Introduction

The correlation between adverse childhood experiences and later development of a substance use disorder (SUD) was found to be so consistent over the past 30 years, that in 2019, the American Society of Addiction Medicine updated their definition of addiction, “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences” (American Society of Addiction Medicine, 2019). When we change our definition, and our narrative, about what causes SUDs, we have an opportunity to look at how we may best serve those who use substances or have SUDs. Moreover, we have an opportunity to treat and serve people with this disease using the trauma-informed paradigm.

Trauma-informed care has been extensively written about, but the literature about trauma-informed care in treating SUDs has been minimal in recent years. The existing work describing trauma-informed care showed increased patient retention and dropout rate decrease (Amaro et al., 2007; Brown et al., 2013; Hales et al., 2019). This discussion article introduces nurses to an overview of the theory, science, and practice of trauma-informed care in a SUD treatment setting. First, we will describe the neurobiology of trauma as it makes individuals vulnerable to developing SUDs. Then, we will describe the trauma-informed care theory. Next, we will apply the trauma-informed care paradigm in an SUD setting to show its effectiveness in shifting stigma (through language use) and structural violence (through procedural review and revision). Finally, we will offer initial actionable items for nurses and allies to consider to begin implementing trauma-informed care practices in their SUD treatments and offer further areas for inquiry.

The Neurobiology of Trauma and Substance Use Disorder

As mentioned earlier, a shift in the narrative about the cause of SUD is imperative because it helps determine new treatment and engagement pathways. The following review of neurobiology helps inform a cohesive narrative about the cause of substance use. This is in stark contrast to previous understandings of addiction that relied almost entirely on a hedonistic and stigma-inducing narrative: People who struggle with addiction do so because they simply enjoy pleasure too much (Foddy & Savulescu, 2006).

The original Adverse Childhood Experiences (ACEs) study was conducted from 1995 to 1997. The authors found that there was a direct correlation between traumatic childhood experiences and risk of substance use later in life (Dube et al., 2003). An ACE score of 4 or more was correlated with a 500% (fivefold) increased risk of developing an alcohol use disorder, and a score of 6 was correlated with a 4,600% (46-fold) increased lifetime risk of injected substance use (Felitti, 2003). The correlation was so strong Felitti (2003) wrote, “Our findings indicate that the major factor underlying addiction is adverse childhood experiences that have not healed with time and that are overwhelmingly concealed from awareness by shame, secrecy, and social taboo” (p. 554).

Subsequent research, seeking to understand this connection, has shown that trauma in early childhood alters the brain in ways that increase the risk of developing a SUD. The medial prefrontal cortex (mPFC) is widely connected to areas throughout the brain and is involved in a variety of functions related to executive function, the interpretation of events and construction of personal meaning, suppression of negative emotions, attribution of salience, and regulation of reward circuits (Kessler et al., 2020; Pujara et al., 2016; Zhang & Volkow, 2019). The mPFC typically has strong connections to the amygdala, a brain region which creates feelings of anxiety, fear, and anger when activated. The influence of the mPFC allows individuals to modulate their experience of negative emotions, but in those who have experienced early childhood trauma this connection is weakened. As a result they experience more negative emotions and have less control over them, which has been shown to increase risk of multiple SUDs, and greater reduction in mPFC-amygdala connectivity was found to increase the risk of return to use (Zhang & Volkow, 2019). The mPFC is also connected to the ventral striatum, a region which is involved in monitoring for and response to rewards (Pujara et al., 2016). Increased connection between the mPFC and ventral striatum has been found in both individuals with early childhood trauma and in those with cocaine and heroin use disorders (Hanson et al., 2018; Ma et al., 2010; Wilcox et al., 2011). This increased connection appears to reflect stronger reactions to cues suggesting possible reward and increased motivation to attain substances. Thus, ACEs appear to alter neurodevelopment in ways that increase emotional dysregulation and sensitivity to reinforcing substances and reward (Berridge & Robinson, 2016). Substance use triggers the release of dopamine throughout the brain, which both reduces negative emotions and activates the reward pathways, demonstrating how ACEs can prime young brains to develop SUDs later in life (Zhang & Volkow, 2019).

Moreover, it has been hypothesized that adversity increases baseline hypervigilance and the central threat response system for an unknown, though persistent, duration (Nusslock & Miller, 2015). This hypervigilance, in turn, gives rise to a global inflammation via inflammatory cytokines. Central nervous system inflammation allows reward sensitivity (akin to neural sensitization) in the basal ganglia (Nusslock & Miller, 2015). In other words, people who have experienced adversity may find substances far more salient than their healthy counterparts, especially when their brain is hypervigilant and with a special affinity toward that which seems to signal survival (Huys et al., 2014; Nusslock & Miller, 2015; Yoo et al., 2017).

In short, traumatic experiences, most especially during brain development, actually prime our brains to be hypersensitive to salience and reward, and confuse reinforcing substances for substances that ensure our survival. Understanding this pattern as neurobiological vulnerability instead of moralistic failing again reinforces the need to attend to people with SUD from a trauma-informed approach.

What Is Trauma Informed Care?

According to the seminal work of Hopper et al. (2010), trauma-informed care can be defined as

a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment. (p. 82)

Unlike trauma-specific care, which attends to the symptoms of psychiatric sequelae of traumatic experiences for individuals (Trauma Informed Oregon, 2017), trauma-informed care asks that we change systems to ensure an experience of safety and empowerment for clients (see Table 1). Most specifically, trauma-informed care is vigilant about prevention of retraumatization (Substance Abuse and Mental Health Services Administration, 2014) by naming the specific ways in which we can either harm or support clients based on their histories. Nurses can and do play a particularly poignant role in trauma-informed care because nurses have always been interested in the patient experience (Peplau, 1997).

Table 1. Trauma-Informed Versus Trauma-Specific Care.

Trauma-informed care is particularly meaningful within the context of SUD for a variety of reasons. Nurses and other service providers must understand trauma is common among people seeking services, and be especially attentive to providing a positive patient experience that does not evoke past trauma (Felitti, 2003; Hales et al., 2019; Merrick et al., 2018). This is important in the context of SUD services because clients may seek our services repeatedly as they build recovery capital (Decker et al., 2017; Hennessy, 2017; Laudet & White, 2008). The less likely they are to feel stigmatized and dehumanized, the more likely they are to return promptly on a recurrence of disease symptoms (Biancarelli et al., 2019).

Key Principles of Trauma-Informed Care

The key principles of trauma-informed care are safety, collaboration, empowerment, trustworthiness, and choice (Harris & Fallot, 2001). Each principle offers insight in systems design and highlights areas wherein we can attend to the patient experience. If we focus on safety and the client experience, we may be attentive to the way in which we arrange furniture in therapeutic offices and allow easy access to doorways for clients, prioritizing the safety of both clients and staff. If we consider psychological safety, we may arrange bathrooms differently for a urine sample collection, with the understanding that iatrogenic harm can come from the urine drug screen process for trauma survivors. An example of empowerment might look like participants self-authoring group agreements for process or psychoeducation groups. If we focus on collaboration we will write treatment paperwork, such as behavioral agreements, with patient input and voice. Moreover, we may begin to use the collaborative problem solving model for disruptive behavior (Greene, 2011; Greene et al., 2003). Choice in SUD may, for example, highlight the need for clients themselves to determine their treatment goals, versus a unilateral assumption that the end goal is cessation of all substances.

Foundations of Trauma-Informed Care for Substance Use Disorder: Battling Stigma

The foundation for a trauma-informed SUD workforce and clinical system is only possible when the stigma of addiction is actively acknowledged and resisted. According to Avery and Avery (2019), the stigma of addiction is the “negative attitudes towards those suffering substance use disorders that . . . are likely to impact physical, psychological, social or professional well being” (p. 2). Moreover, stigmatization was found by Fleury et al. (2014) to be “the strongest predictor of substance dependence” (p. 203). Researchers have identified multiple layers of stigma, each building on the other to vastly influence the lived experiences of people with SUDs and their families (Hatzenbuehler, 2017). First, there is the vast, far-reaching, and powerful structural level stigma such as policies, laws, and inequitable resource allocation for research (Hatzenbuehler, 2017). More intimately, there is interpersonal stigma; this type of stigma is damaging and includes the ill-treatment of a person who uses drugs by a police officer, health care professional, or clergy—the very people who are supposed to tend to and protect the vulnerable. And finally, personal stigma, the uniquely personal experience of low-self esteem and poor self-efficacy that can hinder attempts at recovery and self-transformation (Hatzenbuehler, 2017). Each layer of stigma compounds the others, ultimately prohibiting recovery and decreasing the health and well-being of the drug user (Hatzenbuehler, 2017), propelling them further away from the thing society most wants from them: recovery. A trauma-informed SUD system ensures that each layer of stigma is addressed but most specifically the interaction between staff and client.

Language choice is one of the most important and actionable steps we as nurses can take today to decrease stigma against people who use substances. The data tell us that some specific words actually decrease stigma for people who use drugs, while other words that we might think of as innocuous are harmful to people who use or have used substances, because they bolster bias and stigma (Ashford et al., 2018; Wakeman, 2017). As researchers have identified, there may be appropriate locations to utilize words like addict and alcoholic (e.g., mutual aid meetings) but this language has no place in clinical practice (see Table 2). It is imprecise, and it allows us to think about addiction from a place of moralism rather than a place of clinical acumen. The word choices described in the attached table affirm human dignity and help reground us in our clinical knowledge, allowing us to move away from the interpersonal stigma that we know health care providers enact (Biancarelli et al., 2019).

Table 2. Trauma-Informed Language Shifts.

Foundations of Trauma-Informed Care for Substance Use Disorder: Structural Violence

Structural violence is defined as:

One way of describing social arrangements that put individuals and populations in harm’s way . . . The arrangements are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people . . . neither culture nor pure individual will is at fault; rather, historically given (and often economically driven) processes and forces conspire to constrain individual agency (Farmer et al., 2006, p. 1686).

While an understanding of structural violence is imperative throughout health care, it is particularly important in the context of trauma-informed care for SUD for two distinct but intertwined reasons. First, trauma often originates within structural violence. As the Centers for Disease Control and Prevention Division of Violence Prevention explores in a 2019 briefing, one of the primary modes of preventing adverse childhood experiences is to address structural violence, such as poverty and wealth inequity (Centers for Disease Control and Prevention, 2019). Thus, in order to understand trauma and toxic stress and its long lasting effects on our neurobiology, we must understand that traumatic experiences are not generally individual experiences but instead are shared experiences with a foundation in systemic problems such as racism, socioeconomic inequity, and gender based violence. One example highlighting the role of structural violence is reflected in the original ACES questions and asks about losing a family member to incarceration. African Americans and Blacks are disproportionately criminalized and incarcerated compared with their White counterparts based on systemic racism and historical criminalization (Bailey et al., 2021; Biancarelli et al., 2019; Jeffers, 2019).

Second, when we fully understand the way in which structural violence gives rise to traumatic experiences, we can then understand how best to transform our services to ensure that retraumatization based on structural violence is less likely to occur. For example, trauma-informed SUD services may be especially attentive to the implicit bias that White clinicians can, and do, exhibit with their Black, Indigenous, or people of color clients, most especially in the context of substance use, which is heavily stigmatized, creating a dual stigma (Ben et al., 2017).

Further Considerations and Implications for Practice

While an evidence base for trauma-informed systems changes and interventions grows, this article can offer both immediate implications for practice as well as further consideration and locations for inquiry. Conceptually, trauma-informed SUD services should rely heavily on the theory and practice of other humanistic paradigms, notably harm reduction and patient-centered care. Harm reduction “refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely” (Hawk et al., 2017, p. 1); it aligns well within trauma-informed care in that both highlight the need for collaborative and equitable relationships, and as well as a return of the control of the part of the service utilizer. Harm reduction methods were recently named as the public health model of choice by the Biden administration to limit overdoses and other harms associated with substance use (joebiden.com, 2020). Patient-centered care is a framework that highlights the needs of individual clients within sometimes overwhelming health systems; it aligns well with the trauma-informed paradigm because both highlight the need for easy access to systems as well as individual interventions based on patient need and vulnerability (Marchand et al., 2019).

Ideas for practice transformation can vary widely, and yet there are some immediate actionable steps that nurses can take to transform their practice. First and foremost, nurses must begin to use nonstigmatizing and more clinically accurate language to discuss clients who use substances and those who have SUDs. Second, all nurses (regardless of practice location, level of education, etc.) can interrupt harmful narratives that exist within health care about people who use drugs. For example, most nurses understand the concept of a patient who is “drug seeking.” We suggest that nurses immediately interrupt these narratives, both internally and externally and find ways to allow even the most challenging patients to feel safe. Interruption of this narrative may look like correcting a coworker who uses this term and offering data on the ways in which trauma creates a neurobiological vulnerability to addiction, or, attending specifically to the psychosocial needs of the patient in question and reminding said patient that there are some medications that disallow safety, such as opioids or benzodiazepines and that a denial of these medications is rooted in a desire to keep the patient safe.

The authors suggest the following examples of places we need to inquire in order to provide more deeply informed trauma-informed services within SUD services: patient experience of urine drug screens, withdrawal management setting strategies for psychological safety, patient experience of difficult conversations with providers and staff (e.g., referral to a higher level of care or denial of controlled substances). Moreover, the use of community participatory research is needed to most fully understand the needs of people using drugs and accessing SUD services.

Conclusion

As we enter into a new period of understanding SUDs based on the neurobiology of trauma and addiction, we must equally transform our services to meet the needs of people who use drugs and people who seek our support to cease drug use. We will need to address stigma, change how we think about (and refer to) people who use drugs, and understand the ways in which structural violence contributes to SUDs. SUDs services must forgo previous treatment paradigms, which relied heavily on harmful and reductive beliefs regarding both the cause of SUDs and the appropriate interventions, which were often based on models of accountability and criminalization despite a lack of evidence. Substance use services and the nurses who strive to provide compassionate, judgement-free services to clients with SUDs can and should embrace the trauma-informed paradigm.

Summary

The persistent correlation between adverse childhood experiences (ACEs) and substance use disorder (SUD) necessitates a paradigm shift in understanding and treating SUDs. A trauma-informed approach, emphasizing safety, collaboration, and empowerment, offers a more effective strategy compared to previous models rooted in moralistic narratives.

The Neurobiology of Trauma and Substance Use Disorder

The hedonistic understanding of addiction as solely pleasure-seeking is insufficient. Research demonstrates a strong correlation between ACEs and increased SUD risk. High ACE scores significantly elevate the likelihood of developing alcohol use disorder and injected substance use. Neurobiological research reveals that early childhood trauma alters brain structures, weakening the connection between the medial prefrontal cortex (mPFC) and the amygdala. This results in impaired emotional regulation and increased sensitivity to reward, making individuals more vulnerable to SUDs. Further, adversity may increase baseline hypervigilance, leading to central nervous system inflammation and heightened reward sensitivity. This highlights the neurobiological vulnerability underlying SUD development, rather than a moral failing.

What Is Trauma-Informed Care?

Trauma-informed care is a strengths-based framework acknowledging and responding to the impact of trauma. It prioritizes safety, both physical and psychological, for both providers and clients, fostering a sense of control and empowerment. Unlike trauma-specific care, it focuses on systemic changes to prevent retraumatization. The approach is particularly relevant in SUD treatment due to the high prevalence of trauma among clients and the importance of positive patient experiences in promoting sustained engagement with services.

Key Principles of Trauma-Informed Care

Central principles include safety, collaboration, empowerment, trustworthiness, and choice. These inform systems design and patient interactions. Safety considerations encompass physical environment and procedures, while empowerment involves client participation in treatment planning. Collaboration is reflected in shared decision-making and collaborative problem-solving approaches. Choice emphasizes client autonomy in defining treatment goals.

Foundations of Trauma-Informed Care for Substance Use Disorder: Battling Stigma

Addressing the stigma of addiction is crucial for effective trauma-informed care. Stigma exists at multiple levels: structural (policies, resource allocation), interpersonal (ill-treatment by professionals), and personal (low self-esteem). Language choices significantly impact stigma; using person-first language and avoiding stigmatizing terms is essential in fostering a supportive environment.

Foundations of Trauma-Informed Care for Substance Use Disorder: Structural Violence

Structural violence, encompassing social arrangements causing harm, is a critical factor in understanding trauma and SUDs. Trauma often stems from structural issues like poverty and inequity, and these same structures can perpetuate retraumatization within SUD services. Addressing implicit bias and systemic inequalities is vital for providing equitable and effective care.

Further Considerations and Implications for Practice

Trauma-informed SUD services should integrate harm reduction and patient-centered care principles. Actionable steps for nurses include using nonstigmatizing language and challenging harmful narratives within healthcare settings. Further research is needed to understand patient experiences within specific aspects of SUD services, such as urine drug screens and interactions with providers. Community participatory research can enhance understanding of client needs.

Conclusion

A trauma-informed approach is essential for effective SUD treatment. This requires addressing stigma, transforming language, and acknowledging the role of structural violence. By abandoning outdated treatment paradigms rooted in harmful beliefs and embracing a trauma-informed perspective, SUD services can provide more compassionate and effective care.

Summary

The evolving understanding of substance use disorders (SUDs) emphasizes the significant role of adverse childhood experiences (ACEs) and their impact on brain development. This understanding necessitates a shift towards trauma-informed care in SUD treatment. This approach prioritizes safety, collaboration, empowerment, trustworthiness, and choice to mitigate the effects of trauma and reduce stigma. Addressing structural violence, which often underlies traumatic experiences, is crucial for effective and equitable care.

The Neurobiology of Trauma and Substance Use Disorder

Research demonstrates a strong correlation between ACEs and the development of SUDs. Early childhood trauma alters brain structures like the medial prefrontal cortex (mPFC), weakening its connection to the amygdala and increasing emotional dysregulation. This, coupled with strengthened connections between the mPFC and ventral striatum, enhances sensitivity to reward cues and increases the risk of substance use. Furthermore, adversity may lead to hypervigilance and inflammation, further increasing reward sensitivity and making substances seem more salient. This neurobiological vulnerability highlights the need for trauma-informed approaches in SUD treatment.

What Is Trauma-Informed Care?

Trauma-informed care is a strengths-based framework emphasizing safety, responsiveness to trauma's impact, and empowerment for both providers and clients. It contrasts with trauma-specific care by focusing on systemic changes to prevent retraumatization. In SUD treatment, this approach is crucial for fostering positive patient experiences, enhancing retention, and promoting recovery. The emphasis is on preventing the re-traumatization of patients, recognizing the high incidence of trauma amongst those with SUDs.

Key Principles of Trauma-Informed Care

The core principles of trauma-informed care—safety, collaboration, empowerment, trustworthiness, and choice—guide system design and interactions with clients. These principles inform the design of physical spaces, treatment processes, and therapeutic interactions to prioritize client safety and empower participation in their care. Collaboration includes patient input in developing treatment plans and addressing disruptive behaviors. Offering choices empowers clients in determining their treatment goals.

Foundations of Trauma-Informed Care for Substance Use Disorder: Battling Stigma

Addressing stigma is fundamental to trauma-informed SUD care. Multiple layers of stigma—structural, interpersonal, and personal—impact individuals with SUDs. Language is a key tool in combating stigma. Using person-first language and avoiding stigmatizing terms creates a more supportive and less judgmental environment. This shift from moralistic views to a clinically informed perspective promotes recovery and well-being.

Foundations of Trauma-Informed Care for Substance Use Disorder: Structural Violence

Structural violence, encompassing societal arrangements that cause harm, is inherently linked to trauma and SUDs. Addressing structural issues like poverty, racism, and gender-based violence is essential for preventing ACEs and mitigating the impact of trauma. Trauma-informed care necessitates awareness of how structural violence influences the delivery of services and may perpetuate disparities in treatment access and outcomes.

Further Considerations and Implications for Practice

Trauma-informed SUD services benefit from integration with harm reduction and patient-centered care models. Practical steps include adopting nonstigmatizing language, challenging harmful narratives about substance users, and addressing patients' psychosocial needs. Future research should focus on improving patient experiences in various aspects of treatment, such as urine drug screening and interactions with staff. Community participatory research can enhance the understanding of client needs and optimize service delivery.

Conclusion

The growing understanding of SUDs' neurobiological underpinnings necessitates a paradigm shift towards trauma-informed care. This approach involves addressing stigma, transforming treatment paradigms, and acknowledging the impact of structural violence. By prioritizing safety, collaboration, empowerment, and choice, SUD services can better support individuals in their recovery journeys.

Summary

For the past 30 years, research consistently shows a strong link between adverse childhood experiences (ACEs) and the later development of substance use disorders (SUDs). This understanding has led to a shift in how addiction is viewed, recognizing it as a chronic medical disease influenced by brain chemistry, genetics, environment, and life experiences. Trauma-informed care offers a promising approach to treating SUDs, focusing on safety, empowerment, and collaboration to improve patient outcomes and reduce relapse.

The Neurobiology of Trauma and Substance Use Disorder

Understanding the neurobiological impact of trauma is crucial to effective SUD treatment. Early childhood trauma alters brain development, weakening connections between the medial prefrontal cortex (mPFC) and the amygdala, leading to increased emotional dysregulation. This, combined with a strengthened connection between the mPFC and ventral striatum, increases sensitivity to rewards and substances, making individuals more vulnerable to SUDs. Adverse experiences also trigger hypervigilance and inflammation, further enhancing reward sensitivity and the salience of substances.

What Is Trauma-Informed Care?

Trauma-informed care is a strengths-based approach that recognizes the impact of trauma and prioritizes safety and empowerment for both patients and providers. It focuses on preventing retraumatization and creating opportunities for healing and control. Unlike trauma-specific care, which targets individual symptoms, trauma-informed care works to change systems and practices to support better patient experiences and reduce the chance of relapse.

Key Principles of Trauma-Informed Care

The core principles of trauma-informed care are safety, trustworthiness, collaboration, empowerment, and choice. Implementing these principles involves creating physically and psychologically safe environments, fostering collaborative relationships with patients, empowering patients in their treatment, and building trust through respectful interactions. It also means providing clients with genuine choices in their treatment plans.

Foundations of Trauma-Informed Care for Substance Use Disorder: Battling Stigma

Addressing the stigma surrounding addiction is essential for effective trauma-informed care. This stigma exists on multiple levels: structural (policies, laws, resource allocation), interpersonal (ill-treatment by professionals), and personal (low self-esteem). Changing language is a key step, shifting from stigmatizing terms to more person-centered and clinically accurate ones. This promotes patient dignity and fosters a more supportive treatment environment.

Foundations of Trauma-Informed Care for Substance Use Disorder: Structural Violence

Structural violence, encompassing social arrangements that cause harm (like poverty and inequality), significantly contributes to both the development of trauma and the perpetuation of SUDs. Understanding and addressing structural violence is critical in preventing retraumatization and promoting equitable access to care. Addressing implicit bias among clinicians and acknowledging how systemic issues disproportionately affect certain groups (e.g., racial disparities in incarceration) are crucial for developing just and fair SUD services.

Further Considerations and Implications for Practice

Trauma-informed SUD care aligns well with harm reduction and patient-centered care, emphasizing collaboration, empowerment, and respect for patient choices. Practical steps include using non-stigmatizing language, interrupting harmful narratives within healthcare settings, and focusing on patient safety and well-being. Future research should explore improving patient experiences in areas like urine drug screening, withdrawal management, and difficult conversations with providers. Community involvement in research is also needed to better address the unique needs of those affected by SUDs.

Conclusion

A trauma-informed approach is crucial for effectively treating SUDs. By acknowledging the neurobiological impact of trauma, addressing stigma, and confronting structural violence, SUD services can shift from punitive models to supportive, empowering, and effective interventions that promote healing and recovery.

Summary

For many years, people thought addiction was caused by a person's choice to enjoy pleasurable things too much. But now, we know that difficult experiences in childhood can change the brain and make someone more likely to have a substance use disorder (SUD). This article explains how trauma affects the brain, what trauma-informed care is, and how nurses can help people with SUDs in a better way.

The Neurobiology of Trauma and Substance Use Disorder

Tough things that happen to kids, called Adverse Childhood Experiences (ACEs), can seriously increase the chances of them having problems with drugs and alcohol later in life. These experiences change how the brain works, making it harder to control emotions and more sensitive to things that feel good. Drugs and alcohol can then become a way to cope with these difficult feelings.

What Is Trauma-Informed Care?

Trauma-informed care is a way of helping people who have been through hard times. It focuses on making people feel safe and giving them a sense of control over their lives. It's different from other types of care because it changes how systems work to make sure people aren't hurt again. Nurses are important in this kind of care because they focus on how people feel.

Key Principles of Trauma-Informed Care

The main ideas of trauma-informed care are safety, working together, feeling empowered, trust, and having choices. This means making sure people feel safe physically and emotionally, working with them to make decisions, and letting them choose what's best for themselves.

Foundations of Trauma-Informed Care for Substance Use Disorder: Battling Stigma

Stigma, or negative attitudes towards people with SUDs, makes it harder for them to get better. Using respectful language and understanding that everyone deserves help is very important in overcoming this stigma.

Foundations of Trauma-Informed Care for Substance Use Disorder: Structural Violence

Things like poverty and racism can lead to trauma. To provide better care, we need to understand how these larger problems affect individuals and change the systems that might cause further harm.

Further Considerations and Implications for Practice

Nurses can help by using kind words, correcting negative ideas about people with SUDs, and focusing on helping people feel safe. More research is needed to understand how to make systems better for people with SUDs and make sure they feel supported and understood.

Conclusion

We now understand that difficult childhood experiences can make people more vulnerable to SUDs. To help people with SUDs, we need to change how we think about addiction and treat them with respect and understanding. Trauma-informed care is a way to make sure everyone feels safe and empowered, leading to better outcomes.