How trauma can lead to drug and alcohol use

Trauma is personal and it isn’t the event itself: it’s our response to something overwhelming that shatters our sense of safety and makes us feel helpless or terrified or overwhelms our ability to cope. It has lasting, adverse effects on our physical, social, emotional and spiritual well-being.

Trauma can stem from a singular event, a series of events or circumstances. Trauma can be a response to violence, abuse or witnessing harm done to others. It doesn’t have to be something physical, like being attacked; it can also be something emotional, like experiencing racism, discrimination or bullying because of gender, race or sexual orientation.

Trauma can make the brain go into "survival mode," constantly scanning for danger, even when there is none. This heightened state of alertness doesn’t just go away. It can shape how someone reacts to situations, even years later.

Watch: Trauma and the Nervous System: A Polyvagal Perspective

Our brains are wired to seek out rewards—food, social connection, even sex. When we do something that feels good, our brain releases a chemical called dopamine, which makes us feel pleasure and motivates us to repeat the behaviour.

But trauma can disrupt this process. When someone experiences trauma, their brain’s fear centre (the amygdala) becomes overactive, while the reward pathways (those that tell us when something feels good) become less responsive.

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This is where substance use can come into play. Drugs and alcohol can flood the brain with dopamine, creating intense feelings of pleasure. For someone who has experienced trauma, this can feel like a quick fix to their emotional pain, numbing bad memories and feelings that are difficult to deal with.

The more someone uses substances, the more their brain gets "rewired" to prioritize these intense feelings of reward over everything else. In time, the brain starts to rely on substances just to feel “normal”. So, even if someone wants to stop using the substance(s), their brain’s wiring makes it incredibly difficult to do so. This is why addiction isn’t just a matter of willpower—it’s a complex interaction of trauma, brain chemistry and life circumstances.

A major way trauma affects people is through adverse childhood experiences (ACEs). ACEs are events like neglect, abuse or household dysfunction, but can also include divorce and frequent moves. Research shows that people who experience four or more ACEs are at a much higher risk for developing substance use disorders -- up to 1,000 per cent greater than the general population, and the risk of suicide can increase 1,000 per cent as well.

ACEs don’t just affect emotional health—they can disrupt brain development too. Children who experience chronic trauma often struggle with emotional regulation, which can lead to impulsive behaviour, difficulty in relationships, and coping in ways that others might not see as healthy.

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Yet this is the way a person knows how to survive their struggles. These emotional struggles can make substances seem like a way to numb the pain, escape or feel some sense of relief. When the brain is in a constant state of survival, it becomes harder to thrive and connect with others in healthy ways.

Substance use disorders—commonly known as addiction—is often misunderstood. It’s easy to think that people choose to use drugs or alcohol, but the truth is far more complicated.

Addiction can result from trauma, stress, mental health struggles, environmental factors and even genetics. The brain's reward system, after repeated substance use, can become dependent on those "high" moments so that it becomes nearly impossible to stop, even when someone knows it's harmful.

Some people try drugs once or use them occasionally. Others use drugs more often, sometimes to try to cope with trauma or pain. No matter the reason, no one chooses to become addicted. Physical dependence to substances makes it hard to stop using drugs: withdrawal symptoms can be intolerable and even deadly.

Watch: The Neuroscience on Why Addiction Was Not My Choice

For those who have experienced trauma, using substances might feel like a coping mechanism—something to help them feel better, if only for a little while. But it’s not about making bad choices. It's about survival. When the brain’s fear centre is overactive and the reward system is underactive, substances can seem like the only way to balance those feelings of fear and discomfort.

Stigma is the negative attitudes society holds towards people who use substances, and it often manifests in harmful stereotypes, labels and discrimination.

People with substance use disorder are often called "junkies," “addicts” or "drunks," and these labels can make them feel worthless or ashamed. When someone is already dealing with the emotional aftermath of trauma, the added weight of stigma can be unbearable.

For people who have experienced trauma, stigma can feel like a second layer of harm. It's not just about feeling judged—it’s about being ignored, dismissed or mistreated by others, including health-care providers who are often the first people someone turns to for help. The shame that comes with stigma often leads to isolation, making it even harder for people to seek help or come back and try again.

Watch: End Stigma – Stigma and Substance Use

It’s a vicious cycle: trauma leads to substance use, and stigma keeps people from getting the support they need to heal. When they do seek help, for example in an emergency department, health-care workers can advertently or inadvertently perpetuate the cycle of shame. An eye roll, dismissive comment or a derogatory name can be all that it takes to turn someone away.

A key to helping people recover is reducing stigma. We need to challenge the harmful stereotypes and labels that people with substance use disorder face. It’s important to recognize that substance use disorder is a health condition, not a moral failing. We can do this by using language that focuses on the person, not their condition—by using "person-first" language that acknowledges them as human beings first, rather than defining them by their struggles.

Call 310-MHSU (6478) to reach your local Mental Health and Substance Use Centre for support in your community.

If you’re experiencing feelings of hopelessness or thoughts of self-harm, you can call one of these numbers. These services are available 24 hours a day, seven days a week, including holidays:

• Interior Crisis Line Network - 1-888-353-2273
• Suicide Crisis Helpline - 988
• KUU-US (Indigenous) Crisis Line - 1-800-588-8717
• Métis Crisis Line - 1-833-638-4722

April 14, 2025 marks the ninth anniversary of the declaration of the toxic drug emergency in B.C. Throughout the month of April, we’re bringing you stories to help educate, and destigmatize and humanize this wicked crisis.