The Role of Psychoactive Substances in Trauma Recovery

"In times of desperation, individuals are willing to try just about anything to regain a semblance of control."

Trauma, with its far-reaching effects on the mind and body, has driven individuals throughout history to seek solace and relief in various ways. One avenue explored is psychoactive substances, with each culture and generation having preferences. From the soothing comfort of gin, vodka, beer, and whiskey to the more recent embrace of substances like hashish, marijuana, cannabis, cocaine, opioids, or tranquillizers such as Valium, Xanax, and Klonopin, people have sought refuge in these substances during their darkest hours.

Mainstream psychiatry, too, has ventured into this territory, employing an array of psychotropic drugs that include antidepressants, antipsychotics, sedative-hypnotics, and other controlled substances to mitigate the effects of trauma. However, it's crucial to understand that while these drugs may temporarily dampen the expression of a disrupted physiology, they do not possess the power to 'cure' trauma. Instead, they function by altering the chemical systems responsible for regulating engagement, motivation, pain, and pleasure, often resetting the fear circuits in the brain.

Certain groups of psychotropic agents have demonstrated some effectiveness in addressing specific aspects of trauma. Selective serotonin reuptake inhibitors (SSRIs) like Prozac, Zoloft, Effexor, and Paxil, for instance, work by reducing the intensity of emotions, making them more manageable. This can help traumatized individuals feel calmer, regain control, and reduce the overwhelming sensations associated with trauma. Medications targeting the autonomic nervous system, such as propranolol and clonidine, aim to decrease hyperarousal and reactivity to stress, offering relief to those trapped in a perpetual state of heightened alertness.

Tranquillizing drugs, reminiscent of the calming effect of alcohol, also play a role in trauma management. Benzodiazepines, for example, can help individuals find temporary respite from anxiety and worry. Anticonvulsants and mood stabilizers like lithium provide mild relief from hyperarousal and panic.

Yet, it's essential to recognize the limitations of these medications, as they often fall short in addressing certain trauma-related issues such as disassociation, self-mutilation, fragmented memories, and amnesia.

Beyond pharmacological interventions, some individuals have embarked on a different journey involving mind-altering substances to access and confront their trauma safely. LSD, a substance known for its profound effects on consciousness, has been used in treating Holocaust survivors. MDMA, commonly known as ecstasy, has been experimentally employed with psychotherapy, yielding impressive results. In a U.S. trial, 83% of patients who underwent MDMA-assisted psychotherapy were completely cured.

The power of these substances lies in their ability to enable individuals to observe their trauma from a calm and mindful state. While under the influence, they can integrate the effects of the trauma through therapy, remaining within the window of tolerance—preventing overwhelming physiological and emotional arousal—as they revisit their traumatic memories.

While the use of psychoactive substances in trauma recovery continues to be a topic of debate and research, it underscores the multifaceted nature of trauma treatment. It's a journey that varies for each individual, where traditional therapies, pharmacological interventions, and alternative approaches may all have their place in healing and recovery.