The Necessity of a Trauma-Informed Paradigm in Substance Use Disorder Services

OBJECTIVE To raise awareness and understanding about the role of trauma in the development of substance use and to define and clarify the need for trauma-informed care within the treatment of patients with substance use disorders (SUDs). METHOD This article reviews the up-to-date literature on how and why traumatic life experiences promote a neurobiological vulnerability to development of SUDs and combines this with a discussion of the principles of trauma-informed care for SUDs, as well as a review of the role of stigma and structural violence as foundational concepts in the implementation of trauma-informed care for people with SUDs. RESULTS Shifting to a trauma-informed care paradigm in treating SUDs more effectively serves patients by improving patient experiences and accounting for a chronic disease model, wherein multiple episodes of SUD care are often necessary. CONCLUSIONS This article reviews the ways in which nurses and other service providers can increase SUD patient retention and decrease recurrence by understanding the role of trauma in the development of SUDs, exploring the role of stigma, and identifying and interrupting structural violence as it relates to SUDs. This article also offers actionable steps that all nurses can take now as well as areas for further inquiry into trauma-informed care substance use services.