• October 2019 •

From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse

The Impact of Trauma on Health

People with substance use and/or mental health disorders are more likely than others to have experienced traumatic events. Clinical trauma can result from:

  • Physical, sexual, and emotional abuse (experiencing and witnessing)
  • Childhood neglect
  • Violence of any kind (experiencing and witnessing)
  • Sudden, unexplained separation from a loved one
  • Incarceration
  • Poverty
  • Bullying
  • Racism, discrimination, and shame


These events take a heavy toll on our health. They cause the human body to produce adrenaline and cortisol which activates a normal protective process of fight, flight, or freeze. Left untreated, these responses can continue to be stimulated during stress – and even in non-threatening situations. Trauma, especially in childhood, can actually change a person’s brain structure, contributing to long-term physical and behavioral health problems.

In an attempt to alleviate trauma pain, people develop coping mechanisms. Unfortunately, this may include health risk behaviors such as overeating, tobacco use, substance abuse, and risky activities. Unresolved trauma also contributes to anxiety, depression, social isolation, as well as chronic conditions such as hypertension, diabetes, cancer, and other disease.  Studies have even found that “non-compliant” behaviors, such as taking medication erratically or not attending appointments, can be linked back to a patient’s history of trauma.

In an evidence-based effort to address the issue of trauma head-on, the treatment field has shifted the question from “What’s wrong with you?” to “What happened to you?” L.A. CADA and other providers have trained our staff and volunteers (on all levels) to become trauma-informed. This means that an understanding our participants’ traumatic life experiences is an essential part of delivering behavioral healthcare. Trauma-informed care:  1) understands and responds to the impact of trauma on recovery; 2) recognizes signs of trauma in our participants and their families; 3) facilitates trauma-informed policies and practices, and 4) avoids inadvertent re-traumatization.    

Learn more: the delivery of trauma-informed care


Daniel F.

“My name is Daniel, I’m 30. I used alcohol and benzos on a daily basis, and sometimes cocaine. Today, I understand that the reason I used was to try to manage my anxiety and depression. A lot of things had happened to me and I was trying to deal with them the best I could. Also, I had some social motivations, like meeting new people and sharing that high while partying. But before I was done, I lost my job, my home, and my health. I had multiple seizures, ODs, and they put me on a 5150 hold for mental problems. This disease separated me from people who cared about me; it created lots of worry for them. There were issues in trust and communications. The truth is that going to jail was the beginning of my recovery. In jail, L.A. CADA’s START program gave me a support community — I realize I’m not alone in my experiences. Today, I know how to reach out to others who can help me on this journey. What would I tell people still ‘out there’? That your life can drastically improve. YOU are the only true obstacle in the way of your success.”

Seeking Safety

Historically, addiction treatment has not addressed trauma. Participants were asked to “get clean and sober first” – discussion of trauma was viewed as a relapse trigger. Yet, up to 90% of treatment participants have unresolved issues of trauma or PTSD. Addressing trauma requires “trauma-informed” and “trauma-specific” approaches. Trauma-specific services directly address the impact of trauma on people’s lives and facilitate trauma recovery and healing.  An evidence-based practice (EBP) specific to trauma is the “Seeking Safety” curriculum. Developed in 1992 at Harvard Medical School by Dr. Lisa Najavits, it’s one of the most carefully researched trauma practices in the world. Studies show that this present-focused therapy effectively promotes safety and recovery for individuals with PTSD and substance use disorders, as well as for individuals with trauma histories who do not meet clinical criteria for PTSD. The Seeking Safety curriculum consists of 25 topics, including: safety, taking back your power, when substances control you, setting boundaries in relationships, coping with triggers, detaching from emotional pain, self-nurturing, and creating meaning. It’s based on five key principles: safety; interpersonal treatment; focus on ideals; cognitive, behavioral, interpersonal, and case management elements; and attention to the clinician processes.

Take a brief course now:   The Seeking Safety EBP