Severity of childhood trauma is predictive of cocaine relapse outcomes in women but not men

Abstract

We prospectively examined the gender-specific effects of childhood trauma on cocaine relapse outcomes in an inpatient sample of treatment engaged cocaine dependent adults. Cocaine dependent men (n = 70) and women (n = 54) participating in inpatient treatment for cocaine dependence were assessed on severity of childhood trauma and followed for 90 days after discharge from treatment. Greater severity of childhood emotional abuse was associated with an increased risk of relapse in women. Severity of emotional abuse, sexual abuse, and overall childhood trauma was associated with the number of days cocaine was used during follow-up in women, as was the association of severity of physical abuse and overall childhood trauma with the average amount of cocaine used per occasion. No associations between childhood trauma and cocaine relapse outcomes were found in men. These findings demonstrate that childhood trauma increases the likelihood of cocaine relapse and drug use escalation after initial relapse in women but not in men. Comprehensive assessments of childhood trauma and specialized treatments that address trauma-related pathophysiology could be of benefit in improving cocaine treatment outcomes in women.

Assessing traumatic experiences in screening for PTSD in substance use disorder patients: What is the gain in addition to PTSD symptoms?

“…Some studies show that exposure to trauma increases the risk of SUD (Kilpatrick et al, 2003;Sartor et al, 2007). Also, SUD patients with more severe histories of trauma seem more prone to substance use relapse (Westermeyer et al, 2001;Hyman et al, 2008) and show worse treatment outcomes compared to patients with less severe trauma (Brown and Wolfe, 1994;Hien et al, 2000). However, a longitudinal study by Chilcoat and Breslau (1998) showed that exposure to trauma in the absence of PTSD did not increase the risk of SUD.…”

Gender-Specific Predictors of Retention and Opioid Abstinence During Methadone Maintenance Treatment

“…For instance, post-traumatic stress disorder is associated with poorer adherence to MMT (Hien, Nunes, Levin, & Fraser, 2000), however, this has not been universally observed (Himelhoch et al, 2012). Furthermore, among cocaine dependent inpatients, severity of childhood trauma has been found to predict cocaine relapse among women but not among men (Hyman et al, 2008). MMT programs vary widely in the extent to which they provide treatments to address trauma exposure.…”

Childhood Maltreatment and Substance Use Disorders among Men and Women in a Nationally Representative Sample

“…14 For example, in a cocaine treatment-seeking sample, greater severity of childhood emotional abuse increased the likelihood of cocaine relapse for women, but not for men. 33 In another US study, 34 childhood maltreatment among women, but not men, was associated with alcohol abuse or dependence in early adulthood, which was linked to excessive drinking in later adulthood. In a Midwestern US study, an increased likelihood of drug use problems was noted among women and not men.…”