Posttraumatic stress disorder in opioid agonist therapy: A review.

Abstract

Clinical implications of the body of work and recommendations for future research are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

PTSD and opioid use: implications for intervention and policy

“…Treatment interruption is generally operationalized as absence from methadone administration for at least 1 week in a given month, and often used as an indicator of treatment adherence. Furthermore, patients who dropped out of OAT endorsed greater PTSD symptom severity than those who were able to adhere to the treatment regime [4]. Conversely, other studies have failed to find a significant association between PTSD and OAT adherence, retention or outcomes [4].…”

“…Relatively less research has focused on rates of PTSD among OUD individuals. However, preliminary evidence suggests that rates are equally high; among OUD populations, 41% have a lifetime history of PTSD and 33.2% meet criteria for a current PTSD diagnosis, representing the highest rate of PTSD among substance users [4].…”

“…Accordingly, substance-using populations are 5.91 times more likely to experience traumatization than non-SUD populations [5], therefore placing individuals who already suffer from one condition (SUD) at an increased risk of developing the other (PTSD). Furthermore, being diagnosed with both conditions appears to increase the risk and severity of the other: substance use increases the risk of re-traumatization, and retraumatization increases the risk and severity of subsequent substance use, therefore perpetuating the PTSD-substance use comorbidity cycle [4].…”

“…Furthermore, patients who dropped out of OAT endorsed greater PTSD symptom severity than those who were able to adhere to the treatment regime [4]. Conversely, other studies have failed to find a significant association between PTSD and OAT adherence, retention or outcomes [4]. Moreover, recent research suggests that OAT can be equally effective in reducing illicit opioid use, regardless of PTSD comorbidity [3,4].…”

“…Posttraumatic stress disorder (PTSD) and mental illness have been found to commonly co-occur, in particular, a growing body of literature points to high rates of PTSD among opioid-using populations [2][3][4]. Despite high prevalence rates of PTSD among SUD/OUD populations, patients seeking treatment for substance use are rarely assessed for trauma or offered PTSD-based interventions alongside SUD treatments [2].…”