Considering discontinuation of drug use as a potentially traumatizing event

Abstract

As a trauma-informed clinician working with substance use disorder (SUD) patients I find it highly interesting that the trauma-informed care curriculum says virtually nothing about discontinuation of drug use qualifying as a potentially traumatizing event. The idea that patients who have been emotionally attached to their drug of choice might generate feelings leading to symptoms of post-traumatic stress disorder (PTSD) after “giving up” their drug of choice is a phenomenon that the clinical literature has paid little attention to. For SUD patients to understand that that is the potential source and cause of their emotional, psychological, physiological, and behavioral symptoms, can in turn help them make sense of why they feel the way they do. Such an approach to trauma-informed care in the venue of SUD treatment can help clients see the relevance of that approach in the absence of their experiencing a classically recognized trauma event. This letter attempts to provoke dialog among trauma-informed clinicians that spurs consideration for the comparison of DSM-5 criteria for PTSD and drug-loss-induced PTSD-like symptoms among patients in SUD treatment.

Keywords:

• trauma
• substance abuse treatment
• DSM-5 classification
• mental health
• intervention
• trauma-informed care