Substance use disorder (SUD) treatment providers are increasingly recognizing the critical role trauma plays in addiction and are integrating trauma therapy into their practices. By offering trauma screenings and specific trauma-informed treatments, providers not only improve patient outcomes but also position themselves as preferred partners for health plans. However, many providers may still be missing a significant portion of their patient population who need trauma care. This shift towards trauma-informed substance use disorder treatment marks a vital advancement in behavioral health care.
The Link Between Trauma and Substance Use Disorder
Research has shown a strong correlation between traumatic experiences and the development of SUDs. Early-life trauma such as violence, abuse, or neglect significantly increases the risk of developing substance use disorders later in life. This understanding has helped shift the healthcare field’s perspective on addiction — from viewing it as a moral failing to recognizing it as a disease often rooted in trauma. This growing awareness has driven the adoption of trauma-informed substance use disorder treatment models nationwide.
Dr. Steven Pratt, senior medical director for the employer segment at Magellan Healthcare, explains:
“We now know [addiction] is often related to trauma history,” highlighting the growing recognition of trauma’s impact on substance use.
This research underscores why integrating trauma care within SUD treatment programs is essential for lasting recovery.
What Is Trauma-Informed Substance Use Disorder Treatment?
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma through the “three Es”:
- An event or series of events
- The individual’s experience of those events
- Long-lasting adverse effects on mental, physical, social, emotional, or spiritual well-being
While this definition guides clinicians, many adapt it thoughtfully to identify trauma in patients whose experiences may not be obvious. This approach is central to trauma-informed substance use disorder treatment, ensuring patients receive appropriate care that acknowledges trauma’s varied impacts.
Core Principles of Trauma-Informed Care
To avoid re-traumatizing patients, providers follow six principles outlined by the Centers for Disease Control and Prevention (CDC) and SAMHSA:
- Safety: Creating a physically and emotionally safe environment
- Trustworthiness and Transparency: Maintaining open, honest communication
- Peer Support: Promoting connections with others who understand trauma
- Collaboration and Mutuality: Fostering partnerships between providers and patients
- Empowerment and Choice: Supporting patient autonomy
- Cultural, Historical, and Gender Issues: Respecting diversity in trauma experiences
These principles form the foundation of trauma-informed substance use disorder treatment, shaping how care is delivered to promote healing and trust.
Trauma Therapies in Substance Use Disorder Treatment
Common therapies used in trauma-informed substance use disorder treatment include:
- EMDR (Eye Movement Desensitization and Reprocessing): Helps patients process traumatic memories safely using guided eye movements
- Accelerated Resolution Therapy (ART): Replaces negative images linked to trauma with positive ones, sometimes after just one session
- Mindfulness and Grounding Techniques: Build emotional regulation and tolerance for trauma-related distress
By incorporating these therapies, providers enhance recovery outcomes by addressing trauma’s root causes alongside substance use symptoms.
Trauma-Informed Care as an Organizational Approach
According to Frances Myers-Routt, clinical director at River Oaks Treatment Center, trauma-informed substance use disorder treatment is more than individual therapy — it’s an organizational culture. Training everyone from clinical staff to housekeeping in trauma awareness ensures every interaction supports healing.
“One of the most essential principles is to approach people without judgment or assumptions and to work collaboratively,” Myers-Routt explains.
This holistic approach improves patient engagement and fosters an environment where trauma survivors feel safe and supported throughout their recovery journey.
Benefits of Trauma-Informed Substance Use Disorder Treatment
Offering trauma-informed care improves treatment retention, decreases relapse risk, and enhances overall patient outcomes. Unrecognized trauma can cause treatment dropouts and unpredictable behaviors, complicating recovery. Health plans like Magellan Healthcare prioritize partnering with providers that offer trauma-informed substance use disorder treatment, recognizing its value in achieving successful long-term outcomes.
Advancing Trauma Care Through Harm Reduction
New research recommends integrating harm reduction strategies before traditional symptom stabilization in trauma-informed substance use disorder treatment. This phase emphasizes engaging patients where they are, especially those with opioid use disorder (OUD) and trauma histories, through trauma screening and psychoeducation.
“We need to meet people where they are,” says Dr. Benjamin Israel, co-author of a recent review on trauma care, underscoring the importance of dignity and relationship-building in treatment.
This integration reflects the evolving nature of trauma-informed care and its critical role in comprehensive SUD treatment.
Expanding Trauma Screening and Care Access
Expanding universal trauma screening within SUD treatment programs reveals many patients in need of trauma care who may not self-report symptoms. River Oaks Treatment Center’s experience shows trauma treatment needs can increase significantly when all clients are screened, emphasizing the importance of proactive assessment in trauma-informed SUD treatment.
The Future of Trauma-Informed Substance Use Disorder Treatment
The pervasiveness of trauma in SUD populations means all patients should be evaluated and offered trauma-informed care. Moving forward, providers must:
- Implement universal trauma screenings
- Provide ongoing trauma training for all staff
- Combine trauma therapies with harm reduction strategies
- Address cultural and gender-specific trauma factors
- Foster patient empowerment through collaboration
This comprehensive approach positions trauma-informed addiction treatment as the future standard for addiction care, improving outcomes and patient experience across the board.
