AsianScientist (Aug. 20, 2012) – A world-first study of an integrated treatment for post-traumatic stress disorder (PTSD) and substance use has shown that people with substance use issues, who are frequently excluded from treatment for post traumatic stress, may in fact benefit from psychological therapy.
The study, published last week in the Journal of the American Medical Association (JAMA), offers new hope for millions worldwide who experience the debilitating comorbid disorder.
Led by researchers from the National Drug and Alcohol Research Center at the University of New South Wales, the study randomly assigned patients to an integrated therapy called COPE which involved exposing patients to their traumatic memories and treating their substance use at the same time.
Patients were administered the treatment over thirteen 90 minute sessions with a clinical psychologist. The control group received usual treatment for substance use only.
From the beginning of the study to nine month follow-up the integrated treatment group had significantly greater reductions in PTSD symptoms compared with the control group.
Study leader Dr. Katherine Mills said that given the extremely high rates of trauma among people receiving treatment for drug and alcohol use disorders the results of the trial were extremely encouraging.
“Currently a majority of people with substance use disorders are excluded from receiving PTSD treatment as there is a widely held view that patients need to be abstinent before any trauma work, let alone prolonged exposure therapy, can be undertaken. However, this is often very difficult for patients to achieve as their trauma symptoms tend to resurface when they stop using,” said Mills.
“Our positive findings indicate that by using an integrated treatment program such as this, the many Australians who suffer from both of these conditions can be treated successfully.”
It is estimated that close to three-quarters of a million Australians experience PTSD in any one year, and one in ten will develop PTSD at some point in their lives. A third of people with PTSD have a substance use disorder.
Nearly half of people receiving treatment for substance use have current symptoms of PTSD and 80 to 90 percent have experienced trauma over their lifetime.
When mental health and substance use disorders occur together they are extremely difficult to treat as both conditions serve to maintain or exacerbate the other, the researchers say.
Combined, the two disorders account for more years of life lost due to disability than any other disorder and are second only to cancer and cardiovascular disease as leading causes of disease burden.
The article can be found at: Mills KL et al. (2012) Integrated Exposure-Based Therapy for Co-occurring Posttraumatic Stress Disorder and Substance Dependence.
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Source: UNSW; Photo: HelloImNik/Flickr.
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