Major Breakthrough for victims and survivors of child abuse dependent on substances as a consequence of trauma

The Dept. of Health 2017 publication of UK guidelines on clinical management is most welcome. Frankly, it is about time recognition and acknowledgement of the plight of victims and survivors of child abuse who have turned to drugs in order to suppress the emotions that follows such trauma was shown by the authorities: now we need consistent budgets made available for the appropriate treatment of these totally innocent victims of crime, I have great pleasure in sharing this news. Mike Peirce

Dept. of Health Drug misuse and dependence - UK guidelines on clinical management (2017)

Page 42 Box 2: Principles for trauma-informed care Underpinning principles for trauma-informed care??Recognise the high rates of trauma exposure in substance misusers.??Promote awareness and understanding of trauma among patients and the workforce.??Recognise trauma symptoms and behaviours as the individual’s best attempts to adapt to and manage their experiences.??This promotes a ‘strengths and resilience’ perspective on the individual’s difficulties, with the focus not on ‘what is wrong with you?’ but rather ‘what has happened to you?’ and ‘what has worked for you?’??This occurs in familial, community, societal and cultural contexts, which are unique to each individual, and ensures that trauma-informed care is personalised.??Provide a treatment environment that promotes physical and emotional safety.??Avoid inadvertent re-traumatisation.??Treatment procedures and interventions have the potential to trigger trauma reactions in individuals with a history of trauma, especially when the procedure or intervention is in some way reminiscent of the original trauma experience (e.g. feeling exposed during observation of a supervised urine sample).??Prioritise trauma recovery as part of treatment goals.??Many patients will not recognise the relationship between their trauma experiences and symptoms such as substance misuse. Services should help patients to develop a holistic, compassionate understanding of their difficulties.??Support patients to make choices and take control of treatment decisions.??Adopt a stance that is collaborative, participatory and provides hope and a belief in recovery from trauma.??This applies to all therapeutic relationships with keyworkers and other professionals, the design and planning of services and the professional development of the workforce.??Recognise the potential for secondary traumatic stress (also known as vicarious traumatisation) and develop strategies to manage this and promote self-care in the workforce.??Undertake routine screening for trauma experience and reactions.??Explain the principles of trauma-informed care to patients??For example, by explaining the purpose of trauma-related questions at assessment; by providing psychoeducation/normalisation of trauma reactions; facilitating access to specialised, trauma-specific interventions (where desired by the individual).