Trauma, stress, and environment

Many people with addiction have lived through trauma: abuse, violence, neglect, loss, war, or other overwhelming experiences. Substances and behaviors such as gambling can temporarily quiet intrusive memories, numb pain, or make sleep possible. Over time, that relief can become a trap.

Ongoing stress — money worries, insecure work, discrimination, caregiving, unsafe housing — wears on the same brain stress systems involved in addiction. Stress is one of the most common triggers for craving and for return to use.

• How available and affordable substances or gambling are
• Advertising and social norms that make use seem normal
• Family patterns and peer groups
• Access to health care, treatment, and safe housing
• Community connection, purpose, and opportunity

The U.S. Surgeon General's report on addiction emphasized that prevention and recovery depend on communities as well as individuals.¹

Trauma-informed services recognize how trauma affects people and avoid practices that re-traumatize, such as confrontation and shaming. When trauma and substance use occur together, treating both — rather than one after the other — tends to work better.²