Exhibit 1.3-6PTSD and Substance Use Disorders: Important Treatment Facts

Profile Severity

  • PTSD is one of the most common co-occurring mental disorders found in clients in substance abuse treatment (CSAT, 2005c).
  • People in treatment for PTSD tend to abuse a wide range of substances, including opioids, cocaine, marijuana, alcohol, and prescription medications.
  • People in treatment for PTSD and substance abuse have a more severe clinical profile than those with just one of these disorders.
  • PTSD, with or without major depression, significantly increases risk for suicidality (CSAT, 2009a).

Gender Differences

  • Rates of trauma-related disorders are high in men and women in substance abuse treatment.
  • Women with PTSD and a substance use disorder most frequently experienced rape or witnessed a killing or injury; men with both disorders typically witnessed a killing or injury or were the victim of sudden injury or accident (Cottler, Nishith, & Compton, 2001).

Risk of Continued Cycle of Violence

  • While under the influence of substances, a person is more vulnerable to traumatic events (e.g., automobile crashes, assaults).
  • Perpetrators of violent assault often are under the influence of substances or test positive for substances at the time of arrest.

Treatment Complications

  • It is important to recognize and help clients understand that becoming abstinent from substances does not resolve PTSD; in fact, some PTSD symptoms become worse with abstinence for some people. Both disorders must be addressed in treatment.
  • Treatment outcomes for clients with PTSD and a substance use disorder are worse than for clients with other co-occurring disorders or who only abuse substances (Brown, Read, & Kahler, 2003).

From: Chapter 3, Understanding the Impact of Trauma

Cover of Trauma-Informed Care in Behavioral Health Services
Trauma-Informed Care in Behavioral Health Services.
Treatment Improvement Protocol (TIP) Series, No. 57.
Center for Substance Abuse Treatment (US).

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