Trauma-Informed Care in Addiction Treatment

A large percentage of people in treatment for substance use disorder have a history of trauma, whether single-incident trauma, developmental trauma, or chronic trauma. The relationship between trauma and addiction is well-documented in the clinical literature. Untreated trauma keeps the nervous system in a state that substances offer relief from; the substance becomes part of the trauma response. Treating one without the other rarely works for long.

The Archangel Centers delivers trauma-informed care across the program as the default — every group facilitator, every individual therapist, and the clinical environment itself are oriented to recognize trauma responses and reduce the chance of re-traumatization. We position our work as trauma-informed care, not as a primary trauma program.

For many people, the relationship between trauma and substance use is something like:

1. A traumatic experience (or chronic traumatic environment) overwhelms the nervous system's capacity to process and integrate 2. The unprocessed trauma produces ongoing hyperarousal (anxiety, vigilance, insomnia), emotional numbing, intrusive memories, or all three 3. Substance use, often discovered by accident, briefly relieves the symptoms 4. The relief is real but temporary; the substance does not address the underlying trauma 5. Use escalates as tolerance develops and the substance becomes the only reliable regulator of the nervous system 6. The substance use becomes its own source of trauma, adding to the original burden

Treating only the substance use without addressing the trauma rarely produces durable recovery. Treating only the trauma without supporting the substance use leaves the client without their main coping tool while the new tools are being built. Doing both, in sequence and in parallel, is the work.