’s entirely logical. But decriminalisation is only the beginning: reform must cut much deeper. “The whole legal system is based on the idea that people are making a choice,” he says. “This is false – because no one chooses to be an addict, or to be violent.”

Everything about Maté seems to be based on a workaday, efficient kindness: his message is about understanding, blue-sky thinking and common sense. However, with any philosophy that references retrospective experiences, there’s the inevitable tendency to parent-bash – the “they fuck you up” mentality. But read on in Larkin, and his approach is not so different from Maté’s: “They may not mean to, but they do. There’s no room for blame because," says Maté, "virtually all parents do their best, and the deepest love they have is for their child. One of the best things that ever happens," he says, "is when a parent whose child has died of an overdose comes up to him and tells him that, through his book, they can understand why it happened." And when readers tell him – sometimes accusingly, sometimes gratefully – that his work humanises addicts, he can only answer: addicts are human. The only question for him is, why has it taken us so long to realise that?

*From the article here:

 

mr peabody

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Take it from me, addiction doesn’t start at the border

by Jill Richardson | February 22, 2019

As the sister of someone lost to an opioid overdose, the claim that we need a border wall to keep drugs out is offensive to me on multiple levels. Fact checkers also report this claim is untrue — a border wall would not keep drugs out of our country.

After the death of my brother, I went looking for answers about drugs and addiction. Gabor Maté, a medical doctor who treated addicts in Vancouver, found that his patients had all suffered severe trauma before succumbing to addiction. Maté's book, In the Realm of Hungry Ghosts, explains how trauma makes the brain more susceptible to addiction.

That was also the finding of the Adverse Childhood Experiences study, which surveyed patients about whether they experienced 10 different types of stressful or traumatic experiences (called ACEs for short) in childhood: various types of abuse, parents divorcing, a parent going to prison, or a parent suffering addiction or mental illness.

The higher your ACE score, the more likely you are to suffer alcoholism, drug addiction, or a host of other health problems.

My brother and I both experienced childhood trauma. I ended up suffering anxiety, depression, and chronic migraines. He developed panic attacks and coped with his pain by binge eating and using drugs. I’m told the day he overdosed was only the third time he’d ever used heroin. He was alone in his apartment, age 23.

Through random chance, I was luckier than he was. Life dealt us both severe pain, but for me the pain took a form that was less deadly and more conducive to getting help. His death was my catalyst to get therapy. It’s taken a decade, but I finally feel like my life has turned around.

When just getting through everyday life hurts so very much, drugs present a welcome relief. I don’t think I’m a better person than he was; I was just luckier. Trauma left him susceptible to addiction, and for some reason it just landed me with 20 years of migraines.

The U.S. has tried to solve its drug problem by cutting off the supply of drugs coming through its borders since at least the 1980s. It hasn’t worked. Neither has prison sentences for nonviolent drug offenses. In fact, these approaches have only made the problem worse, and created many others besides.

If we want to cut down on our drug problem, we need to cut down on the factors that cause addiction in the first place. We must work on reducing the amount of trauma, poverty, and despair Americans experience and offer help to those who’ve suffered so they can overcome it.

We should also reduce demand for illegal drugs by offering safe, legal, and regulated drugs when they can provide health benefits, as medical marijuana has done for me.

Even if a border wall were a cost effective and feasible way to keep drugs from coming over the border (which according to virtually every expert, it isn’t), it would do nothing to address the root causes of addiction in America.

When people are in pain, they’ll find a way to get drugs. So long as there’s a market for illegal drugs, traffickers will find ways to produce them here or bring them in. The real answer to the illegal drug trade is addressing the root causes of addiction.

 
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Childhood trauma and its lasting scars on adult behavior and mental health

by Arash Javanbakht | reset.me | Jun 3 2019

With the awakening in society of the importance of mental health, combined with advances in neuroscience and psychiatry, much needed attention to trauma and childhood trauma is slowly forming.

In a recent interview with Anderson Cooper and in his latest book published May 14, Howard Stern discussed childhood adversity and trauma. The two men also discussed their exposure to their parents’ stress and how their reactions as children formed their adult behavior.

As a trauma psychiatrist, I am glad that men with such celebrity are willing to talk about their experiences, because it can help bring awareness to the public and reduce stigma.

Childhood: Learning about the world and the self

A child’s brain is a sponge for learning about how the world works and who they themselves are. We humans have an evolutionary advantage in having the ability to trust the older and learn from them about the world. That leads to cumulative knowledge and protection against adversity, about which only the experienced know. A child absorbs the patterns of perceiving the world, relating to others and to the self by learning from adults.

But when the initial environment is unusually tough and unfriendly, then a child’s perception of the world may form around violence, fear, lack of safety and sadness. Brains of adults who experience childhood adversity, or even poverty, are more prone to detecting danger, at the cost of ignoring the positive or neutral experiences.

Some who experience childhood adversity have to mature faster and become caretakers or provide emotional support for siblings or parents at an age they themselves need to be taken care of. They may end up carrying those patterns of relating to others throughout their adult life.

The child of trauma may also perceive himself or herself as unworthy of love, guilty or bad. The brain of an unknowing child may think: If they do this to me, there should be something wrong with me, I deserve it.

The little world people experience as children forms the way we perceive the real big world, its people and the people we are as adults. This will then form the way the world reacts to us based on our actions.

A world filled with trauma

Childhood trauma is more common than one would think: Up to two-thirds of children experience at least one traumatic event. These include serious medical illness or injury, firsthand experience of violence or sexual abuse or witnessing them, neglect, bullying and the newest addition to the list: mass shootings.

Unfortunately, when it comes to domestic violence and sexual abuse, it is often chronic, repetitive exposure, which can be even more detrimental to the child’s mental and physical health and behavior.

Ongoing civil wars and refugee crises also expose millions of children to extremely high levels of trauma, which is often ignored.

How do children react to trauma?

To understand the child’s reaction to trauma, one has to keep in mind their developmental level of emotional and cognitive maturity. Most of the time, confusion is the reaction: The child does not know what is happening or why it is happening.

I hear frequently from my adult patients that when they were molested by a relative as a five-year-old, they did not know what was happening or why a supposedly trusting caregiver was doing it to them. Fear and terror, coupled with a sense of lack of control, are often companions of this confusion.

There is also guilt, as the child may believe they did something wrong to deserve the abuse, and often the perpetrating adults claim they did something wrong to deserve the abuse. Sadly when it comes to sexual abuse, sometimes when the parents are told about it, they choose to deny or ignore the incident. This makes the feelings of guilt and helplessness worse. When the trauma is happening to parents, such as frequent battering of a mother by an alcoholic father, children are stuck between two people they are supposed to love. They may be angry with the father for violence, or angry at the mother for not being able to protect herself and themselves.

They may try to rise to protect mom from father or from her sadness. They may feel guilty for not being able to save her, or have to raise their siblings when parents fail to do so. They learn the world is a brutal and unsafe place, a place where one is abused and one is violent.

Adulthood scars of childhood trauma

There is a growing body of research suggesting longstanding impact of childhood trauma: not only that such childhood experiences can form the way the person perceives and reacts to the world, but also that there are lifelong academic, occupational, mental and physical health consequences. These children may have lower intellectual and school performance, higher anxiety, depression, substance use and a variety of physical health problems including autoimmune disease.

Adults who endured childhood trauma have a higher chance of developing post-traumatic stress disorder when exposed to new trauma and show higher rates of anxiety, depression, substance use and suicide. Physical health consequences of childhood trauma in adults include but are not limited to obesity, chronic fatigue, cardiovascular disease, autoimmune disease, metabolic syndrome and pain.

Not all who are exposed to childhood adversity are permanently scarred, and a front line in research of childhood adversity is the predictors of risk and resilience. For instance, there are genetic variations which may make the person more or less vulnerable to impact of trauma. I often see those who were lucky enough to transform their trauma to a meaningful cause, and with the help of a good mentor, therapist, grandparent or positive experiences rise and develop more strength.

This, however, does not mean those who sustain long-term impacts were weaker or tried less. There are a multitude of genetic, neurobiological, family, support, socioeconomic and environmental factors, besides the severity and how chronic the trauma is, that can lead to breaking of the strongest of people when exposed to trauma.

How to deal with childhood trauma

We as a society can do a lot: reduce poverty; educate and provide less privileged parents with support needed for raising their children (although childhood trauma happens also in privileged homes); take seriously children’s report of abuse; remove the source of trauma or remove the child from the traumatic environment; psychotherapy. When necessary, medications can also help.

Fortunately for all of us, recent advances in neuroscience, psychotherapy and psychiatry have provided us with strong tools to prevent the negative impact in the child and reduce a lot of the negative impact in the adults, if we choose to use them.

 

mr peabody

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The link between childhood trauma and addiction in adulthood

There is a clear and distinct correlation between child trauma and drug and alcohol addiction. The traumatic incidents that we experience in our childhood very easily can, and often do, wind up following us into maturity creating a variety of long-term mental health issues that may cause us to self-medicate through excessive drinking or drug abuse. The National Institutes of Health (NIH) report that more than a third of adolescents with a report of abuse or neglect will have a substance use disorder before they reach their 18th birthday.

Data published in TIME Magazine indicates that 55 to 60 percent of all post-traumatic stress disorder (PTSD) victims end up developing some form of chemical dependency, an assertion backed up by the American Psychological Association (APA). In addition, the National Institute of Mental Health (NIMH) reports that 7 to 8 percent of the American population suffers from some level of PTSD. Identifying trauma-related substance abuse triggers is a key element of treatment and fundamental to helping individuals in recovery live a rich and full life as they endeavor to stay clean.

Where does trauma take root?

The term trauma is defined as an adverse and often malignant emotional reaction to a singular or repetitive event that caused severe physical or psychological harm. It is characterized by a patient’s inability to move past and process the experience without reliving it over and over again. Trauma victims will very often develop serious mental illness for which they turn to drugs and alcohol. Data published in JAMA Psychiatry suggests that more than 30 percent of all PTSD sufferers develop a major depressive disorder, and the Department of Veterans Affairs reports that ten percent of Americans suffer from trauma-related depression each year.

Trauma is a broad term used to describe a wide range of incidents, the most common include:

- Rape or sexual assault
- General physical assault
- Domestic or intimate partner violence
- Extreme verbal and emotional abuse

- Bullying and repeated harassment of any kind
- Terminal illness
- Natural disasters
- Accidents such as car crashes or fire
- Parental neglect

The reality of trauma is that it can come from anywhere and manifest in a variety of physical and psychological symptoms.

Behavioral and psychological trauma symptoms

Individuals who experience childhood trauma may experience a number of short-term and long-term psychological and behavioral symptoms, including but not limited to:

- Prolonged agitation and irritability
- Avoidance of things that remind them of the trauma
- Erratic changes in mood and behavior
- Prolonged and Consistent Fear and Nervousness

- Timidity and lack of confidence
- Constantly reliving the event(s)
- An excessive and often inappropriate display of emotions

Trauma symptoms that take root in childhood often have a severely negative impact on quality of life in adulthood, affecting a full range of areas.

Professional life problems

Data indicates that lingering effects of childhood trauma can manifest as conflict in the workplace. Trauma experienced in childhood has a direct influence on how sufferers perceive and process adversity, trust and relate to others, handle responsibility, and much more, all factors with which adults are expected to contend in the workplace every day. Inability to process childhood trauma can have a direct impact on professional mobility and quality of life.

Romantic and social relationships issues

Childhood trauma survivors, particularly those who have experienced sexual trauma or any other type of physical or emotional abuse, often have serious intimacy issues that cause create significant obstacles to forming healthy romantic relationships. Data indicates that childhood trauma has a direct impact on how we form general and sexual identity, trust others, develop self-worth, assert our confidence, avoid or embrace destructive relationships, and more.

Eating disorders – binge eating, bulimia, anorexia

Binge eating disorder, bulimia, and anorexia are psychological illnesses often brought about by childhood abuse. According to The New York Center for Eating Disorders, 50% of all patients presenting with eating disorders are victims of childhood assault. For many people with eating disorders, trusting food is safer than trusting people! It never abuses you, ridicules you, dies, or abandons you. It is the only relationship where we get to say where, when, and how much. No other relationship complies with our needs so absolutely.

Food, after all, is the cheapest, most available, legal, socially acceptable mood-altering drug on the market. Patients report that even as children they turned to bingeing, purging, or starving as a way to manage unbearable emotions following sexual trauma. The comfort of compulsive overeating, vomiting, laxatives or self-starvation as well as the numbing effects of the “drug” of food can be a short term solution to the pain, grief, and rage of abuse and live on as a coping mechanism in adulthood.

Eating disorder evaluation and treatment should be part of an individualized, comprehensive plan for each patient.

Watch this webinar on opioids and early adversity: connecting childhood trauma and addiction:


One landmark study, known as the Adverse Childhood Experiences Survey, showed definitively how childhood trauma can directly influence the formation of the brain. The study also found that child abuse and other forms of trauma were a leading cause of death among adults through a variety of factors. While trauma treatment has gotten incrementally more intuitive since this study was published, childhood trauma is still linked to a number of fatal factors, including suicide.

Examples of childhood trauma influencing drug addiction

Chemical dependency takes many forms, and many of them are often linked to trauma sustained in developmental years. Whether we develop a crippling alcohol addiction out of a need for social acceptance or any other reason; start smoking marijuana to escape our everyday reality; start shooting heroin or taking painkillers to avoid memories of deep-rooted abuse or anything else.

There are multiple contexts in which a person can experience co-occurring childhood-related PTSD and addiction:

- The NIH, among other agencies, reports that those who sustain childhood trauma are at extremely high risk for developing alcohol addiction.
- Multiple data, including a recent global collaborative survey, reveals a direct correlation between childhood trauma and marijuana abuse.
- Data from the National Conference on Legislatures, as well as many other organizations, points to a close relationship between childhood adversity and the development of opioid dependency.
- A recent study from Florida’s Miller School of Medicine revealed that childhood abuse and other types of developmental trauma can increase the likelihood of meth abuse.

These increased risks stem from a variety of factors. Some children who crave stability, acceptance, and community in their home lives look for it elsewhere among equally toxic influences and start abusing alcohol or other drugs as a means of gaining that sense of acceptance and solidarity. The chronic nature of substance abuse means that these early behaviors can very easily follow children into adulthood. Other children simply fail to recognize, acknowledge, and effectively process this trauma until it manifests in self-destructive ways like self-harm, substance abuse, or the inability to control their emotions. This is why early intervention is such a critical part of the clinical trauma-treatment process.

Domestic abuse and addiction

Domestic abuse is one of the most common forms of childhood trauma and can have a direct impact on the formation of addiction. In a recent study published in the Journal of Drug and Alcohol Dependence, researchers from Columbia University found that domestic abuse drastically increases the likelihood of the onset of chemical dependency. Another recent study from Emory University revealed a close relationship between physical and emotional child abuse and the development of drug or alcohol addiction as a result of emotional dysregulation. This trauma can either form as a result of direct abuse or having to witness abuse in the home, the latter being a factor with which far too many children are forced to contend.

Sexual abuse and addiction

Another tragically common element of childhood trauma includes sexual abuse. Data from the Department of Health and Human Services indicates that almost sixty-thousand children are sexually abused per year in the United States. The Department of Justice’s report “Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics” indicates that 14 percent of all men and 36 percent of all women in prison were abused as children.

Other data indicates that sexually abused children are less likely to practice safe sex, putting them at greater risk for STDs. They’re also 25 percent more likely to experience teen pregnancy and significantly more likely to develop problems related to drug and alcohol addiction. To compound this unthinkable trauma, 90 percent of child sexual abuse victims know the perpetrator in some way. Nearly 70 percent are abused by a family member.

Physical abuse and addiction

Whether it’s through acute one-time physical assault, a prolonged and consistent pathology of bullying, or a lifetime of abuse inside the home, physical abuse is an all-too-common part of the average child’s life. The American Society for the Positive Care of Children reports that more than 18 percent of children who are maltreated experience physical abuse and that nearly half of those children die from it. The National Institute on Drug Abuse (NIDA) reports that two-thirds of the people in treatment for drug abuse reported being abused or neglected as children. There are multiple levels of physical abuse that can put children in harm’s way and lead to the development of drug or alcohol addiction later in life.

Emotional abuse and addiction

Emotional abuse is a broad term that can describe a range of behaviors, including direct verbal assault, active manipulation, or simple neglect and ignoring of the child. One of the emotional abuse-related behaviors most closely linked to the development of substance abuse is the early exposure to drugs and alcohol from a parent or guardian. Data from the United States Department of Health and Human Services reveals that between 30 and 60 percent of all of child maltreatment cases involve substance use to some degree and that children whose parents abuse drugs or alcohol are three to four times more likely to be abused and neglected, thus perpetuating the cycle.

Treating co-occurring addiction and childhood trauma

Treatment for childhood trauma-related addiction must simultaneously address the immediate medical and behavioral aspects of substance abuse while providing targeted and in-depth treatment for the trauma-related triggers that sustained it. This is accomplished through a comprehensive course of professional addiction treatment beginning with medically supervised detoxification, followed by focused and customized behavioral rehab. While each patient’s addiction care needs will vary according to their level of trauma and their scope of substance abuse, addressing both of these factors is crucial to successful management of stress and to sustaining recovery. More severe cases of co-occurring trauma and substance abuse may require long-term inpatient treatment, whereas those with a more limited history may benefit from intensive outpatient (IOP) care.



Detoxification and withdrawal management

Medical detox provides a safe, supportive, and compassionate environment to help patients heal from the worst of their withdrawal symptoms and get expert help for any medical issues that may arise during the process. This is perhaps the most vulnerable that patients will ever be during the addiction treatment process, and it’s critical that they have quality help and support to help them get through their acute withdrawal symptoms. Patients who endeavor to detox on their own, specifically those with a longer history of substance abuse, run a heightened risk of relapse because they’re simply unable to endure the process alone.



Childhood abuse rates of people in prison

Rehab and Behavior Modification

Most patients who develop substance abuse as a result of childhood trauma never confront or effectively process their trauma without reliving it over and over and letting it run their lives. Behavioral rehab during the addiction treatment process allows patients to work with a trained mental health expert to address the trauma-related root causes and sustaining factors of their addictions. Through techniques like group therapy, individualized counseling, and supplemental therapies like cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, eye-movement desensitization and reprocessing (EMDR), and more, patients can begin to healthily process their trauma, recognize triggers, and successfully manage stress in their everyday lives.

After patients complete their treatment program, they should be given a comprehensive and targeted aftercare plan that builds on their progress in treatment and provides contact information for addiction and trauma specialists in their area to whom they can go for ongoing therapy.

Stopping childhood trauma in its tracks

Parents of childhood trauma survivors often feel powerless to help their sons or daughters, and many of them fail to grasp exactly how much the trauma they’ve sustained has affected them.

If you suspect your child has sustained trauma for which they need professional help, there are multiple resources to help them get the care they need, from organizations such as:

- The Substance Abuse and Mental Health Services Administration SAMHSA
- The United States Department of Health and Human Services (HHS)
- The Child Mind Institute
- That National Child Traumatic Stress Network (NCTSN)

Early intervention in childhood trauma can mean the difference between a healthy and productive life and significant psychological and emotional impairment and substance use.

Don’t let your past dictate your future

Millions of Americans struggle with addiction related to one more traumatic childhood experiences; the primary difference that determines their lives is the steps they take to choose their future once they realize they have a problem. It’s important to realize the trauma you have sustained may have compelled you to unwittingly develop an identity, value system, long-term behaviors, and even your very sense of right and wrong—unpacking these issues will not occur overnight or in a vacuum. Don’t let your early trauma put you in an early grave. Get the help you need now to start fighting back against your trauma-related addiction.

 
Last edited:

Snowy_Hell

Temporary Ban
Joined
Jul 12, 2017
Messages
182
Location
Eastern Europe



The link between childhood trauma and addiction in adulthood

There is a clear and distinct correlation between child trauma and drug and alcohol addiction. The traumatic incidents that we experience in our childhood very easily can, and often do, wind up following us into maturity creating a variety of long-term mental health issues that may cause us to self-medicate through excessive drinking or drug abuse. The National Institutes of Health (NIH) report that more than a third of adolescents with a report of abuse or neglect will have a substance use disorder before they reach their 18th birthday.

Data published in TIME Magazine indicates that 55 to 60 percent of all post-traumatic stress disorder (PTSD) victims end up developing some form of chemical dependency, an assertion backed up by the American Psychological Association (APA). In addition, the National Institute of Mental Health (NIMH) reports that 7 to 8 percent of the American population suffers from some level of PTSD. Identifying trauma-related substance abuse triggers is a key element of treatment and fundamental to helping individuals in recovery live a rich and full life as they endeavor to stay clean.

Where does trauma take root?

The term trauma is defined as an adverse and often malignant emotional reaction to a singular or repetitive event that caused severe physical or psychological harm. It is characterized by a patient’s inability to move past and process the experience without reliving it over and over again. Trauma victims will very often develop serious mental illness for which they turn to drugs and alcohol. Data published in JAMA Psychiatry suggests that more than 30 percent of all PTSD sufferers develop a major depressive disorder, and the Department of Veterans Affairs reports that ten percent of Americans suffer from trauma-related depression each year.

Trauma is a broad term used to describe a wide range of incidents, the most common include:

- Rape or sexual assault
- General physical assault
- Domestic or intimate partner violence
- Extreme verbal and emotional abuse

- Bullying and repeated harassment of any kind
- Terminal illness
- Natural disasters
- Accidents such as car crashes or fire
- Parental neglect

The reality of trauma is that it can come from anywhere and manifest in a variety of physical and psychological symptoms.

Behavioral and psychological trauma symptoms

Individuals who experience childhood trauma may experience a number of short-term and long-term psychological and behavioral symptoms, including but not limited to:

- Prolonged agitation and irritability
- Avoidance of things that remind them of the trauma
- Erratic changes in mood and behavior
- Prolonged and Consistent Fear and Nervousness

- Timidity and lack of confidence
- Constantly reliving the event(s)
- An excessive and often inappropriate display of emotions

Trauma symptoms that take root in childhood often have a severely negative impact on quality of life in adulthood, affecting a full range of areas.

Professional life problems

Data indicates that lingering effects of childhood trauma can manifest as conflict in the workplace. Trauma experienced in childhood has a direct influence on how sufferers perceive and process adversity, trust and relate to others, handle responsibility, and much more, all factors with which adults are expected to contend in the workplace every day. Inability to process childhood trauma can have a direct impact on professional mobility and quality of life.

Romantic and social relationships issues

Childhood trauma survivors, particularly those who have experienced sexual trauma or any other type of physical or emotional abuse, often have serious intimacy issues that cause create significant obstacles to forming healthy romantic relationships. Data indicates that childhood trauma has a direct impact on how we form general and sexual identity, trust others, develop self-worth, assert our confidence, avoid or embrace destructive relationships, and more.

Eating disorders – binge eating, bulimia, anorexia

Binge eating disorder, bulimia, and anorexia are psychological illnesses often brought about by childhood abuse. According to The New York Center for Eating Disorders, 50% of all patients presenting with eating disorders are victims of childhood assault. For many people with eating disorders, trusting food is safer than trusting people! It never abuses you, ridicules you, dies, or abandons you. It is the only relationship where we get to say where, when, and how much. No other relationship complies with our needs so absolutely.

Food, after all, is the cheapest, most available, legal, socially acceptable mood-altering drug on the market. Patients report that even as children they turned to bingeing, purging, or starving as a way to manage unbearable emotions following sexual trauma. The comfort of compulsive overeating, vomiting, laxatives or self-starvation as well as the numbing effects of the “drug” of food can be a short term solution to the pain, grief, and rage of abuse and live on as a coping mechanism in adulthood.

Eating disorder evaluation and treatment should be part of an individualized, comprehensive plan for each patient.

Watch this webinar on opioids and early adversity: connecting childhood trauma and addiction:


One landmark study, known as the Adverse Childhood Experiences Survey, showed definitively how childhood trauma can directly influence the formation of the brain. The study also found that child abuse and other forms of trauma were a leading cause of death among adults through a variety of factors. While trauma treatment has gotten incrementally more intuitive since this study was published, childhood trauma is still linked to a number of fatal factors, including suicide.

Examples of childhood trauma influencing drug addiction

Chemical dependency takes many forms, and many of them are often linked to trauma sustained in developmental years. Whether we develop a crippling alcohol addiction out of a need for social acceptance or any other reason; start smoking marijuana to escape our everyday reality; start shooting heroin or taking painkillers to avoid memories of deep-rooted abuse or anything else.

There are multiple contexts in which a person can experience co-occurring childhood-related PTSD and addiction:

- The NIH, among other agencies, reports that those who sustain childhood trauma are at extremely high risk for developing alcohol addiction.
- Multiple data, including a recent global collaborative survey, reveals a direct correlation between childhood trauma and marijuana abuse.
- Data from the National Conference on Legislatures, as well as many other organizations, points to a close relationship between childhood adversity and the development of opioid dependency.
- A recent study from Florida’s Miller School of Medicine revealed that childhood abuse and other types of developmental trauma can increase the likelihood of meth abuse.

These increased risks stem from a variety of factors. Some children who crave stability, acceptance, and community in their home lives look for it elsewhere among equally toxic influences and start abusing alcohol or other drugs as a means of gaining that sense of acceptance and solidarity. The chronic nature of substance abuse means that these early behaviors can very easily follow children into adulthood. Other children simply fail to recognize, acknowledge, and effectively process this trauma until it manifests in self-destructive ways like self-harm, substance abuse, or the inability to control their emotions. This is why early intervention is such a critical part of the clinical trauma-treatment process.

Domestic abuse and addiction

Domestic abuse is one of the most common forms of childhood trauma and can have a direct impact on the formation of addiction. In a recent study published in the Journal of Drug and Alcohol Dependence, researchers from Columbia University found that domestic abuse drastically increases the likelihood of the onset of chemical dependency. Another recent study from Emory University revealed a close relationship between physical and emotional child abuse and the development of drug or alcohol addiction as a result of emotional dysregulation. This trauma can either form as a result of direct abuse or having to witness abuse in the home, the latter being a factor with which far too many children are forced to contend.

Sexual abuse and addiction

Another tragically common element of childhood trauma includes sexual abuse. Data from the Department of Health and Human Services indicates that almost sixty-thousand children are sexually abused per year in the United States. The Department of Justice’s report “Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics” indicates that 14 percent of all men and 36 percent of all women in prison were abused as children.

Other data indicates that sexually abused children are less likely to practice safe sex, putting them at greater risk for STDs. They’re also 25 percent more likely to experience teen pregnancy and significantly more likely to develop problems related to drug and alcohol addiction. To compound this unthinkable trauma, 90 percent of child sexual abuse victims know the perpetrator in some way. Nearly 70 percent are abused by a family member.

Physical abuse and addiction

Whether it’s through acute one-time physical assault, a prolonged and consistent pathology of bullying, or a lifetime of abuse inside the home, physical abuse is an all-too-common part of the average child’s life. The American Society for the Positive Care of Children reports that more than 18 percent of children who are maltreated experience physical abuse and that nearly half of those children die from it. The National Institute on Drug Abuse (NIDA) reports that two-thirds of the people in treatment for drug abuse reported being abused or neglected as children. There are multiple levels of physical abuse that can put children in harm’s way and lead to the development of drug or alcohol addiction later in life.

Emotional abuse and addiction

Emotional abuse is a broad term that can describe a range of behaviors, including direct verbal assault, active manipulation, or simple neglect and ignoring of the child. One of the emotional abuse-related behaviors most closely linked to the development of substance abuse is the early exposure to drugs and alcohol from a parent or guardian. Data from the United States Department of Health and Human Services reveals that between 30 and 60 percent of all of child maltreatment cases involve substance use to some degree and that children whose parents abuse drugs or alcohol are three to four times more likely to be abused and neglected, thus perpetuating the cycle.

Treating co-occurring addiction and childhood trauma

Treatment for childhood trauma-related addiction must simultaneously address the immediate medical and behavioral aspects of substance abuse while providing targeted and in-depth treatment for the trauma-related triggers that sustained it. This is accomplished through a comprehensive course of professional addiction treatment beginning with medically supervised detoxification, followed by focused and customized behavioral rehab. While each patient’s addiction care needs will vary according to their level of trauma and their scope of substance abuse, addressing both of these factors is crucial to successful management of stress and to sustaining recovery. More severe cases of co-occurring trauma and substance abuse may require long-term inpatient treatment, whereas those with a more limited history may benefit from intensive outpatient (IOP) care.



Detoxification and withdrawal management

Medical detox provides a safe, supportive, and compassionate environment to help patients heal from the worst of their withdrawal symptoms and get expert help for any medical issues that may arise during the process. This is perhaps the most vulnerable that patients will ever be during the addiction treatment process, and it’s critical that they have quality help and support to help them get through their acute withdrawal symptoms. Patients who endeavor to detox on their own, specifically those with a longer history of substance abuse, run a heightened risk of relapse because they’re simply unable to endure the process alone.



Childhood abuse rates of people in prison

Rehab and Behavior Modification

Most patients who develop substance abuse as a result of childhood trauma never confront or effectively process their trauma without reliving it over and over and letting it run their lives. Behavioral rehab during the addiction treatment process allows patients to work with a trained mental health expert to address the trauma-related root causes and sustaining factors of their addictions. Through techniques like group therapy, individualized counseling, and supplemental therapies like cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, eye-movement desensitization and reprocessing (EMDR), and more, patients can begin to healthily process their trauma, recognize triggers, and successfully manage stress in their everyday lives.

After patients complete their treatment program, they should be given a comprehensive and targeted aftercare plan that builds on their progress in treatment and provides contact information for addiction and trauma specialists in their area to whom they can go for ongoing therapy.

Stopping childhood trauma in its tracks

Parents of childhood trauma survivors often feel powerless to help their sons or daughters, and many of them fail to grasp exactly how much the trauma they’ve sustained has affected them.

If you suspect your child has sustained trauma for which they need professional help, there are multiple resources to help them get the care they need, from organizations such as:

- The Substance Abuse and Mental Health Services Administration SAMHSA
- The United States Department of Health and Human Services (HHS)
- The Child Mind Institute
- That National Child Traumatic Stress Network (NCTSN)

Early intervention in childhood trauma can mean the difference between a healthy and productive life and significant psychological and emotional impairment and substance use.

Don’t let your past dictate your future

Millions of Americans struggle with addiction related to one more traumatic childhood experiences; the primary difference that determines their lives is the steps they take to choose their future once they realize they have a problem. It’s important to realize the trauma you have sustained may have compelled you to unwittingly develop an identity, value system, long-term behaviors, and even your very sense of right and wrong—unpacking these issues will not occur overnight or in a vacuum. Don’t let your early trauma put you in an early grave. Get the help you need now to start fighting back against your trauma-related addiction.

Well, there's no help where I live, they just load me with pills and kick me out after some months in a psychiatric cage.
Hallucinogens are the only thing that helps me but I can't use those while on antipsychotics. No benzos available at the moment either, so I compulsively do speed, then sleep on antipsychotics, waiting for benzos to break the cycle. The problem is that I'd have to stave off the antipsychotics for two weeks before I can do LSD. Say, do you or anyone else knows of a way to flush out the antipsychotics out of my system?
 

Snowy_Hell

Temporary Ban
Joined
Jul 12, 2017
Messages
182
Location
Eastern Europe



The link between childhood trauma and addiction in adulthood

There is a clear and distinct correlation between child trauma and drug and alcohol addiction. The traumatic incidents that we experience in our childhood very easily can, and often do, wind up following us into maturity creating a variety of long-term mental health issues that may cause us to self-medicate through excessive drinking or drug abuse. The National Institutes of Health (NIH) report that more than a third of adolescents with a report of abuse or neglect will have a substance use disorder before they reach their 18th birthday.

Data published in TIME Magazine indicates that 55 to 60 percent of all post-traumatic stress disorder (PTSD) victims end up developing some form of chemical dependency, an assertion backed up by the American Psychological Association (APA). In addition, the National Institute of Mental Health (NIMH) reports that 7 to 8 percent of the American population suffers from some level of PTSD. Identifying trauma-related substance abuse triggers is a key element of treatment and fundamental to helping individuals in recovery live a rich and full life as they endeavor to stay clean.

Where does trauma take root?

The term trauma is defined as an adverse and often malignant emotional reaction to a singular or repetitive event that caused severe physical or psychological harm. It is characterized by a patient’s inability to move past and process the experience without reliving it over and over again. Trauma victims will very often develop serious mental illness for which they turn to drugs and alcohol. Data published in JAMA Psychiatry suggests that more than 30 percent of all PTSD sufferers develop a major depressive disorder, and the Department of Veterans Affairs reports that ten percent of Americans suffer from trauma-related depression each year.

Trauma is a broad term used to describe a wide range of incidents, the most common include:

- Rape or sexual assault
- General physical assault
- Domestic or intimate partner violence
- Extreme verbal and emotional abuse

- Bullying and repeated harassment of any kind
- Terminal illness
- Natural disasters
- Accidents such as car crashes or fire
- Parental neglect

The reality of trauma is that it can come from anywhere and manifest in a variety of physical and psychological symptoms.

Behavioral and psychological trauma symptoms

Individuals who experience childhood trauma may experience a number of short-term and long-term psychological and behavioral symptoms, including but not limited to:

- Prolonged agitation and irritability
- Avoidance of things that remind them of the trauma
- Erratic changes in mood and behavior
- Prolonged and Consistent Fear and Nervousness

- Timidity and lack of confidence
- Constantly reliving the event(s)
- An excessive and often inappropriate display of emotions

Trauma symptoms that take root in childhood often have a severely negative impact on quality of life in adulthood, affecting a full range of areas.

Professional life problems

Data indicates that lingering effects of childhood trauma can manifest as conflict in the workplace. Trauma experienced in childhood has a direct influence on how sufferers perceive and process adversity, trust and relate to others, handle responsibility, and much more, all factors with which adults are expected to contend in the workplace every day. Inability to process childhood trauma can have a direct impact on professional mobility and quality of life.

Romantic and social relationships issues

Childhood trauma survivors, particularly those who have experienced sexual trauma or any other type of physical or emotional abuse, often have serious intimacy issues that cause create significant obstacles to forming healthy romantic relationships. Data indicates that childhood trauma has a direct impact on how we form general and sexual identity, trust others, develop self-worth, assert our confidence, avoid or embrace destructive relationships, and more.

Eating disorders – binge eating, bulimia, anorexia

Binge eating disorder, bulimia, and anorexia are psychological illnesses often brought about by childhood abuse. According to The New York Center for Eating Disorders, 50% of all patients presenting with eating disorders are victims of childhood assault. For many people with eating disorders, trusting food is safer than trusting people! It never abuses you, ridicules you, dies, or abandons you. It is the only relationship where we get to say where, when, and how much. No other relationship complies with our needs so absolutely.

Food, after all, is the cheapest, most available, legal, socially acceptable mood-altering drug on the market. Patients report that even as children they turned to bingeing, purging, or starving as a way to manage unbearable emotions following sexual trauma. The comfort of compulsive overeating, vomiting, laxatives or self-starvation as well as the numbing effects of the “drug” of food can be a short term solution to the pain, grief, and rage of abuse and live on as a coping mechanism in adulthood.

Eating disorder evaluation and treatment should be part of an individualized, comprehensive plan for each patient.

Watch this webinar on opioids and early adversity: connecting childhood trauma and addiction:


One landmark study, known as the Adverse Childhood Experiences Survey, showed definitively how childhood trauma can directly influence the formation of the brain. The study also found that child abuse and other forms of trauma were a leading cause of death among adults through a variety of factors. While trauma treatment has gotten incrementally more intuitive since this study was published, childhood trauma is still linked to a number of fatal factors, including suicide.

Examples of childhood trauma influencing drug addiction

Chemical dependency takes many forms, and many of them are often linked to trauma sustained in developmental years. Whether we develop a crippling alcohol addiction out of a need for social acceptance or any other reason; start smoking marijuana to escape our everyday reality; start shooting heroin or taking painkillers to avoid memories of deep-rooted abuse or anything else.

There are multiple contexts in which a person can experience co-occurring childhood-related PTSD and addiction:

- The NIH, among other agencies, reports that those who sustain childhood trauma are at extremely high risk for developing alcohol addiction.
- Multiple data, including a recent global collaborative survey, reveals a direct correlation between childhood trauma and marijuana abuse.
- Data from the National Conference on Legislatures, as well as many other organizations, points to a close relationship between childhood adversity and the development of opioid dependency.
- A recent study from Florida’s Miller School of Medicine revealed that childhood abuse and other types of developmental trauma can increase the likelihood of meth abuse.

These increased risks stem from a variety of factors. Some children who crave stability, acceptance, and community in their home lives look for it elsewhere among equally toxic influences and start abusing alcohol or other drugs as a means of gaining that sense of acceptance and solidarity. The chronic nature of substance abuse means that these early behaviors can very easily follow children into adulthood. Other children simply fail to recognize, acknowledge, and effectively process this trauma until it manifests in self-destructive ways like self-harm, substance abuse, or the inability to control their emotions. This is why early intervention is such a critical part of the clinical trauma-treatment process.

Domestic abuse and addiction

Domestic abuse is one of the most common forms of childhood trauma and can have a direct impact on the formation of addiction. In a recent study published in the Journal of Drug and Alcohol Dependence, researchers from Columbia University found that domestic abuse drastically increases the likelihood of the onset of chemical dependency. Another recent study from Emory University revealed a close relationship between physical and emotional child abuse and the development of drug or alcohol addiction as a result of emotional dysregulation. This trauma can either form as a result of direct abuse or having to witness abuse in the home, the latter being a factor with which far too many children are forced to contend.

Sexual abuse and addiction

Another tragically common element of childhood trauma includes sexual abuse. Data from the Department of Health and Human Services indicates that almost sixty-thousand children are sexually abused per year in the United States. The Department of Justice’s report “Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident, and Offender Characteristics” indicates that 14 percent of all men and 36 percent of all women in prison were abused as children.

Other data indicates that sexually abused children are less likely to practice safe sex, putting them at greater risk for STDs. They’re also 25 percent more likely to experience teen pregnancy and significantly more likely to develop problems related to drug and alcohol addiction. To compound this unthinkable trauma, 90 percent of child sexual abuse victims know the perpetrator in some way. Nearly 70 percent are abused by a family member.

Physical abuse and addiction

Whether it’s through acute one-time physical assault, a prolonged and consistent pathology of bullying, or a lifetime of abuse inside the home, physical abuse is an all-too-common part of the average child’s life. The American Society for the Positive Care of Children reports that more than 18 percent of children who are maltreated experience physical abuse and that nearly half of those children die from it. The National Institute on Drug Abuse (NIDA) reports that two-thirds of the people in treatment for drug abuse reported being abused or neglected as children. There are multiple levels of physical abuse that can put children in harm’s way and lead to the development of drug or alcohol addiction later in life.

Emotional abuse and addiction

Emotional abuse is a broad term that can describe a range of behaviors, including direct verbal assault, active manipulation, or simple neglect and ignoring of the child. One of the emotional abuse-related behaviors most closely linked to the development of substance abuse is the early exposure to drugs and alcohol from a parent or guardian. Data from the United States Department of Health and Human Services reveals that between 30 and 60 percent of all of child maltreatment cases involve substance use to some degree and that children whose parents abuse drugs or alcohol are three to four times more likely to be abused and neglected, thus perpetuating the cycle.

Treating co-occurring addiction and childhood trauma

Treatment for childhood trauma-related addiction must simultaneously address the immediate medical and behavioral aspects of substance abuse while providing targeted and in-depth treatment for the trauma-related triggers that sustained it. This is accomplished through a comprehensive course of professional addiction treatment beginning with medically supervised detoxification, followed by focused and customized behavioral rehab. While each patient’s addiction care needs will vary according to their level of trauma and their scope of substance abuse, addressing both of these factors is crucial to successful management of stress and to sustaining recovery. More severe cases of co-occurring trauma and substance abuse may require long-term inpatient treatment, whereas those with a more limited history may benefit from intensive outpatient (IOP) care.



Detoxification and withdrawal management

Medical detox provides a safe, supportive, and compassionate environment to help patients heal from the worst of their withdrawal symptoms and get expert help for any medical issues that may arise during the process. This is perhaps the most vulnerable that patients will ever be during the addiction treatment process, and it’s critical that they have quality help and support to help them get through their acute withdrawal symptoms. Patients who endeavor to detox on their own, specifically those with a longer history of substance abuse, run a heightened risk of relapse because they’re simply unable to endure the process alone.



Childhood abuse rates of people in prison

Rehab and Behavior Modification

Most patients who develop substance abuse as a result of childhood trauma never confront or effectively process their trauma without reliving it over and over and letting it run their lives. Behavioral rehab during the addiction treatment process allows patients to work with a trained mental health expert to address the trauma-related root causes and sustaining factors of their addictions. Through techniques like group therapy, individualized counseling, and supplemental therapies like cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, eye-movement desensitization and reprocessing (EMDR), and more, patients can begin to healthily process their trauma, recognize triggers, and successfully manage stress in their everyday lives.

After patients complete their treatment program, they should be given a comprehensive and targeted aftercare plan that builds on their progress in treatment and provides contact information for addiction and trauma specialists in their area to whom they can go for ongoing therapy.

Stopping childhood trauma in its tracks

Parents of childhood trauma survivors often feel powerless to help their sons or daughters, and many of them fail to grasp exactly how much the trauma they’ve sustained has affected them.

If you suspect your child has sustained trauma for which they need professional help, there are multiple resources to help them get the care they need, from organizations such as:

- The Substance Abuse and Mental Health Services Administration SAMHSA
- The United States Department of Health and Human Services (HHS)
- The Child Mind Institute
- That National Child Traumatic Stress Network (NCTSN)

Early intervention in childhood trauma can mean the difference between a healthy and productive life and significant psychological and emotional impairment and substance use.

Don’t let your past dictate your future

Millions of Americans struggle with addiction related to one more traumatic childhood experiences; the primary difference that determines their lives is the steps they take to choose their future once they realize they have a problem. It’s important to realize the trauma you have sustained may have compelled you to unwittingly develop an identity, value system, long-term behaviors, and even your very sense of right and wrong—unpacking these issues will not occur overnight or in a vacuum. Don’t let your early trauma put you in an early grave. Get the help you need now to start fighting back against your trauma-related addiction.

Also, did you know about the enzymatic cascade that methylates neuronal genes required for expression of glucocorticoid neuroreceptors without which, brain can't "sniff out" catecholamine levels in itself, thus failing to shut down the adrenal glands, leading to permanent state of fight-or-flight mode, scorching the prefrontal cortex with said catecholamines, leading to brains's inability to intercept amygdala's impulses to fight or flee or in my case, to freeze?
 
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Adverse Childhood Experiences and trauma

by Addiction Policy Forum | Oct 1 2019

70% of adults in the U.S. have experienced at least one form of traumatic event in their lives.

Traumatic childhood experiences have a significant impact on individuals and the consequences can affect entire communities, making it a serious public health issue. Trauma is defined as a person’s response to one or multiple events that are physically or emotionally harmful or threatening. Many events that cause trauma include natural disasters, childhood abuse or neglect, sexual assault, and other forms of violence, which can have a lasting effect on behavior and health. If left unaddressed, these traumatic experiences can increase the likelihood of individuals developing mental illnesses, substance use disorders, and other mental and physical health conditions that affect the overall quality of life.

This fact sheet, developed by Addiction Policy Forum, discusses the impact of childhood trauma and subsequent health and social consequences, strategies to prevent trauma, and innovative approaches to support children and young adults with high number of Adverse Childhood Experiences (ACEs) across the country.

What are ACEs?

Adverse Childhood Experiences (ACEs) is the term used to describe potentially traumatic events experienced by persons under 18. They can be categorized into three types:

- Childhood abuse – physical, emotional, or sexual abuse;

- Neglect – physical or emotional neglect;

- Household challenges – mental illness, parental separation or divorce, and parental violence or substance misuse.

When children are exposed to stressful events, brain development can be impacted. These altered brain developments can cause unhealthy coping mechanisms.

The higher the number of ACEs results in a higher risk for long-term negative outcomes such as depression, heart disease, liver disease, trouble at school and work, financial stress and substance misuse and addiction.

What can be done

While many states have implemented ACEs screening, research recommends pairing screening with intensive intervention and focusing on prevention.

According to Harvard University, “The ideal approach to ACEs is one that prevents the need for all levels of services: by reducing the sources of stress in people’s lives, whether basic needs like food, housing, and diapers, or more entrenched sources of stress, like substance abuse, mental illness, violent relationships, community crime, discrimination, or poverty.”

Primary prevention to stop ACEs from happening can include:

- Home visits for families with newborns

- Parenting training programs; family wellness

- Child welfare and criminal justice early interventions

Policymakers and practitioners in many different sectors can improve outcomes for children and families by implementing interventions built on the science of child development.

In Three Principles to Improve Outcomes for Children and Families, Harvard researchers recommend three areas for those with ACEs scores:

- Support responsive relationships for children and adults.

- Strengthen core life skills.

- Reduce sources of stress in the lives of children and families.

Trauma should not go unaddressed, and trauma-informed care promotes positive health outcomes. The core values of trauma-informed care include safety, transparency, trustworthiness and dignity.

Trauma-informed care means treating a whole person, taking into account past and present experiences, and service delivery mechanisms when attempting to understand behaviors and treat the patient.

Prevention begins with protective factors in a youth’s life. The Child Welfare Information Gateway defines protective factors as “conditions or attributes of individuals, families, communities, or the larger society that mitigate risk and promote healthy development and wellbeing. Put simply, they are the strengths that help to buffer and support families at risk.”

 
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Nadine Burke Harris


How iboga can resolve and heal childhood trauma

ECFES | Oct 30 2018

Imagine being able to go back in time to relive those experiences from your childhood which have had the greatest impact on your life. Imagine being able to witness yourself as a child, but from the perspective of yourself today, looking at traumatic events with the understanding and compassion of an adult.

On the cutting edge of human health and mental wellness is the exploration of the effects of childhood trauma on the long-term health of human beings. Dr. Robert Block, former President of the American Academy of pediatrics remarked, “adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”

American pediatrician Nadine Burke Harris looks at how exposure to adversity and trauma during their developmental years leads to mental health diagnoses such as ADHD, anxiety and depression. She points out the negative effects of trauma on the developing brain and immune systems of children, as well as how traumatic events can develop into chronic stress, and even PTSD.

Her viewpoint that behavioral and physical issues can be rooted in adverse childhood experiences (ACE) runs counter to the popular understanding of illness, which presumes strictly material causality and dismisses intangible psychological factors. A 1990’s study on ACE, however, demonstrates significant corollaries between trauma and lifelong health, linking them to illnesses and high-risk and impulsive behaviors such as drug addiction.

"Adverse childhood experiences have a dose–response relationship with many health problems. As researchers followed participants over time, they discovered that a person’s cumulative ACEs score has a strong, graded relationship to numerous health, social, and behavioral problems throughout their lifespan, including substance use disorders. Furthermore, many problems related to ACEs tend to be comorbid, or co-occurring." [source]

Counseling, psychotherapy, hypnotism and even prescription psychotropic medications may be used to help people resolve traumatic experiences, but some view this type of healing as an issue of spiritual health. Dr. Gabor Maté looks at severe drug addiction as the result of childhood trauma, treating some patients with the ceremonial use of Ayahuasca.

Approaching trauma with the use of shamanic plant medicines can be quite effective, and the African plant medicine iboga is uniquely powerful in this regard. Ingestion of this sacred medicine is known to induce a powerful and visionary psychological experience which allow the participant to review and relive key moments of their past.

"Iboga is a psychoactive plant medicine derived from the root bark of the Iboga tree, found in certain parts of Africa. It is administered ceremonially in rites of passage and healing ceremonies tended to by master shamen who have successfully negotiated the spiritual realms into which the medicine plunges its participants. It is known for its power to bring a person into direct contact with the realms of the deceased, and also for allowing a person to see deeply into their past in a way that permits open communication with themselves as they were in the past. The psychoactive journey typically lasts for up to 36 hours and dramatically detoxifies the physical body, as well as the psycho-spiritual body." [source]

"People that have gone through the iboga process to work on their PTSD describe the experience as comparable to 10 years of therapy compacted into a week. Iboga gives you a chance to go deep. It not only helps with detoxing the body, but the mind as well. As long as the person is open and willing to work on themselves, iboga is a powerful tool. Many people have said that it gave them a chance to relive a traumatic event from an observer’s point of view. During a retreat they were able to forgive and move on, experiencing closure for the first time. Also, it gave their body a chance to detox from anti-depressants that they have tried with no success. Every person has a unique life, therefore every person has a unique journey." -Iboga Wellness

The journey itself is an adventure through the timeless realms of consciousness and the cosmos, looking at the entire library of information about one’s life, and making corrections and connections to rewrite the present by re-integrating the past and understanding the future.



“…the shaman or healer will guide the patient in additional iboga journeys, opening up an introspective experience where a connection is made with an over-soul or cosmic consciousness that assists the mind in a deep examination of the self from an objective, omniscient and timeless perspective. In this, a process of self-revelation unfolds which unravels one’s past, offering life-changing insights and liberation from accumulated self-judgments and harmful thought patterns."

"For 12-24 hours the patient lies still, with blindfolded eyes, in a bizarre dream-like state where the brain behaves as if in REM sleep, but, while the conscious mind remains awake, very alert and able to interact with and direct the content of the mental journey."

"As the experience deepens, the barrier between the conscious and sub-conscious mind seems to dissolve, and the information in the sub-conscious mind becomes available for review and rejection by the reflective self. In this, a lifetime’s worth of learned mental processes, memories, emotional impressions, false judgments and psychological conditioning that combine to inform and instruct the self are presented to the patient in rapid fire fashion… a sort of high velocity behind-the-scenes tour of one’s personality. A multi-dimensionalimpression of one’s character emerges, and they are given an incredible opportunity to re-assess or reject misunderstood feelings, traumatic events, implanted suggestions, negative self-images, and habitual behaviors.”
– Dylan Charles

While the term adverse childhood experiences typically refer to severe physical or sexual abuse and/or emotional neglect, often, seemingly less significant events can also cause a lifetime of problems.

As an example, I like to tell the story of a friend who was able to overcome 54 years of emotional turmoil in one night during a powerful iboga journey. Going into the ceremony, she set the intention of working to understand why she had always had night terrors and high anxiety over an event which happened when she was less than two-years-old.

For her entire life, she was carrying around the terrorizing imprint of this shocking event, which had all this time remained incomplete in her mind, leaving her confused and resentful. All she could remember was being stuck in a crib, screaming for help, as her mother and aunt came and went in a frenzy, totally ignoring her.

During her journey, she asked to relive this moment, and she did so, but from the perspective of herself as an adult, having a better understanding of human behavior and dramatic situations. Seeing herself in the crib in startling clarity, she was able to explore this event, and she discovered that this terrible memory was of the day her father had a heart attack.

She was able to see her father, collapsed in the hallway outside of her room, as her mother and aunt worked frantically with the medical crew to ensure his survival. Until this moment, she had never before understood why she felt so scared, confused and ignored,

Iboga gave her the ability to see what had really happened, and she was able to instantly forgive her family and herself of any enduring blame or guilt about the traumatic event. In the morning she was a brand new person, with a light and bright smile on her face. It was a life-changing and liberating realization for her.

Final thoughts

The efficacy of shamanic and psychedelic plant medicines in treating the root causes of trauma, addiction, disease and behavioral disorders is being demonstrated by a growing body of research and experiential evidence. And as more and more personal accounts of such journeys are presented online, we inch closer to an integration of these medicines into the contemporary scientific worldview.

 
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'Clear link' between childhood trauma and substance abuse, addiction doctor says*

by Jonathan Roberts | Sep 2 2019

Almost half of all American children have experienced at least some form of childhood trauma.

Many of these adverse childhood experiences, or ACEs, can be tied back to drug and substance abuse, but their impact may be more widespread than many perceive.

In Tennessee, an estimated 49% of children have at least one adverse childhood experience, and 24% have at least two. Nationally, those numbers sit at 45% and 21%, respectively. Children with ACEs — neglect, physical or sexual abuse, family dysfunction — are more likely to suffer from a wide range of health disorders, both physical and mental — including substance abuse.

What are ACEs and trauma-informed care?

Adverse childhood experiences are traumas children experience from ages 0-17. The original study identified 10 ACEs, but has since expanded to 14. They include:

• Physical abuse
• Emotional abuse
• Sexual abuse
• Emotional neglect
• Physical neglect
• Domestic violence
• Household substance abuse
• Incarcerated care provider
• Mental illness in the home
• Witnessing violence
• Living in unsafe neighborhoods
• Experiencing racism
• Living in foster care
• Experiencing bullying

Trauma-informed care is the framework and structure for treatment that involves understanding, recognizing and responding to the effects of trauma. Being trauma-informed, however, is the individual understanding that many — if not most — people have experienced some form of trauma in their lives, and using that knowledge to provide better, more in-depth and well-rounded care.

In 2018, Johnson City became one of the first trauma-informed communities in the country, and its model — which was developed by Ballad Health Administrator Becky Haas and East Tennessee State University professor Dr. Andi Clements — is being used across the country as a toolkit for all communities.

“Though many communities across the nation are beginning to implement some of these (Substance Abuse Mental Health Services Administration) recommendations, Johnson City clearly stands out as a leader in embracing this model,” Dr. Joan Gillece, director of the National Center for Trauma Informed Care, wrote to Haas and Clements in 2018.

“We’re looking at ways to raise awareness and educate folks, and then collaborate to reduce the effects of childhood trauma,” Haas said. “I’m hopeful we’ll see a decline in children experiencing trauma, but the one thing we learned about ACEs is that what’s predictable is preventable."

“If we know children experience these traumas, then how can we raise up sources of resilience so we can have a buffer,”
she added. “Education is a must.”

ACEs by the numbers

In 2016, a study done by the Tennessee Department of Health found that 61% of participants had at least one ACE, and 27% had at least three — almost 3% higher than the national average.

A different study, completed by the U.S. Census Bureau in 2017, found that 66% of American adults have at least one ACE, which is significantly higher than the number of children with ACEs, which is estimated to be around 45%.

The most prevalent ACEs are divorce, emotional abuse and substance abuse by a household member.

The connection between ACEs and the opioid crisis

Numerous studies have shown the more ACEs a child has, the more likely they are to struggle with substance abuse, health problems and depression, among other health issues.

The evidence, which comes from the U.S. Census Bureau, doesn’t surprise Dr. Daniel Sumrok, assistant professor and former director of the University of Tennessee’s Center for Addiction Science.

“It’s absolutely a clear link … ACEs link all of these things,” Sumrok said of the connection between ACEs, substance abuse, disease and mental illness.

Angelee Murray, director of community development for ReVIDA Recovery, sees a similar link.

“They are absolutely a part of addiction,” she said. “What we have to do as a community, is wrap our arms around individuals that are suffering, and help them figure out how to cope a different way.”

Sumrok also says that not only are ACEs and ACE scores linked to those health effects, they also increase the odds of relapse after getting sober.

“We were able to, incrementally in a linear way, link the likelihood of opiate use disorder relapse to ACE score,” Sumrok said of the findings of a recent study he completed, which monitored more than 100 patients over a two-year period, adding that the results didn’t surprise him.

According to data from the Centers for Disease Control and Prevention, Tennessee ranks 15th for highest opioid overdose death rate per 100,000 people. Ohio, Maine, New Mexico, Florida, Kentucky, West Virginia and North Carolina also rank inside the top 20 in both categories.

“I personally call opiate use disorder a symptom of trauma,” Sumrok said. “Opiate use disorder is a symptom of trauma. Period.”

Haas, who is training police departments, governments, medical professionals and hosting seminars across the country, is bringing a similar message with her.

“Trauma is the gateway drug,” Haas says. “I feel, as we raise awareness and begin to reduce the effects of childhood trauma, I’m very, very hopeful we’ll start to see addiction, jail overcrowding, homelessness numbers in the next five to ten years start to decline.”

*From the article here:

 
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Understanding anger in addiction recovery

by Seth Blais | The Times Record | 24 Feb 2020

I locked my anger up in solitary confinement with my other emotions during a decade of drug use. Letting it back into the world has proven challenging.

For a long time, I used drugs to snuff out my emotions. I’d utilize any tool I could find to achieve this, but heroin seemed to work the best for me. I would do anything to avoid feeling pain and being honest with myself. Avoidance is a response that I learned through experiences in my childhood, and it has affected me negatively in my adult life. You can read more about this in my previous article.

I no longer use heroin to deal with painful emotions. This dramatic change has left me scrambling to learn new ways to manage these feelings and my response to them. One response to the emotional pain that I’ve struggled with, is anger.

My anger has exploded on co-workers, loved ones, strangers. Sometimes the anger was justified, but it was never helpful. I’ve spent hours inside my own head thinking about how someone has wronged me or caused my anger, only to make the feelings intensify.

Beneath all of our anger lies hurt. Have you ever stubbed your toe on a piece of furniture and then instantly became angry? You placed the furniture where it stands and you’re in control of your feet, so who are you angry with? It’s a response to the pain you felt. It works the same way with emotional pain.

Almost everyone who suffers from addiction has trauma in their past and struggles with how to process the pain from those events. Not everyone with trauma struggles with addiction, but many people, including myself, do. Struggling to navigate feelings of anger are common in addiction recovery.

Anger doesn’t just disappear when we suppress it. Anger suppression has always caused me to build up like a pressure cooker until I explode. Instead, I’m trying to understand it differently as a secondary emotional reaction, so I can make better decisions in emotional situations.

I locked my anger up in solitary confinement with my other emotions during a decade of drug use. Letting it back into the world has proven challenging.

Anger as a secondary emotion

What is the emotion that’s being overshadowed by my anger?

This is one question that has recently helped me take a step back and think about why I feel the way that I do. Typically, another emotion, like fear or sadness, can be found underneath the anger. Fear includes things like anxiety and worry, while sadness comes from the experience of loss or disappointment.

You may fear something or someone, but more often the greater fear is that of having your ego damaged or of being abandoned. Understanding the root causes of anger is the first step to addressing them in a better way.

I recently experienced something personally that would have normally sent me into a rage. My first impulse was to become angry, which is normal and maybe even justifiable in this situation. The problem is that when I allow anger to take the wheel, it can be almost impossible to regain control. I will burn the entire house down while I’m still standing inside of it. The consequences of my anger are almost always worse than the reason causing it.

Instead of completely letting anger take control, I asked myself the question above. What emotion is being overshadowed by my anger? I realized that I was covering up sadness and my ego was damaged. I wanted to blame another person for causing me to feel the way that I did.

In the year 1858, Abraham Lincoln and Stephen Douglas engaged in seven political debates aptly referred to in our history books as the Lincoln-Douglas debates. Douglas was up for re-election in the United States Senate and Lincoln hoped to defeat him. These debates happened a few years before Lincoln would become President, and slavery was a very hot political topic.

During their first debate, Lincoln passionately expressed his hate for slavery and even expressed his hatred for the attitude of being indifferent towards such injustice. He then paused and made a statement regarding Southern people who supported slavery at the time.

“They are just what we would be in their situation,” he said.

Lincoln realized that sometimes the actions of people are merely the result of their own circumstances. I’m not trying to compare the Lincoln-Douglas debates of 1858 and my personal daily struggles, but this one sentence has stuck with me. It’s helped me to look beyond anger, being strict with my own emotional responses while being forgiving of other people.

The hard truth is that your circumstances don’t care how you feel about them, and sometimes people in your life don’t either. As that old and seemingly not attributable saying goes: Holding onto anger is like taking poison and expecting the other person to die. Every situation is made better with a calm mind. Without the ability to control your anger, you become a prisoner to it.

 
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