Last week I attended the annual training of the National Association of Drug Court Professionals. One of the speakers I seek out every year is Dr. Brian Meyer, Ph.D. He is a nationally recognized expert in the area of trauma. I attended his informative session on “The Effects of Opioid Use on Families.”

Dr. Meyer starts with the premise that addiction is a family disease because it causes family members to adapt their roles in order to cope. Children of parents with substance use disorders commonly take on the role of enabler, hero, clown, and substance misuser. These children often suffer from mood disorders, conduct problems, low school performance, child abuse and neglect.

PTSD and Substance Abuse co-occur at a high rate. According to SAMHSA, 20-40% of people with PTSD also have substance use disorders. Similarly 40-60% of people with substance use disorders suffer from PTSD. Unaddressed PTSD increases the risk of substance relapse. So it is obvious that trauma must be taken into account when treating substance abuse.

Further 80% of those with substance use disorders are diagnosed with some form of mental health issue. The great majority of women (up to 90% of those appearing in Court) have sexual abuse in her history.

It is critical that judges and treatment providers are Trauma Competent – not just Trauma Informed. This means that clients are referred ONLY to evidence-based programs treating trauma and substance use disorders. Regular trauma trainings are mandated.

We must watch our language! Avoid shaming and stigmatizing words. NEVER call someone an addict – it defines him/her. Instead recognize him/her as a person first who suffers from the disease of substance use disorder. NEVER tell an individual “you can stop if you want.” Remember that changes occur in the brain from opioid use, requiring more than “willpower” to conquer this disease. Such a statement implies, instead, that this brain disease is a moral failing. NEVER refer to a positive urine sample as a “dirty urine.” It implies that the client is a dirty person.

Finally, we must realize that expecting immediate abstinence from trauma victims can leave them defenseless and may not be possible right away. Often times medically assisted treatments such as Suboxone, Vivitrol or Methadone will be required to ultimately reach abstinence.

For more information, two excellent resources are: “Beyond Trauma: a Healing Journey for Women” by Stephanie Covington and “Seeking Safety” by Lisa Najavits.