Substance Use Isn’t the Problem—It’s the Solution That Stops Working

Trauma and substance use go together like peas and carrots. It might sound lighthearted, but the reality is far from it. As a therapist and human being, I’ve seen how substance use disorders (SUD) and trauma often walk hand in hand. We live in a harsh world, and every one of us—consciously or not—is trying to find ways to cope.

It’s a spectrum, right? We all have our “drug of choice”—and I don’t just mean substances.

Some turn to alcohol or cannabis, others to pornography, work, exercise, or perfectionism.

These coping strategies are often less about enjoyment and more about survival. They help

us not feel something. They numb, distract, soothe. And sometimes, they work… until they

don’t.

Healing Begins with Curiosity, Not Judgment

I believe that healing only happens in states of safety and compassionate connection. So how

do we begin the work of healing when someone is using substances to manage unhealed

trauma? Or even running from the trauma that has occurred while using? (Quite the cycle, am I

right?) We start with curiosity — not judgment — and gently ask:

 What am I doing?

 Why am I doing it?

 When did this start?

This process isn’t about fixing or stopping behaviors right away—it’s first about understanding

them. Substance use, like most coping strategies, often make perfect sense when viewed in the

context of a person’s lived experiences. It's a response to something deeper. Often, that

“something” is pain.

What Does Soothing Look Like?

We can invite exploration of coping strategies by asking:

 What do you do—physically, emotionally, mentally—to soothe yourself?

 Does it help?

 Are there any costs or consequences?

 What would happen if you didn’t do it?

The honest answers to these questions usually reveal something important. For many, if they

didn’t soothe in the way they currently do, they’d feel overwhelmed by anxiety, sadness,

emptiness, or other emotional pain.

Trauma and Substance Use Healing Go Together

I believe trauma and substance work must go hand in hand. You can’t just take away the substance and expect someone to be okay and go about their lives. That substance—however harmful it may be in the long run—serves a function. We want to support learning and building

new ways of self-soothing, nervous system regulating, connecting, and feelings and experiences

of safety.

Recovery is not just about abstinence—it’s about integration. It’s about helping people

understand the why behind their use, and then, compassionately, building a toolbox of new

strategies in order to safely reprocessing past painful experiences. It’s about helping find safe

relationships, including the one they have with themselves.

Final Thoughts

So, whether you’re a person interested or in recovery, someone supporting a loved one, or a

fellow clinician—remember this: substance use is often an attempted solution to a problem.

When we approach with curiosity and compassion, we create the conditions for real, lasting

healing.

Let’s keep asking the brave questions. Let’s keep choosing connection over correction. And let’s

never underestimate the power of safety in the healing process.