Course and treatment of patients with both substance use and posttraumatic stress disorders
Abstract
Posttraumatic stress disorder (PTSD) is a common co-occurring diagnosis in patients with substance use disorders (SUDs). Despite the documented prevalence of this particular "dual diagnosis," relatively little is known about effective treatment for SUD-PTSD patients. This article reviews empirical research on the course and treatment of SUD-PTSD comorbidity and highlights clinically relevant findings. Based on this review, the following is noted: PTSD is highly prevalent in SUD patients, consistently associated with poorer SUD treatment outcomes, and related to distinct barriers to treatment. Specific treatment practices are recommended for substance abuse treatment providers: (a) All patients should be carefully screened and evaluated for trauma and PTSD; (b) referrals should be provided for concurrent treatment of SUD-PTSD, if available, or for psychological counseling with the recommendation that trauma/PTSD be addressed; and (c) increased intensity of SUD treatment should be offered in conjunction with referrals for family treatment and self-help group participation.
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There is recognised need for more trauma-informed approaches to substance use treatment.
“As such, there is recognised need for more trauma-informed approaches to substance use treatment [62–64].”
Many substance use treatment programs do not directly address trauma histories, and participants suffering from PTSD often have worse treatment outcomes.
“Yet, many substance use treatment programs do not directly address trauma histories, and participants suffering from PTSD often have worse treatment outcomes [62].”
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References 42 · Cited by 245
- Authors
- Ouimette, P. C., Brown, P. J., & Najavits, L. M.
- Affiliations
- VA Palo Alto Health Care System (US)
- Brown University (US)
- Harvard University (US)
- Corresponding author
- Ouimette, Paige Crosby
- ORCID
- Najavits, Lisa M.
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 1998-11
- Volume
- 23
- Issue
- 6
- Pages
- 785-795
- ISSN
- 0306-4603 (ISSN-L)
- OpenAlex
- W2086921334
- Cited by
- 245
- References
- 42
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 8 · 2021: 9 · 2020: 11 · 2019: 13 · 2018: 11 · 2017: 13 · 2016: 11 · 2015: 11 · 2014: 16 · 2013: 12 · 2012: 11
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, substance use disorders, dual diagnosis, comorbidities, treatment outcomes, barriers to treatment, trauma screening, trauma-informed care, concurrent treatment, family therapy, self-help groups, treatment intensity
- MeSH terms
- Humans, Longitudinal Studies, Medical History Taking, Outcome and Process Assessment, Health Care, Patient Acceptance of Health Care, Prognosis, Stress Disorders, Post-Traumatic, Practice Guidelines as Topic, Diagnosis, Dual (Psychiatry), Disease Progression, Substance-Related Disorders
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