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Posttraumatic Stress Disorder and Substance Use Disorder Screening, Assessment, and Treatment
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Posttraumatic Stress Disorder and Substance Use Disorder Screening, Assessment, and Treatment
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Journal Article
Posttraumatic Stress Disorder and Substance Use Disorder Screening, Assessment, and Treatment
2024
Overview
Purpose of Review
We review prevalence, etiology, impact on treatment, and best practices for treatment of posttraumatic stress disorder (PTSD) in a substance use disorder (SUD) treatment setting. Recommendations are given related to screening, assessment, and symptom monitoring.
Recent Findings
PTSD and SUDs are highly comorbid. This comorbidity is associated with higher acuity, more difficulty completing treatment, and worse prognosis. Integrated treatment is recommended, and trauma-focused psychotherapies combined with pharmacotherapy show particular promise.
Summary
PTSD is highly prevalent in substance using samples, negatively impacting treatment course and worsening prognosis. This comorbidity has been explained by a variety of models, with self-medication having garnered the most support. Trauma-focused psychotherapies combined with pharmacotherapy demonstrate the most efficacy and are recommended when treating co-occurring SUDs and PTSD. Specifically, prolonged exposure (PE), concurrent treatment of PTSD and SUDs using PE (COPE), and cognitive processing therapy (CPT) have been seen as promising trauma-focused treatments. Investigations into ways to best augment therapy are also underway, both through treatment format and neuromodulation. Several recommendations are given.
Publisher
Springer US,Springer Nature B.V
Subject
/ Diagnosis, Dual (Psychiatry)
/ Drug use
/ Humans
/ Medicine
/ Post traumatic stress disorder
/ Review
/ Stress Disorders, Post-Traumatic - diagnosis
/ Stress Disorders, Post-Traumatic - epidemiology
/ Stress Disorders, Post-Traumatic - therapy
/ Substance-Related Disorders - diagnosis
/ Substance-Related Disorders - epidemiology
