Principles of Trauma-Informed Care in Substance Abuse Treatment

trauma informed care

A trauma-informed care approach in the treatment of substance abuse considers the prevalence of trauma’s impact on an individual’s life, wellbeing, and the path to recovery. This approach helps substance abuse professionals give the highest level of care to patients who have experienced trauma or trauma-related stressors. Creating trauma-informed environments, providing services sensitive to the unique needs of trauma survivors, and offering trauma-specific interventions can help facilitate recovery and healing in those struggling with a substance use disorder. 

Trauma occurs as a response to a profoundly distressing event or series of events that makes a significant psychological impact on a person. It can overwhelm an individual’s ability to cope, causing them to exhibit adverse behaviors and emotions. Considering the high occurrence between trauma and substance abuse, it is vital to understand the implications of trauma-informed care when treating those in treatment for addiction.  

The Prevalence of Trauma

The need for trauma-informed substance abuse treatment is essential, especially when considering the frequency of patients with trauma-related disorders such as post-traumatic stress disorder (PTSD) often have comorbid substance use disorders (SUDs). A study on the treatment of co-occurring post-traumatic stress disorder and substance use disorders reports that approximately half of individuals seeking SUD treatment meet the criteria for PTSD. This study also indicates that PTSD can cause subsequent SUD because of an individual’s desire to self-medicate or cope with psychiatric distress. When treating a person diagnosed with these two disorders, it is essential to recognize that they can influence each other such that improvements in PTSD can help decrease substance use. In practical terms, this suggests the critical role that trauma-informed care has on SUD treatment.  

What is Trauma-Informed Care?

Trauma-informed care consists of several approaches that consider how trauma is processed in the brain and translates this into informed clinical practice. It is guided by understanding how the threat-appraisal system of the brain and the autonomic nervous system respond to trauma. Many techniques and interventions applied through the trauma-informed approach take into account the impact trauma has on the autonomic nervous system. It aims to reduce overstimulation of the sympathetic nervous system, which otherwise increases heart rate and respiration. By focusing on managing these symptoms within patients and reducing the likelihood of any re-traumatization through the treatment process, this approach takes the necessary precautionary and responsive steps for overall better care. 


There are many essential ideas and principles to enact when implementing trauma-informed care. Keeping these guidelines in mind when treating those with SUD can help improve the quality of treatment. These principles have been laid out by SAMHSA, suggesting that the basic tenets of trauma-informed services should:

  • View trauma as a defining experience that can shape an individual’s sense of self and others. Patients should understand that many problem behaviors stem from attempts to cope with traumatic experiences. The effects of trauma may reveal themselves in areas not obviously related to their experiences, such as showing up in substance abuse, relationship difficulties, or eating disorders.
  • Create an open and collaborative relationship between care providers and patients while prioritizing patient safety, choice, and control. Services with these goals in mind are welcoming to trauma survivors, minimize the possibility of re-victimization, and support patient empowerment and skill development. 
  • Integrate understanding and education of trauma and substance abuse throughout the program. Providers should recognize the complicated relationship between alcohol and drug use and trauma, be aware that survivors often use substances to cope with the distress that follows trauma, and understand that substance abusers can become more vulnerable to re-victimization through the risks associated with addiction-related behavior. 
  • Simultaneously address trauma and substance abuse. Other models offer two distinct sets of services- one for trauma and one for addiction- often in different settings with various providers. However, the reality is that the close and mutually reinforcing relationships between trauma and substance use require integrated services. This method can also help people in recovery understand the range of possible connections between their trauma and substance abuse. 
  • Ensure patients’ physical and emotional safety by creating a hospitable, engaging, and supportive atmosphere. It is critical to avoid practices that may be potentially retraumatizing and avoid shame-inducing confrontations that may trigger trauma-related responses of avoidance, withdrawal, depression, or rage. 
  • Focus on empowering patients by allowing them to engage in collaborative decision-making during all phases of treatment. 
  • Recognize that other services, such as educational services, safe housing, life skills training, and health care, are necessary for comprehensive, holistic interventions. 

Creating a supportive, safe, and informed environment can help individuals in treatment for substance use disorder explore their trauma, its effects, and how to overcome it alongside their recovery. Treating substance abuse without addressing underlying trauma issues may reduce the likelihood of long-term treatment effectiveness and recovery as many individuals may have initially turned to substance abuse as a way to cope with distressing emotions. Trauma-informed care is a process that requires understanding from the counselors, the patients, and the facility of the prevalence of trauma-related disorders in individuals seeking treatment for SUD. Combined with effective substance abuse and mental health programs, trauma-informed care can improve long-term results. At Alta Centers, we understand the importance of trauma-informed care and integrate it into all aspects of our substance abuse treatment programs. If you or a loved one struggles with substance abuse and believes trauma may have impacted this, there is help. Call us today at (888) 202-2583.

About Alta Centers Detox

Alta Centers Detox is  Addiction Treatment Centers with Alcohol Rehab and Drug Rehab in Los Angeles California