How ChildhoodTrauma Create Addicts—And Why "Tough Love" Rarely Works

Childhood abuse and chronic stress massively increase the risk of people turning to drugs and alcohol. A little advice to fans of "tough love" treatment like Dr. Drew: Try a little tenderness.


By Maia Szalavitz     09/25/11

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 ten 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).

Memoirs of a Rock Star Wife

A recovering addict and former 60’s rock star wife reminisces about all the lives lost to drugs—and all those that can be saved today.

The author with Berry Oakley, Chuck Negron, and John Densmore

By Julia Negron

09/01/11

• A Day For Those Who Died by OD

Last week, as I was typing up a list of all the overdose victims I'd known over the years, I couldn't help but think back to the time 40 years ago when I got up close and personal with overdose myself. It was back in the late 1960's: the burgeoning Sunset Strip music scene, 1967's "Summer of Love" and the Monterey Pop Festival were my Rock and Roll training grounds. By ’67, I was working as an employee in the A&R department of Liberty Records—my personal stairway to heaven. I still maintained a regular presence on the Sunset Strip club scene, but by 1968, I moved in with and soon married to rock icon John Densmore of The Doors.   

It was the beginning of a most fabulous lifestyle. I often look back and wonder what the world would be like if we knew then what we know now. We did not know what dangerous games we were playing.  

All fun and games (and an occasional nod and wink), I remember an intimate birthday dinner party for Jim Morrison before he went off to Paris. We all laughed when another Doors wife Lynn Krieger and I rolled up the birthday present we had found for Jim—a Courvoisier cognac bottle decanter on wheels made to look like an antique war cannon. Today I might choose something different.

Even then there was whispering about some of our very favorite musician friends being “real” junkies: Tim Hardin, James Taylor? But no, it was hard to believe. I had been swimming in the Los Angeles drug scene for a while and had never even seen heroin. Then came the news: both Jimi Hendrix and Janis Joplin dead? Wow, they must have been living in a rock world somewhat different from mine.   

The real shock started with my own mother, who was 47 when she died of an overdose; my baby sister Connie would follow her 12 years later. Still, I saw my mother’s death as a fluke or even expected. After all, she had a long history of drug and alcohol problems.  

But then Jim. Jim! Jim Morrison! Newspaper headlines screamed. Even our own little band circle didn’t seem to know an overdose killed Jim. Today I have no doubt that it did—and that his life could have been saved.

After Jim's death people started dropping like flies, it seemed. Hearing someone you knew from the music scene dying from an overdose became commonplace. “Remember so-and-so, the drummer from so-and so?” “Yeah, why?” “He died of an overdose.”  “Far out.”

Only it wasn’t really so far out. It was just sad. I myself, along with my second husband, Three Dog Night singer Chuck Negron, had developed a hideous heroin habit, along with so many from our time. Friends died, we took it in stride: it was part of the price, part of the game.  

Who knew we would survive long enough to look back in sadness on the wasted lives and unsung songs, the unwritten poetry, and the unpainted art?

My own life was saved twice by Narcan (naloxone) administered by the private paramedic we kept on speed dial. My sister Connie OD’d in 1984; in 1985, I checked into rehab at Cedars, and never shot heroin again.

As time marched on, the day came when I saw my own son on life support, a victim of overdose—he lived thanks to medical intervention. But other rocker parents who did lose their children weren’t so lucky. We never thought this would happen. Oscar Scaggs, Jessica Rebennack, Andre Young Jr.—so many offspring of music legends lost. All lives that could have been saved, like mine, if overdose prevention and awareness was part of drug education in schools, rehabs and medical facilities.  

August 31st was International Overdose Awareness Day, a darn good idea. It’s a new time—a time when we are finally seeing that all life matters and that things change. Now that I am a cleverly preserved rock dowager, relying on my stories and memories for thrills, I’ve had to live with a painful awareness as a younger generation of rockers dies from overdose. Their numbers are legion, the sadness intolerable when I think of how they would have filled the world with their art for another 40 years like my living peers have. Long grey hair, our leather pants bursting a little bit at the bum, we are still full of stories and music and all the promise that rocked life in the 60s. I love the music coming from our new generations and want them to live.

On International Overdose Awareness Day, I took my hippie sensibilities out of moth balls and participated in a street protest in Hollywood to raise awareness about how overdose is preventable and a medical emergency should be treated with dignity and not fear of arrest. It was almost startling to walk out onto the newly sanitized "walk of fame.” All new and spiffy, it’s no longer the stomping grounds of long-haired freaks panhandling for dinner; now "actors" dressed up as Marilyn Monroe, Darth Vader and Charlie Chaplin walk the block. Looking down at the "stars" on the pavement, it was clear to me that overdose hits hard in the entertainment world. I placed a purple "prevent overdose" ribbon on quite a few.

I once lived around the corner back in my earliest Hollywood days, an easy hitchhike to my waitressing job on the Sunset Strip; my sister died in one of the decaying apartment buildings around the corner. Janis Joplin died around the corner as well, so it was the perfect spot for our "action." I hoped our speaker could be heard over the homeless guy with the bra on his head protesting support garments. 

I don't know how much we broke through to the large crowd of tourists that surrounded us, sizzling on the pavement like so many battered shrimp, but if one or two got the message, the scalding was worth it. At least half the protesters were my age, as well as a flock of what we'll call "reform" recovering folk—AA/NA's willing to have the "courage to change the things they can" outside the rooms.

Like a churchgoer, I am quiet and respectful in my own meetings so I can hear the message, but like many that believe in principles of compassion and fellowship in their respective "churches,” I have no problem taking it to the streets and being a missionary for policies that help, not harm. In this spirit, I salute the vibrant mix of grievers, addicts, activists, and just plain people who all showed up and were willing to fry on behalf of all who died and in support of all who can live with 911 good Samaritan legislation and Naloxone availability. 

If Jim Morrison were alive today, he would have surely have written about a poem about it. And maybe joined me, gray hair, bursting leathers pants and all.

Julia Negron is Los Angeles director of A New PATH (Parents for Addiction Treatment and Healing) and has organized a “Die-In” to raise Overdose prevention awareness (the group meets at 12:20 pm Wednesday at the Hollywood/Highland Metro station entrance). 

An Addiction Counselor’s War on Drugs

Some mental health professionals are realizing that profound changes have to occur health care before we can effectively deal with the mushrooming problem of drug addiction in America.  Barry Lessin is one therapist, stepping out on this issue.  He makes a point in his recent article that  America spends  fifty billion dollars per year to wage a war on drugs that has done nothing to slow the problem.  He goes on to say that failed policies focus primarily on the reduction of the supply of drugs by carrying out paramilitary operations in other countries as well as on drug users here in the United States, combined with amplified law enforcement approaches involving tens of millions arrested, and many millions incarcerated for nonviolent acts since the drug war began in the 70′s.   Barry Lessin brings up a few key points that legislators need to acknowledge if Americans want their tax dollars to count for something positive, that can deal with drug addiction and lessen demand without killing or ruining lives.  Please view his article by clicking on this link:   An Addiction Counselor’s War on Drugs | Barry Lessin.

Performance Art Meets Political Action! PATH Los Angeles "DIE IN"

Performance art meets political action as Parents for Addiction Treatment & Healing (PATH-LA) and their new campaign, Moms United to End the War on Drugs, along with the support of Drug Policy Alliance and other local advocacy groups, held a ‘Die-in’ in front of Grauman’s Chinese Theater to celebrate life and bring awareness to the lives lost by accidental drug overdose.

By Sam Sabzehar

Parents for Addiction Treatment & Healing, Moms United to End the War on Drugs, and The Drug Policy Alliance helped coordinate the "Die-In." (Photo credit: MedicalMarijuana411.com)

To commemorate and celebrate the lives of loved ones lost to accidental drug overdose around the world, a day of solidarity started by Salvation Army Australia, local actions and vigils took place around the world on August 31.

With roughly forty participants, mostly those affected by an overdose of a loved one, the group ‘Died’ on the Hollywood Walk of Stars in between Michael Jackson and The Doors, and drew a large crowd, especially while reading the names of the fallen.

Hollywood has had their fair share of accidental drug overdose and to commemorate International Overdose Awareness Day, the advocacy groups had coordinated the event online using Facebook and Twitter, asking participants to wear a picture of someone this world has lost due to accidental drug overdose.

Moms United is a campaign of the group A New PATH, which began in San Diego by Gretchen Burns Bergman. Julia Negron leads the L.A. chapter and along with Drug Police Alliance, were there in support of A New PATH”s campaign: Moms United to End the Drug War.