Substance use is often an attempt to escape trauma — especially for women. The path to recovering from an addiction and healing from trauma is a long process for women that requires a strong support system, a sense of community, and understanding from others. Women often face stigma for addiction. This is coupled by the loss of stability at home and work, and a cycle of recurring trauma by abusive members of the community.
Patrice Salmeri, executive director of Augsburg University’s Recovery Advancement initiative and former director of Augsburg’s StepUP program, says trauma is often a huge factor in addiction. “Women are more likely to suffer childhood abuse or sexual abuse,” she says. “One in three women has been sexually abused in her lifetime — but many women don’t even recognize they’ve been abused. They just think it’s part of life.”
To suppress the memories and emotions associated with a traumatic experience, people will often abuse chemicals, Salmeri says. For women who are struggling with addiction, it can be even more difficult to enter a recovery program when their reports of abuse are dismissed or minimized.
“Childhood abuse is usually believed by professionals, regardless of whether it’s a man or a woman reporting,” Salmeri says. “But trauma from violence, specifically sexual assault, has a much different societal response. When a woman is sexually assaulted or abused, the response is often ‘it’s all your fault.’”
According to Julia Lemos, a University of Minnesota assistant professor in neuroscience, the ability to recover from both addiction and trauma is dependent on the kind of support received in the community. “Women who suffer from addiction have a high likelihood of having experienced trauma at some point in the past. Then, when you’re an addict, you are more likely to engage in high-risk behavior, which can lead to new traumatic events. The vicious cycle of trauma and addiction continues,” Lemos says.
She adds that it is generally not useful to categorize addiction and trauma as separate issues. “They often go hand and hand, so it is difficult to [divide] them into separate categories.”
Psychiatrist Janet Schmitt, M.D., says, “Prolonged unaddressed abuse in childhood often results in PTSD symptoms. If trauma is disclosed by a child and parents, and others respond with appropriate intervention and support, PTSD symptoms in adulthood may be avoided.”
Sexual abuse has the greatest risk of PTSD, she adds. “In the context of trauma and addiction, women are disproportionately affected. Both women and men are reluctant to talk about abuse, but women’s voices are more easily discounted.”
Salmeri says women are stigmatized for both trauma and addiction in ways that men never are because society is hyper-focused on how women and girls are supposed to act. Being told that abuse and assault is the victim’s fault leads to shame and guilt. She says women often learn they need to keep traumatic experiences hidden or they’ll be viewed as “hysterical” or “emotionally unstable.”
The most common phrase Salmeri says she’s heard women use when going through recovery and healing from trauma is “I’m not good enough,” which is typically a response to the shame and guilt that has been building up.
Thenedra Roots, a chemical dependency counselor at Augsburg’s StepUP program, believes women in recovery are stigmatized differently than men because of expectations in society. “If you are a mother or a career woman and you’re struggling with addiction, you’re ‘not being responsible’ and are shamed for being a ‘bad mother’ or a ‘bad employee,’” Roots says. “If you’re a younger woman, you’re often told ‘you’re too young to have trauma’ or ‘you don’t even know how bad life can be yet.’”
Roots says people often minimize a woman’s addiction by placing the blame on her rather than recognizing that it’s a brain disease.
Roots estimates that 9 out of 10 women battling addiction are also healing from trauma. Of these women, Roots saysit is mostly white women who enter a recovery program —but not because they’re the ones most impacted by trauma and addiction.
“We have to remember who has access to treatment. In African-American communities, there is a lot of stigma around asking for help that creates a barrier for women,” Roots says. “There are also many socioeconomic barriers. Who has access? Who has the privilege to say ‘I need help?’”
Roots says the work she does with women healing from trauma addresses both mental health and substance use. “Being sober is the first part. Then you have to get integrated care to address things on both sides,” she says.
Salmeri says trauma requires another layer of healing. “Traumatic experiences affect the way our brains develop. Brain development, as well as social capabilities, are factors that need to be addressed in recovery from trauma.”
While many people think of abstinence as part of the recovery from substance abuse, Salmeri says another approach appropriate for some is harm reduction — a model to decrease behaviors rather than stop them entirely. This might mean going from drinking every day of the week to only drinking three or four days, she says.
More resources are needed to offer access to women, who need a strong support system to get out of the cycle.
“Can you do it alone? Probably. But is that a good idea? Probably not,” Salmeri says. “You need a good support system. Knowing that thousands of women have gone through it before you can often help women who are feeling alone and disbelieved for the trauma they have endured.”
To fully heal from trauma and addiction, both must be addressed. Salmeri wants people to know that, much like chemical dependency, trauma also is an ongoing battle.
“Trauma isn’t in the past until it no longer affects the present,” she says.