Getting to the root of the drug epidemic

It is no secret that drug use throughout the United States continues to soar. Overdose deaths linked to substance abuse continues to rise, despite massive national attention and efforts to address it. Although millions of dollars are being spent to curb this epidemic, more people are tragically losing their lives.  The consequences of this epidemic are devastating: mothers and fathers are having to bury their children; kids are losing their parents far too soon; teenagers are losing their best friends.

If what we are doing is not working, how can we look at the issue differently? How can we begin to understand addiction? How can we prevent addiction or intervene after use has already began? We need to think critically about what we know about drug abuse – what are the factors and predictors that have been revealed to us in existing research? While there is not enough room in this magazine to come close to addressing it all, one critically important area, often avoided because of the negative stigma it carries, is trauma – primarily childhood trauma, or trauma-informed care, as it is termed in the research world.

Let’s dive in and understand trauma a little more and its correlation to drug use….

Research has shown the high correlation between significant childhood trauma and adult incarceration. This has been revealed through the Adverse Childhood Experience (ACE) test, which measures the 10 highest types of childhood trauma, including abuse (emotional, physical, verbal, and sexual), divorce, mental health, and incarceration. Each of these traumatic experiences have proven to be the most traumatic experiences a child (under 18) can undergo, thus having adverse effects on the child as they grow up, sometimes even affecting brain development.  (If you have not taken an ACE test, google it so you can see your score).

Childhood Trauma and Resilience
Adults incarcerated across the United States have an average ACE score of seven – meaning, out of the ten types of trauma outlined in the test, they have experienced an average of seven. Therefore, it is not difficult to see the extremely high correlation between childhood trauma and adult incarceration. In the jail where I work in Richmond, Virginia, the average ACE score is six and seventy-eight percent of our population battles addiction to drugs and/or alcohol; also, a sad statistic showing a high correlation between the two.

You may ask, then, what is the difference between the adult with a seven who is in jail versus one who is not? The answer is resilience – how someone acts or reacts in an adverse situation.  If someone bounces back, tackles, and manages negative situations head on, they most often cope with trauma and hardship without engaging in negative behavior. However, if resilience is low, often meaning they have a high ACE score, an individual is more likely to attempt suicide, inject drugs, become obese, smoke cigarettes, become incarcerated, and/or even die years sooner.  After all, high resilience typically comes from strong relationships, communication, and connections. The opposite is someone that often lacks a strong family network, does not have close relationships, does not feel strong connections to others and does not have anyone to confide in. As such, those battling childhood trauma, meaning those with higher ACE scores and having a low resilience, do not typically have the skills to cope and manage situations in a healthy manner. This results more often than not in seeking unhealthy lifestyles as a mechanism to cope and numb pain.

When looking at the trauma experiences outlined in ACE, each relates to relationships, or the lack thereof. Whether it be divorced or separated parents, incarcerated parents, or being abused, all directly correlate with relationships and broken connections. Each of these factors can contribute to low resilience.

Trauma and the Drug Epidemic
How does this relate to the drug epidemic? Addiction often stems from drug use that began as a way to self-medicate. As a way to numb the pain or forget about it for a certain period of time, individuals often experiment with drugs. Sometimes, the streets come first, in that individuals sought ‘love’ and ‘family’ from the streets because they did not have it at home. Hanging in the streets, then introduced them to drugs, a way to self-medicate even further, then eventually becoming a full-blown addict.

It is important to remember, however, addiction does not discriminate. Many often think those growing up in the projects, or those whose parents are in jail, are the only ones who experience addiction, but do not be fooled; addiction is seen in middle and upper class communities almost as frequently, however, it is not talked about and caught as often as it is in low-income areas. While those growing up in more affluent areas likely have lower ACE scores, those battling addiction often report feeling as if they are not a priority in the home, they have parents who work often and are not around much, or are given most anything they want – again dealing with broken relationships.

For parents reading this, I encourage you to think deeply and determine where your child falls on the spectrum if they are using drugs and/or alcohol. Many parents scramble trying to figure out how to get their child off of drugs or alcohol. The addict may be sent to the best treatment center in the community, the parent may ground them or keep them from hanging out with the ‘bad influences.’ I would venture to say though, that these attempts often do not work. Often, it simply starts with establishing a new relationship with your child; tell them you are proud of them, use positive affirmations, show concern and enthusiasm about their day, meet their friends, or attend sporting events. While jail or treatment is often needed, the root cause for the addiction must be determined, and then addressed, in order for sobriety to be long-term.

The longer discussion of “what do I do,” is complex. However, the first step is understanding the root cause, which this article has sought to provide. Once understanding is obtained, overcoming the addiction can begin. Seeking professional help is often necessary, be it through an authentic recovery support and peer-based model, which is my typical recommendation, or through a counselor, or 12-step meetings. In the meantime, you are encouraged to look into the 42-resiliency factors, which are building blocks of how to build resilience.

From the addict to their family, law enforcement and the community, to business productivity and victims of those under the influence, drugs and/or incarceration touch almost every pocket of our society.  As such, it is time for us to take a much deeper look and a more strategic approach into the root cause. In the words of my boss, Sheriff C.T. Woody, Jr. of the City of Richmond, “instead of putting a Band-Aid on the wound, it’s time we treat the cause.”

Sarah Scarbrough, Ph.D. is the Program Director under Sheriff C.T. Woody, Jr. in the Richmond City Sheriff’s Office in Virginia. Dr. Scarbrough is responsible for overseeing all treatment and programming for the residents of Virginia’s second largest jail. The REAL Program, the jail’s premier program, was created by Dr. Scarbrough, and has received both national and international attention and accolades for its innovative and holistic approach. She also writes a blog when she has free time in between chasing two toddlers.