There is a strong connection between traumatic stress and substance abuse that has implications for children and families, whether the user is an adolescent or a parent or caregiver.

Research studies have shown that adolescents who engage in problematic substance use are more likely to experience traumatic events and develop PTSD, depression, violent behavior, suicide, and other mental health problems compared to those who do not use substances. Additionally, adolescents exposed to traumatic events are more vulnerable to problematic substance use. Psychoactive substances can both dull the effects of stress and place teens at increased risk for experiencing trauma.

Caregiver substance use carries many risks for child and adolescent development. Starting even before children are born, parental substance use increases children's risk for later mental health problems and victimization. Children and adolescents with substance-using parents may be exposed to other high-risk situations, such as violence in the home and community.