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The dual diagnosis of trauma and cocaine abuse

Living with internal distress is like a morbid game of pinball: it’s soon forgotten from where the weighted ball of turmoil emerged, but you struggle to deflect it as it pings from emotional trauma to mental disorder and shoots up to drugs, alcohol or compulsions. You try to keep up, focusing on juggling the chaotic wrecking ball, but no matter how hard you bat, the ball of traumatic effects inevitably rolls back down within you.

Dual diagnosis is the presence of comorbid or co-occurring disorders. In most cases, it refers to substance abuse and simultaneous mental disorder. Inconsistently treated or raw emotional trauma is often a breeding ground for substance abuse.

Latest research

A study published just this year by the University of Mississippi Medical Center’s director of anxiety research, Matthew T. Tull, Ph.D., explores the tangle of emotion regulation difficulties, post-traumatic stress disorder symptoms, developed association of trauma-related triggers and cocaine use.

The trauma-cocaine cue was explored by testing 42 cocaine-addicted inpatients with interpersonal trauma in their past. Through extensive questionnaires, researchers confirmed that impulsivity and cocaine use rose and emotional self-regulation fell when PTSD symptoms were severe.

While depression makes some people turn to drugs like alcohol or opioids to drown their pain or sorrows, those with PTSD who abuse cocaine seem to gravitate toward it to cope with periods of emotional distress – whether they know it or not.

Emotional trauma, a vivid picture

Marc Lewis, Ph.D., analyzed the three major roots of addiction: choice, disease and self-medication. He explains how each lays validated claim to addiction, but self-medication seems the most accurate of all.  

He excavates trauma as the root of self-medication and illustrates what emotional trauma looks like in the brain.

“That traumatized amygdala keeps signaling the likelihood of harm, threat, rejection, or disapproval, even when there is nothing in the environment of immediate concern. In fact, this gyrating amygdala lassos the prefrontal cortex, foisting its interpretation on the orbitofrontal cortex (and ventral ACC) rather than the other way around (which we might loosely call emotion regulation). The whole brain is dominated by limbic imperialism – making it a less-than-optimal neighborhood in which to reside.”

Emotional trauma is the echo of traumatic experiences that shock the main senses and overwhelm the physical. It’s much harder to diagnose and lasts well beyond physical wounds healing or divorce and death certificates being finalized. Lewis explains emotional trauma can be recognized after emotional abuse or profound loss – be it physical or mental, or if either or both parents emotionally detach due to personal disorders.

Lewis adds that symptoms include “partial memory loss, intrusive thoughts, anxiety and panic attacks, avoidance of particular places, people, or contexts, emotional numbing or a sense of deadness, and overwhelming feelings of guilt or shame.” He goes on to say drugs like cocaine ramp up anticipation of reward, again, as a grand distraction.

Relapse is a part of recovery, many will tell you. However, chronic relapse is an indicator quick detox and blanket treatments aren’t working; each individual needs customized, holistic care. Sovereign Health of Texas treats dual diagnoses concurrently. Using alternative therapies and cognitive recovery modalities, we heal from the inside, out. Call our 24/7 helpline to learn more.

About the author

Sovereign Health Group staff writer Kristin Currin-Sheehan is a mindful spirit swimming in metaphysical pools with faith as her compass. Her cover: a 30s-something Cinderella breadwinner of an all-sport blended family. Her repertoire includes writing poetry, lifestyle articles and TV news; editing, radio production and on-camera reporting. For more information and other inquiries about this media, contact the author at


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