The elephant in the room

The links between childhood trauma and problematic adult substance use – though huge – are still not being properly addressed. If we’re finally going to tackle the drug deaths crisis, they need to be. DDN reports.

Wise elephants‘How long have we known that drugs are connected to childhood trauma? Probably since the seventies,’ says child psychologist and research scientist Suzanne Zeedyk. ‘It just hasn’t filtered into our wider consciousness or our systems.’

The extensive and ongoing adverse childhood experiences (ACE) study identified that people who experienced four or more types of ACE – including physical or emotional neglect; physical, emotional or sexual abuse, or exposure to domestic violence – are seven times more likely to be alcohol-dependent, and ten times more likely to be involved in injecting drug use. But while childhood trauma is clearly a major factor in people going on to develop substance problems in adulthood – quite possibly the biggest – it’s still not discussed as widely as it should be.

This is particularly the case with child sexual abuse. A report by the charity One in Four found that many drug services were still failing to ‘make the link’ between child sexual abuse and adult substance problems (DDN, May 2019, page 10), something that is perhaps surprising in a sector that is so aware of the impact of stigma and its role in deterring people from seeking help. Stigma is clearly a huge issue for survivors of abuse – it’s an extremely difficult thing to disclose, and many people never do. Add problem substance use to that, and you have stigma compounded on stigma.

Blame and Judgement

‘In general in our society we just don’t understand that childhood trauma stays with you, that it stays in the body,’ says Zeedyk, who recently hosted the online Trauma at the heart of Scotland’s drug deaths event. ‘It produces biological change that you need help with later on because your stress system is made more fragile.

If children have to deal with too much emotional distress at a time when they don’t have a stress system that can cope it creates damage. Then when you get a bit older and face distress you need external help, and that becomes your go-to place. But the other thing is we have a society that very quickly turns to blame and judgment. We make it about individual choices – that’s kind of a go-to response for us.’

The Scottish Government does seem, however belatedly, to be determined to properly address the country’s ongoing drug-related deaths crisis, appointing a new minister and pledging £250m over the next five years (DDN, February, page 4). However, it’s ‘grassroots voices that have helped to make that happen,’ she believes – ‘being bolshy and making themselves unpopular.’

So how could that money best be spent? ‘If you’re far removed from the problem you don’t understand the urgency, so you need the voices of lived experience,’ she states. ‘They need a genuine seat at the table, so one way I’d like to see that money used is to have more voices of lived experience at the epicentre of strategy and solution-making. Drugs take away the angst, drugs give you peace, drugs are a way of self-comforting, so I would like to see that money going into a trauma-informed response to the problem and exploring what that looks like.’

Creative Thinking

Alongside more money for organizations led by lived experience, this could include more residential rehab beds and funding of family support charities, she adds. ‘We need to think about how trauma happens and we can think more creatively – we need to stop thinking about this in silos.’

On that note, the Children’s Society has previously called for better joined up working between drug treatment and child sexual exploitation services (DDN, February 2017, page 4) while the One in Four report urged drug services to make sure staff are properly trained to respond appropriately to disclosure of sexual abuse and that the right referral processes are in place.

‘There’s a need for training for everybody,’ says Zeedyk. ‘If we could have a basic understanding of how childhood trauma works, we would be at a different place – your whole response to people can shift quite quickly.

‘We do need more referral but, as a start, drug workers need to understand that listening and affirming in itself will help, because when people feel validated that’s part of the recovery process. It doesn’t mean we stop there, but it’s a step along the way and it gives drug workers something they can do in the moment.

‘The drugs system wasn’t set up to think “I’m going to need to deal with child sexual abuse” so we need to shift that and it won’t happen naturally, it will only happen because of leadership,’ she continues.

‘We need some brave and determined leaders to change the system, and if people in positions of leadership can’t do that then the grassroots will need to hold them to account and say, “I know I’m irritating you, but I’m going to keep at it.”’

Driving change

Which brings us back to the voices of experience. ‘All the time I watch professionals who think they know best, and often they don’t – if the people in charge of the system had been very good at this we wouldn’t have lost 1,264 people last year. The thing that really drives change is people in recovery telling their personal stories. We need to use their courage to drive change elsewhere.’

Dr Suzanne Zeedyk is a research scientist and child psychologist. Since 1993, she has been based at the University of Dundee within the School of Psychology. Her academic career began in the USA, where she completed her PhD at Yale University.

In 2011, Dr Zeedyk stepped away from a full-time academic post in order to establish an independent training enterprise with the aim of helping the public understand the importance of emotional connection for human health and happiness. In 2014, she founded the organisation Connected Baby, where she and her team work to help parents and professionals make practical use of the science of connection.

In January 2021, Dr Zeedyk was a key organiser of the online event Trauma at the Heart of Scotland’s Drug Deaths. Biography at

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