For individuals struggling with substance abuse, successful treatment is crucial to improving their daily functioning and satisfaction. For many, however, substance abuse is only part of the overall problem, and comorbid conditions can complicate treatment options and interfere with a successful outcome. In the March issue of Alcoholism: Clinical and Experimental Research, a team of German researchers report findings on the strong association between substance abuse and post-traumatic stress disorder (PTSD). Their research on individuals with substance abuse problems indicates that simultaneous PTSD is more prevalent among drug users than alcoholics and can have a substantial effect on the treatment outcomes.
Out of the study's 459 participants, all of whom had sought treatment at one of 14 addiction treatment centers throughout Germany, 25% had concomitant PTSD. Nearly 40% of the participants were alcoholics, while about 33% had a drug addiction and 27% grappled with both alcohol and drug dependence. The researchers assessed all participants for PTSD, sub-threshold PTSD, and exposure to trauma that did not result in symptoms of PTSD. They found that PTSD was most common among participants with a drug addiction, occurring among 30% of participants with a drug addiction and 34% of participants with both drug and alcohol addictions. In contrast, only 15% of participants with alcohol dependence also had PTSD.
The study's results also demonstrate that PTSD can have a substantial effect on the treatment for substance abuse, as those with both conditions saw the worst treatment outcomes. They were less likely to achieve abstinence, experienced more cravings, had more problems with their families, were more often unemployed, and experienced greater psychological symptoms. These associations were strongest for patients definitively diagnosed with PTSD and weaker among those who were subthreshold for PTSD.
This study did not determine whether a participant's substance abuse had been present before they developed PTSD, and many factors could contribute to PTSD, substance abuse, or both. Still, some research has found that PTSD can increase the risk for substance abuse, as individuals coping with a trauma may attempt to self-medicate through drugs or alcohol. PTSD may affect an individual's health in other ways as well, and another recent study, this one involving veterans, has implied that a diagnosis of PTSD could be a warning sign of serious health problems, functioning similarly to an elevated white blood cell count or other indications of inflammation and infection. Treatment should address all psychiatric and physical health problems, and further research will hopefully continue to examine the ways in which exposure to trauma can influence overall health. With a clearer understanding of the health problems associated with PTSD, we can provide more effective treatment for those recovering from a traumatic experience.
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