ACCORDING to the European Monitoring Centre for Drugs and Drug Addiction, approximately three in every 10 adults in Ireland report to having used illicit drugs during their lifetime.
Most people use drugs recreationally but for others their drug use becomes a substance dependency issue.
There are many reasons why a person’s recreational use may become an addiction and every person has their individual story. However, researchers in the School of Applied Psychology, UCC have been particularly interested in the relationship between mental health, psychological trauma and addiction.
Addiction is often viewed as a moral failure and illegal drug use has primarily been viewed as an issue for the criminal justice system. However, more and more countries recognise that criminal justice responses are failing with respect to addiction and the current National Drug Strategy for Ireland places addiction firmly as a health issue.
There is a growing interest in the concept of complex psychological trauma and there is now no question about the link between early trauma and the development of many mental health and addiction issues. Adverse childhood experiences or exposure to toxic levels of stress during childhood impact on the developing brain and body. According to the Harvard Centre for the Developing Child harmful levels of stress at critical development periods have lifelong consequences resulting in a stress response system permanently set on fight or flight. A system that is constantly experiencing a stress response is likely to require something to alleviate the symptoms, in the absence of early mental health interventions it is not strange that a person would seek to medicate these symptoms with drug use and there is a risk of addiction and other associated social problems.
Many people in addiction would report to experiencing poor mental health and that the use of substances helped to manage their distress, however when the drug use becomes problematic and a person is experiencing a dual diagnosis of mental health and addiction it can be very difficult to seek the right help. Services for people with a dual diagnosis in Ireland in the main have been poor, except for some grass roots community-based initiatives. A report by MacGabhann published in 2004 highlighted an urgent need to identify the levels of dual diagnosis in Ireland and to develop an appropriate national strategy. This has yet to be achieved.
Addiction is a public health crisis with almost two drug and alcohol related deaths per day in Ireland.
A number of studies conducted by the School of Applied Psychology, UCC has looked at the prevalence of adverse childhood experiences and levels of mental health in addiction and homeless settings and the results indicate that a proportion of people with a drug dependency have experiences of high levels of childhood trauma and/or mental health issues. In 2017 data was collected from service users in a residential addiction service. The results revealed an existing mental health diagnosis in 44% of cases, but this increased to 92 % when service users were asked if they believed they had a mental health issue. Residents were also asked to report about ten specific items that are considered traumatic experiences during childhood. For those who had higher childhood adversity scores there were higher reports of mental health disorders, suicidal ideation and higher levels of imprisonment.
There are some who would argue that experiencing difficulties in childhood is not an excuse for later life addiction, but a vast amount of research shows that addiction is response to a mental health crisis.
Shame and stigma associated with mental health issues in the past prevented people from seeking help we must now ensure that we all recognise addiction as a health issue to reduce the stigma and support those who need help.
The Applied Psychology researchers also worked alongside staff from HSE Social Inclusion and Cork Simon Community to establish levels of childhood trauma in the histories of 50 adults using homeless services. There was a significant relationship between the total numbers of early childhood adverse experiences and poor health and social outcomes. The greater the levels of adversity the earlier the age at which individuals first injected heroin. Also, for those with higher the levels of adversity they reported overdosing more frequently, greater reports of self-harming and suffered more domestic violence. The researchers have also found higher levels of childhood adversity among women in probation services and young people in youth justice systems.
There is now undisputable evidence of the high levels of trauma for many people who experience addiction. We can no longer consider addiction to be a moral failing, for so many it is a mental health issue and should be treated as such.
We need to design services that meet the needs of those who need them. We should be alarmed at the high numbers who die every year from preventable deaths and the impact this has on those left behind. If we truly want to do something about the ‘cycle of addiction’ then we need to address the ‘cycle of trauma’. We need to stop the stigma and provide a trauma informed health led response to addiction.
ABOUT THE AUTHOR:
Dr. Sharon Lambert, is a Lecturer at school of Applied Psychology UCC. Sharon’s research interests revolve primarily around the impact of trauma on development, its link with substance misuse and mental health and consequent considerations for service design and delivery. Sharon conducts research with community based partners such as addiction, homelessness, criminal justice and educational organisations.
TOMORROW: “Drugs do not discriminate. They do not care about your social status, about race or religion, drugs will take anybody willing and what can seem like a temporary release or a good time can quickly turn into a nightmare.” So says Nicole Ryan, whose brother Alex died after taking a synthetic drug. In the latest part of our five-day series, Nicole says we need to educate and teach young people about the dangers of drugs. See EchoLive.ie for the full series.