Treatment challenges associated with comorbid substance use and posttraumatic stress disorder: Clinicians’ perspectives
Open accessAbstract
A significant proportion of individuals with substance use disorders (SUDs) meet criteria for comorbid posttraumatic stress disorder (PTSD). This comorbidity confers a more complicated clinical presentation that carries with it formidable treatment challenges for practitioners. The current study examined sources of difficulty and gratification among clinicians (N = 423) from four national organizations who completed an anonymous questionnaire. As expected, the findings revealed that comorbid SUD/PTSD was rated as significantly more difficult to treat than either disorder alone. The most common challenges associated with treating SUD/PTSD patients included knowing how to best prioritize and integrate treatment components, patient self‐destructiveness and severe symptomatology, and helping patients abstain from substance use. The findings increase understanding of SUD/PTSD treatment challenges, and may be useful for enhancing therapist training programs, supervision effectiveness, and designing optimal SUD/PTSD interventions.
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Historically, misperceptions that distress related to exposure-based PTSD treatments will increase the risk for substance use have led to low adoption among usual care providers.
“Historically, misperceptions that distress related to exposure-based PTSD treatments will increase the risk for substance use have led to low adoption among usual care providers [49,50].”
From Written exposure therapy for treatment of perinatal PTSD among women with comorbid PTSD and SUD: A pilot study examining feasibility, acceptability, and preliminary effectiveness (2023) · cites this paper as [49]
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- Authors
- Back, S. E., Waldrop, A. E., & Brady, K. T.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Back, Sudie E.
- Venue
- The American Journal on Addictions
- Publisher
- Wiley
- Published
- 2009-01-02
- Volume
- 18
- Issue
- 1
- Pages
- 15-20
- ISSN
- 1055-0496 (ISSN-L)
- 1521-0391
- PMC
- PMC2845168
- OpenAlex
- W2169480510
- Cited by
- 129
- References
- 39
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 8 · 2023: 14 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 9 · 2018: 10 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 11 · 2013: 10 · 2012: 3
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal on Addictions (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA030143, K23DA021228)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- substance use disorders, post-traumatic stress disorder, comorbidities, treatment challenges, clinician perspectives, treatment integration, substance use abstinence, therapist training, clinical supervision
- MeSH terms
- Adult, Attitude of Health Personnel, Emotions, Female, Patient Care, Health Personnel, Humans, Male, Middle Aged, Severity of Illness Index, Stress Disorders, Post-Traumatic, Self-Injurious Behavior, Treatment Outcome, Diagnosis, Dual (Psychiatry), Health Care Surveys, Substance-Related Disorders
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