Trauma as a Gateway: Exploring Trauma-Driven Pathways to Substance Use Disorders

This thesis investigates the role of trauma as a gateway to substance use disorders (SUDs), exploring how adverse experiences—particularly during childhood—disrupt emotional regulation and lead to maladaptive coping strategies such as self-medication. Bridging the fields of forensic psychology and addiction counseling, the research employs a mixed- methods approach: a meta-analysis of existing literature and qualitative interviews with experienced addiction counselors. Findings suggest a strong correlation between trauma exposure and the onset of substance use, with post-traumatic stress symptoms often preceding dependence. Counselors report that trauma frequently initiates substance use as a form of emotional escape, which gradually evolves into chronic addiction. The results support the integration of trauma-informed care (TIC) into substance abuse treatment, emphasizing early screening, psychological safety, and evidence-based interventions like TF-CBT. By reframing trauma as a primary gateway, this thesis advocates for a paradigm shift in how addiction is assessed, treated, and understood within forensic and clinical contexts.