By LINDA DOUGLAS
AS I THINK about how we try to address the current heroin crisis, I am drawn to the conclusion that we will fail in our attempts to resolve the crisis until we begin to talk about the private conditions that lead to the public problems.
I have been working with substance using women since the mid 1990s and there is one striking thing in common with 95 percent of the women. They had experienced childhood trauma; most likely sexual abuse (sexual, physical or both). They, and so many of us, were raised in families and cultures that did not discuss shameful family secrets.
As we grew up, we were seen as the problem when the legacy of child abuse and other events led to a need to use substances in order to deal with all the emotions that arise whenever we are reminded of the event. In my own experience as a substance abuse counselor, I was once told by an addict that he used heroin not because he was addicted to the drug but because he was addicted to not feeling the feelings he had because of the abuse he suffered as a child.
A number of substance abusing women who are currently speaking out about their introduction to drugs tell stories of first using with a parent or being coerced into using by an intimate partner.
As New Hampshire looks to solutions to the heroin crisis, it is important that we remember that treatment programs need to address the impact of trauma. This means that the programs are aware of the impact of trauma and provide the person with skills necessary to manage the impact once they stop using.
As someone who has experienced childhood trauma resulting in a number of addictions, I am well aware that when you take away the cigarette, the drink, the food or the drug, the need for something else to manage the feelings underneath the addiction can become intense.
When these childhood experiences are recognized as the source of long-term difficulties in adolescence and adulthood, we are removing the stigma and helping persons understand that it is not about having something wrong with them, but that something was done to them.
The next steps are to assist in finding healthier solutions and recognizing the strength and resiliency that helped them find solutions in the first place and survive.
It also remains that we must find ways to prevent or lessen the effects of childhood trauma, i.e. homelessness, poverty, abuse, exposure to violence, living with persons with mental health or substance use issues. We need to look at the whole family and the root causes, addressing the trauma and not just the addiction, and finding ways to support families in order to decrease the chances of substance abuse passing from one generation to another.
How do we do all this? First, by becoming informed about the impact of childhood trauma. Dr Vincent Felitti, a researcher from Kaiser Permanente, has been providing information from the ongoing 17,000 person Adverse Childhood Experiences (ACE) Study since 1995. This research is now being used by the Centers for Disease Control and Prevention to raise awareness and increase the number of services that address childhood trauma and addiction.
Second, we must make sure that programs that provide stability and protection to children and families are funded. Early childhood programs, family supports, and domestic violence services are all necessary to decrease the impact of trauma on children and decrease the likelihood of substance use in their future.
Finally, remember that by failing to address the trauma in people’s lives we are setting them up to fail. Let’s find solutions that work for both the person using substances now, their children, and for those who may turn to substances in the future.
Linda Douglas is the Trauma-Informed Services Specialist at the New Hampshire Coalition Against Domestic and Sexual Violence.
Heroin Use and its Relationship to Domestic Violence
Mental Health and Substance Use Coercion Surveys
Adverse Childhood Experience (ACE) Study