Monday, March 27, 2017

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   Is addiction caused by drugs alone? Or do chronic stress and trauma in childhood play the determining factor in predicting who will lose control once they start using drugs?
As our society still tries to deal with the consequences of 9/11 a full fifteen years after the attacks, the continuing role of childhood trauma in addiction gains increasing scientific traction. Early life experience programs the brain and body for the environment it encounters: a calm, nurturing upbringing will orient a child to thrive in most conditions, while a stressful, barren one will predispose it to conditions of scarcity, anxiety and chaos. Not all stress is bad, however. Learning requires some stress, and coping with intermittent, mild doses builds the system up, like a muscle. Stress crosses into the hazard zone of trauma only when it comes in "doses" that are too large or too unpredictable or too sustained over which the person has little or no control. Paradoxically, early neglect—an absence of parenting—can be as traumatic as overt abuse.
  One study of children who attended the 10 middle and high schools closest to ground zero where the Twin Towers stood found that the greater the number of trauma-inducing factors they experienced, the more likely the kids were to increase their use of alcohol and other drugs. These factors included knowing someone who died, being personally in fear for your life or that of your loved ones during the attacks and how close their school was to the towers. Compared to those with no exposure factors, teens with one were five times more likely to increase alcohol and other drug use and those with three or more factors were a stunning 19 times more likely to increase their alcohol or drug use. The youth who increased their use had more difficulty with their schoolwork, lower grades and more behavior problems, suggesting that they weren’t just using drugs but had developed drug abuse or even potential dependence.
This research confirms a whole body of literature showing that the more stressful your childhood experiences—and the more different your types of stress—the greater your odds of later life addiction. The Adverse Childhood Experiences (ACE) study, which includes some 17,000 participants in California’s Kaiser Permanente insurance program, found multiple, dose-dependent relationships between severe childhood stress and all types of addictions, including overeating. Adverse childhood experiences measured included emotional, physical and sexual abuse, neglect, having a mentally ill or addicted parent, losing a parent to death or divorce, living in a house with domestic violence and having an incarcerated parent.
Compared to a child with no ACEs, one with six or more is nearly three times more likely to be a smoker as an adult. A child with four or more is five times more likely to become an alcoholic and 60% more likely to become obese. And a boy with four or more ACEs is a whopping 46 times more likely to become an IV drug user later in life than one who has had no severe adverse childhood experiences.
“These are extraordinarily strong relationships,” says Dr. Vincent Felitti, a founder of the ACE study and the former chief of preventive medicine at Kaiser Permanente in San Diego. “You read the newspaper and the cancer scare of the week is about something that raises risk by 30%. Here, we’re talking thousands of percentage points.”
The type of adverse experience doesn’t make a large difference in the results, according to Felitti: what seems to matter most is the cumulative effect of multiple types of stress.For example, having been both physically abused and neglected is worse than having been physically abused alone.
One factor does stand out, however. “I would have assumed before we looked at it that probably the most destructive problem would be incest—but interestingly it was not, it was co-equal with the others,” says Felitti. Instead, he notes, “The one with the slight edge, by 15% over the others, was chronic recurrent humiliation, what we termed as emotional abuse,” citing examples like parents calling their children stupid and worthless. (The study did not look at bullying by peers, but other studies have found that such abuse can haver similarly negative health effects.)
Ironically, humiliation is a common theme in addiction treatment, where tough confrontation to “break” addicts remains a frequent practice, despite research showing its ineffectiveness and harmfulness. Some so-called therapeutic-community programs, for example, place people on a “hot seat,” where they are confronted about their personality flaws and other negative qualities, sometimes for hours on end. Other programs force people to wear humiliating signs or even diapers. Sexual humiliation, such as forcing men or teenage boys to wear drag or women pose as prostitutes, is not uncommon. Although mainstream programs like Phoenix House and Daytop have worked to eliminate such degrading practices, they persist in the industry, particularly—and tragically—with adolescents.
Indeed, people traumatized as children can actually be re-traumatized by this form of treatment, exacerbating both post-traumatic stress disorder and addiction.
Felitti insists that the best way to treat addiction is with empathy and compassion. “I would argue that the person using [drugs] is not using them to have a problem, they’re using drugs to find a solution,” he says. Although some addicts have no apparent childhood trauma, at least half have suffered at least one form of severe childhood stress and many have experiences multiple exposures. Among people with the most severe addictions, trauma histories are ubiquitous. And emotional sensitivity, which varies widely with genetics, may make experiences that would not be traumatic for most children intensely traumatic for some. Though all addiction is certainly not caused by trauma, it is becoming increasingly clear that it can be a big part of the disorder.
Fortunately, the same key factor that provokes resilience in children coping with chronic stress also spurs recovery in from addiction. That’s social support: whether it comes from a 12-step program like AA, from family members, a loving spouse, friends, other support groups or civic and religious organizations. Safe, familiar people buffer us against stress: the physiology of our stress systems is designed to calm down with a nurturing word or touch from someone we trust. If we want to prevent addiction and promote recovery, we need to love more and stress less.
Maia Szalavitz is a columnist at The Fix. She also is a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

21 comments:

Five Hundred Pound Peep said...

I stay away from Christians who say God has to "break you". They can go worship the antichrist themselves. Also those youth programs where they teach they are going to "break" the child's will, all abusers one in all. I think emotional abuse with the ACE scores breaks the hormonal system and metabolism. With drugs and alcohol, a lot is self medication to deal with the resultant PTSD and other horrors from abusers.

Joan S said...

I have been placed on the "humilation hot seat" by therapists, and it did me no good. I had the kids with me at the time, and everything became very overwhelming, everything. But I guess the point of it was to teach me that I won't die through it. I think I've spoken of it before, and it did nothing to boost my confidence.

Joan S said...

I find that the "I am enough" statement is enough. Probably hard to believe, but I am 500 times better because of it. Lots of hard work, but better than walking around town in a catsuit.

q1605 said...

I know a lot about the tragic life of being a substance abuser. But in the spirit of the Trump spin I will neither confirm or deny if I did my research in a laboratory or in the oleander bushes behind the 7-11 on Main Street.

Joan S said...

Due to my medication, I can't drink alcohol anymore. But once in a while, I used to like to take the edge off.

q1605 said...

I can't drink anymore either due to medication issues. Sort of.

q1605 said...

It reminds me of a P.J. O'Rourke bit of writing. Because boomers had sex with everything, young people can't have sex with anything.

Judith said...

When I was a kid, I always hoped I'd grow up to be an alcoholic. So I made sure my mother had reasons to dislike me as much as possible and make her treat me like shit to increase my likelihood that I would become a drunk. I was extremely successful!

mulderfan said...

Just read a piece about the seven karmic shadows of dysfunctional families. My life in a nutshell:

Abuse

Addiction

Violence

Poverty

Illness

Abandonment

Betrayal

I consider myself one of the lucky ones. I made it out alive. I'm still here to tell the tale. I have a daughter and cousins who love me. I get to share a laugh with Q pretty much everyday.

q1605 said...

Yeah Judy I remember talking to my father when he was the scoutmaster of our troop telling him I can't wait to grow up so I can become addicted to pain pills and alcohol.

q1605 said...

M-Fan it's a sad statement when those traits are things we end up seeking out because it's what feels normal to us.

q1605 said...

As we discuss this Narcissists thrive and even are encouraged to keep trampling people under foot. My guess is that no one who voted for trump came from an abusive household. His whole campaign was one huge red flag for me. Compassion-less and unrepentant, with no empathy, and total disregard for others.

Bess said...

I'm ​still reeling about that mother****er being elected, and every time i hear his voice, it triggers worse anxiety than usual. When i take the anxiety meds and start to feel good, then i feel miserable guilt for enjoying relief, and then i get scared of being addicted to the peace the meds bring. It's always flavoured with the bitterness of trying to forget the things that i cant and the anger that's just under my skin. My addiction seems to be self-punishment.

q1605 said...

I hear ya Bess. One time I remember talking to a friend during a relatively stable period and telling him this non chaos is boring and it's about time for me to fuck it all up. I think I meant the relationship I was in, but the same could go for life in general. I will never get this last election. Talk about an electorate suffering from cognitive dissonance. They are tired of rich elitist's holding office so they elect a guy who won't take a dump unless the toilet is made of gold. I have been toying with a post, but you have pushed me to the side of posting it. Thanks for pushing me to the side of spilling my guts. To me the clip I have in mind encapsulates the spirit of your comment.

mulderfan said...

Post NC it took me ages to adjust to a drama-free life after spending decades in "holy shit!!!" mode.
Best part now is the zero tolerance I have for BS and drama. No apologies accepted. No second chances given. Kick 'em to the curb. Gives a whole new meaning to FUCK 'EM and I'm loving it.

q1605 said...


Yes M-fan it was one of your fellow Canuckleheads that summed it up so succinctly. "It doesn't mean that much to me to mean that much to you".(them)

Bess said...

I lurve you, Q

Agnes said...

Q, fascinating (like watching a train wreck) reading as usual. Why have I never heard of this ACE study before? Could be we were always disposable. Nah. It is too much fun to kick us around. People are really afraid of giving children legal rights and protections. Shocker.

mulderfan said...

Bess,everyone lurves Q! Even my NGC brother has a man-crush on him!

Can't wait for 2020 so Q can run for President!

q1605 said...

Yeah Agnes and I mean this with all the sincerity I can muster. I doubt the Romans did too many studies on the Christian's they fed to the lions. They didn't care and they didn't want to know. Academia is rife with megalomaniacs and people with personality disorder's. Pedophiles want to study small children but they want to conduct it in their hot tubs. Google around it's not hard to find articles about a casual link with adult substance abusers and horrific child hoods.

q1605 said...

With any luck M-fan I'll be dead by then. I am projecting a sit down with the grim reaper in about 2018 if all go's well. Me making a prediction like that and with my contrary luck that means I might live forever.