The Challenges of Treating PTSD and Substance Abuse
Substance abuse often occurs alongside other mental health disorders, One of the most common pairings is substance abuse with post-traumatic stress disorder (PTSD), with an estimated one-third to one-half of those seeking treatment for one condition also struggling with the other. One major study of PTSD among individuals seeking treatment for substance abuse found a greater prevalence of PTSD among those who were drug- rather than alcohol-addicted. In addition, researchers found that having PTSD was associated with more severe substance abuse as well as worse treatment outcomes.
Scientists already knew that a strong association existed between PTSD and substance abuse disorders, and more specifically that PTSD is a risk factor for the development of a substance abuse disorder. But the aim of this study was to analyze the association among individuals who were clearly dependent on drugs or alcohol, not just drug abusers.
"Drug dependence has frequently been observed in war veterans who also suffer from PTSD," said Andreas Heinz, director and chair of the department of psychiatry at Charité University Medical Center Berlin. "Both men and women often increase drug abuse and develop dependence following war and other trauma."
For this study, researchers interviewed more than 400 men and women receiving treatment in 14 German drug rehab centers: 39.7 percent had alcohol dependence; 33.6 percent had drug dependence; and 26.8 percent had both.
The findings were as follows:
- The prevalence of PTSD was roughly double among those with drug addiction as compared to those with alcohol addiction.
- Having PTSD was associated with worse outcomes for a substance abuse disorder, such as added family problems, fewer employment opportunities and more severe psychological symptoms.
- Individuals suffering from PTSD had higher hospitalization rates, shorter periods of abstinence, and more drug cravings
- The associations between a substance use disorder and PTSD were stronger when the PTSD diagnosis was definitive (based on the interview as well as the questionnaire) � compared to individuals with probable PTSD. Exposure to trauma without developing PTSD was not associated with a substance use disorder.
