Keynote – the intertwined nature between trauma and drug and alcohol use: the self-medication hypothesis

Abstract

The split between mental health services and drug and alcohol services has been a major impediment to the development to drug and alcohol rehabilitation programs in Australia. Increasingly epidemiological studies have highlighted the inescapable relationship between psychiatric disorders and drug and alcohol usage. Of particular relevance is the role of trauma exposure and its propensity to lead to the onset of psychiatric disorders. These populations are also particularly prone to using drugs and alcohol to self-medicate their distress. Given the role that alcohol consumption plays in violence and trauma, this is an ever-spiraling confl uence of distress and adverse social outcomes. This relationship is perhaps best demonstrated by the relationship between child abuse and neglect and adult substance abuse that then hands the risk to the next generation. Ultimately effective government intervention will depend upon an over-arching perspective of the central role of trauma events and their multiple causes and consequences in our society. These issues will be highlighted with a longitudinal study into adulthood of two populations who have been followed over a period of 21 years and a study of motor accident victims. These data would argue for the importance of early identifi cation of populations at risk and the provision of treatment for those who suffer signifi cant psychological disorders following trauma exposure. There is considerable evidence that drugs of choice represent attempts at self-medication, highlighting the opportunity for therapeutic interventions.