Substance Abuse October 14, 2024

The Connection Between Incarceration Trauma and Addiction Treatment

Written by: Kayla Fenty, MSW, LCSW-A, LCAS-A

A barred window set in a red brick wall, with a warm light glowing from inside. The bricks have a textured, weathered appearance, echoing stories of incarceration and trauma. A small ledge rests beneath the window, adding a touch of subtle nostalgia.

In recent years, the intersection of incarceration and substance use disorder (SUD) has gained increasing attention within the fields of mental health and addiction treatment. The experience of incarceration is inherently traumatic, with profound implications not only for individuals during their time in prison but also for their recovery journey after release. Understanding the trauma of incarceration is crucial for developing effective treatment strategies for those struggling with substance use disorders.

 

People have always asked me how I got interested in this subject. It goes back to one of my very first clients that I had out of graduate school. He was in his mid-30’s, and throughout completing his history, I learned that he had been incarcerated in some form for the past 15 years, nearly half of his life. The more we worked together, he kept telling me about how much better his life was on the inside. “I want to use again so I can go back.” As someone who has never been incarcerated, this answer fascinated me because it made no sense. I decided to try and make sense of it.  

The Nature of Incarceration Trauma 

Incarceration trauma can be understood as the psychological and emotional distress caused by the experience of being imprisoned. This trauma can manifest in various ways, including anxiety, depression, post-traumatic stress disorder (PTSD), and other mental health issues. The environment of incarceration is often harsh and dehumanizing, characterized by: 

  • Isolation: Inmates frequently experience separation from family and community, leading to feelings of loneliness and abandonment. This isolation can exacerbate existing mental health issues and create new ones. 
  • Violence: Prisons can be rife with violence, both from other inmates and from correctional staff. Witnessing or experiencing violence can have lasting psychological effects, contributing to trauma. 
  • Lack of Control: Inmates have little control over their daily lives, from basic routines to decisions affecting their futures. This loss of autonomy can lead to feelings of helplessness and despair. 
  • Stigmatization: Individuals with a history of incarceration often face societal stigma, making reintegration into the community challenging. This stigma can perpetuate feelings of worthlessness and contribute to ongoing mental health struggles. 

 

The Connection Between Incarceration and Substance Use Disorders 

 

The relationship between incarceration and substance use disorders is complex and multifaceted. Many individuals who enter the criminal justice system have pre-existing substance use issues, and incarceration can exacerbate these problems for several reasons: 

  • Increased Substance Use: For some, incarceration may serve as a temporary respite from substance use, but upon release, the urge to return to substance use can be overwhelming. This cycle can lead to increased use as individuals attempt to cope with the trauma and stress of reintegration.

 

  • Trauma Responses: The trauma of incarceration can lead individuals to seek out substances as a coping mechanism. Drugs and alcohol may be used to numb feelings of anxiety, depression, or post traumatic stress disorder (PTSD) that arise from the prison experience. 

 

  • Reinforcement of Substance Use Patterns: Incarceration does not typically address the root causes of substance use disorders. Without proper treatment and support, individuals are likely to return to old habits, leading to a higher risk of relapse. 

 

The Impact of Incarceration Trauma on Treatment 

 

The trauma associated with incarceration significantly affects the effectiveness of substance use disorder treatment. Understanding this impact is essential for developing trauma-informed care approaches. Here are several key ways that incarceration trauma influences treatment: 

 

  • Engagement and Trust Issues-Individuals who have experienced incarceration may have difficulty trusting treatment providers and engaging in therapeutic relationships. This mistrust can stem from previous negative experiences with authority figures and the prison system itself. Building rapport is crucial in treatment, and trauma-informed care emphasizes the importance of creating a safe and supportive environment where clients feel valued and understood. 

 

  • Heightened Anxiety and Emotional Dysregulation-The trauma of incarceration can lead to heightened anxiety, emotional dysregulation, and difficulty managing stress. These issues can hinder individuals’ ability to engage fully in treatment. Therapy approaches that incorporate skills for managing emotions, such as Dialectical Behavior Therapy (DBT) or mindfulness therapies like Acceptance and Commitment Therapy (ACT), can be beneficial in helping clients learn to cope with their feelings. 

 

  • Need for Trauma-Specific Interventions-Traditional substance use treatment models may not adequately address the unique needs of individuals with incarceration trauma. Trauma-specific interventions, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing (EMDR), can help individuals process their traumatic experiences and develop healthier coping mechanisms. 

 

  • Relapse Prevention Challenges-Individuals with a history of incarceration may face unique challenges in relapse prevention. The stressors associated with reintegration, such as finding stable housing and employment, can trigger substance use as a coping mechanism. Treatment programs must provide comprehensive support that addresses these challenges, including job training, housing assistance, and ongoing therapy. 

 

Creating a Trauma-Informed Care Environment 

 

To effectively support individuals with substance use disorders who have experienced incarceration, treatment providers must adopt a trauma-informed care approach. This involves recognizing the widespread impact of trauma and integrating this understanding into all aspects of treatment. Key principles of trauma-informed care include: 

  • Safety: Ensuring physical and emotional safety for clients is paramount. Treatment environments should be welcoming and free from judgment, fostering a sense of security. 
  • Trustworthiness: Treatment providers should be transparent about the treatment process and maintain consistent boundaries, helping to build trust with clients. 
  • Choice: Empowering clients by involving them in treatment decisions can promote a sense of control and autonomy, counteracting feelings of helplessness experienced during incarceration. 
  • Collaboration: Engaging clients as partners in their treatment fosters a collaborative relationship, which can enhance motivation and commitment to recovery. 
  • Empowerment: Fostering a sense of empowerment in clients can help them reclaim their identities and build resilience. This can include encouraging personal strengths and celebrating successes, no matter how small.

 

Conclusion 

 

The trauma of incarceration has profound and lasting effects on individuals, particularly those struggling with substance use disorders. Recognizing and addressing the impact of this trauma is essential for developing effective treatment strategies. By adopting trauma-informed care principles, treatment providers can create supportive environments that foster healing and recovery. Understanding the complexities of incarceration trauma will ultimately contribute to more successful outcomes in substance use disorder treatment, empowering individuals to reclaim their lives and achieve lasting sobriety. 

 

Raleigh Addiction Treatment

 

Kayla Fenty is one of our wonderful and talented therapists at AIM. She didn’t write this part because she would never be so bold, so it is upon the rest of the team to sing her praises. If you read this article and think Kayla or our outpatient addiction treatment in Raleigh could be of help, please complete a form below and we will get you scheduled for an immediate appointment. You can also listen to Kayla talk at more length about addiction treatment, incarceration, and mental health on the Open Source Health Podcast.

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