Chapter 37 Beyond the medical model: Addiction as a response to trauma and stress


Theories focused on choice, chance or genetic predetermination leading to disease leave out the centrality of childhood adversity in creating the susceptibility for addictions, substance-related or not.

When children do not receive consistent, secure interactions, or experience painfully stressing ones, maldevelopment may result, resulting in brains susceptible to addictions and minds seeking escape from negative affects the individual finds unbearable. In vivo studies have demonstrated that animals exposed to prenatal or early life stress exhibit characteristics of drug addiction, alcoholism and increased risk of self-administration of drugs.

Early trauma or developmental adversity have lifelong consequences for how human beings respond to stress. Trauma in children, such as sexual, physical or emotional abuse or abandonment alter the child’s physical stress mechanisms and, as a result, the child is more reactive to stress throughout their adult life, which all addictions serve as an attempt to soothe.

The dominant brain systems in all addictions are all exquisitely fine-tuned by the environment. To various degrees, in all addicted persons these systems are not functioning properly. This chapter explores the relationship between childhood emotional loss or trauma and addiction, a fact of essential significance to the clinical treatment of addictions.


Gabor Maté - ORCiD:


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