Addiction: Beyond the Single Story, Why Trauma Still Matters

Addiction is complex, multi-layered, and deeply human. It cannot be reduced to one cause, one pathway, or one solution, and yet, for many people, trauma remains a central part of the story.

The Many Roots of Addiction

Addiction is a chronic condition characterised by compulsive engagement in substances or behaviours despite harmful consequences. It is influenced by:

Biology – genetic predisposition, dopamine system sensitivity, executive function capacity.
Psychology – impulsivity, attachment patterns, emotional regulation skills.
Environment – socioeconomic stress, peer influences, cultural norms, exposure to addictive content.
(Volkow et al., 2016; Koob & Volkow, 2010)

This is what’s often called a bio-psycho-social model, and it’s essential. But if we ignore the role of trauma, we miss a key driver of dysregulation.

Trauma is not always a single catastrophic incident. It can be emotional neglect, relational rupture, chronic stress, or a childhood where there was little space for feelings to be safely expressed.

The Adverse Childhood Experiences (ACE) Study showed a graded, dose-response relationship between the number of childhood adversities and the likelihood of later substance use disorders (Felitti et al., 1998). Subsequent studies have replicated these findings, showing that both “big T” traumas and chronic relational stress can disrupt the developing stress response system and increase vulnerability to compulsive coping behaviours.

When we widen our definition of trauma, we begin to understand why so many who say “I have no trauma history” still carry nervous systems primed for hyperarousal, dissociation, or chronic dysregulation.

Addiction as an Attempt to Regulate

Compulsive behaviours often emerge as attempts to regulate overwhelming internal states, to numb, soothe, or restore a sense of control. Even in cases where no overt trauma history is present, we often find histories of chronic stress, unmet needs, or environments that did not support secure attachment and emotional development.

Neuroimaging research has shown that trauma exposure alters brain regions involved in reward processing, stress response, and self-regulation, the same systems implicated in addiction (Sinha, 2008; van der Kolk, 2014).

Today’s environment accelerates and amplifies addictive risk:
Frictionless access – alcohol delivery, online gambling, on-demand pornography.
Algorithm-driven novelty – overstimulation of the brain’s reward system.
Cultural normalisation – binge drinking, workaholism, compulsive scrolling are often glamorised.

These conditions can lead to “rapid-onset” addictions, but sustainable recovery still depends on restoring nervous system balance, not just removing the substance or behaviour.

The most effective interventions integrate:
Trauma-informed care – when trauma is present, safe and paced processing.
Behavioural and habit-based interventions – cue interruption, replacement, relapse prevention.
Neurobiological regulation – teaching self-regulation, stress reduction, vagal tone strengthening.
Identity and social repair – building connection, belonging, and meaning.

This approach avoids therapeutic tunnel vision while respecting the depth and uniqueness of each person’s story.

We’ve seen how addiction can’t be reduced to one story. Trauma runs through it, shaping patterns of survival that often get overlooked.

That’s exactly what we explore inside the Trauma & Addiction Masterclass a 4-hour training designed to move beyond theory and into practice.

You’ll discover:

Why trauma drives addictive patterns and how to spot them

A trauma-informed framework that shifts focus from behaviour to person

Somatic tools you can bring into sessions right away

Practical ways to work with protective parts without judgment

This is where awareness becomes action, so you can support lasting change in the people you work with.

Conclusion:
Addiction is multifactorial. Trauma is not the whole picture, but it is a critical part of it.
By including trauma within a broader bio-psycho-social model, we offer a more complete, compassionate, and scientifically grounded path to recovery.

References:
Felitti VJ, Anda RF, et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The ACE Study. American Journal of Preventive Medicine.

Koob GF, Volkow ND. (2010). Neurocircuitry of Addiction. Neuropsychopharmacology 35, 217–238.

Sinha R. (2008). Chronic Stress, Drug Use, and Vulnerability to Addiction. Ann N Y Acad Sci.

Volkow ND, Koob GF, McLellan AT. (2016). Neurobiologic Advances from the Brain Disease Model of
Addiction. N Engl J Med 374:363-371.

van der Kolk BA. (2014). The Body Keeps the Score. Viking.