Trauma and Substance Misuse: Critical Considerations in Understanding the Maelstrom

Abstract

Research has established that a relationship between trauma and substance use disorders (SUDs) exists. The nature of the relationship and its dimensions are not well understood. Nevertheless, it is important to consider either problem when the other is present. Given the spate of traumatic events occurring globally in recent years, it is critical for the planning group for the development of the “For Whom Is It Permitted, for Whom Is It Forbidden” museum exhibit to consider the complex relationship between trauma and SUDs and ways of representing it in the exhibit. This article briefly discusses what is posited and known about trauma and SUDs in relation to one another. Key points to consider in developing representations of the relationship between trauma and SUDs are raised.

Keywords:

• PTSD
• substance misuse
• substance use disorders
• trauma

Notes

Notes

1. This concept, often noted in the literature, remains inadequately understood in terms of its dimensions (linear, nonlinear), its “demands,” the critical necessary conditions (endogenously as well as exogenously) that are necessary for it to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether its underpinnings are theory driven, empirically based, individual and/or systemic, stakeholder bound, based upon “principles of faith,” etc. This is necessary to clarify whether this posited process is not to remain as yet another shibboleth in a field of many stereotypes. Editor's note.

2. This “code” can and does represent a myriad of complex, dynamic processes that, among others, include whatever is involved in getting the “drug” (licit or illicit), the rituals of use (alone or with others), a range of sites and their dimensions, the pharmacological actions as well as the “drug experience,” what is currently posited in expectancy theories, as well as what the “rational addiction” theorists posited about choice theories. Choice, Behavioral Economics and Addiction, Eds. Vuchinich and Heather, Pergamon, 2003. Editor's note.

3. Definitions of drugs represent, historically, the traditions, beliefs, agendas, and goals of a range of individual and systemic stakeholders, each with their own needs, constituents, foci, types of definitions, factual and non-factual underpinnings associated with types and sources of power and influence. Examples include: religious ritual–based (sacramental substances), cultural-societal definitions (“recreational drugs”), treatment (medicines), legal (“dangerous drugs”), pharmacological-scientific (any active chemical substance which effects the structure or functioning of a living organism). Editor's note.