Department of Behavioral Sciences and Psychiatry, Division of Addiction Sciences, Medical University of South Carolina, 5 Charleston Center Dr., Suite 151, Charleston, SC, 29401 USA.
Department of Behavioral Sciences and Psychiatry, Division of Addiction Sciences, Medical University of South Carolina, 5 Charleston Center Dr., Suite 151, Charleston, SC, 29401 USA.
Drug Alcohol Depend. 2019 Jun 1;199:70-75. doi: 10.1016/j.drugalcdep.2019.04.001. Epub 2019 Apr 9.
Substance use disorders (SUD) frequently co-occur with posttraumatic stress disorder (PTSD). Little is known, however, about how individuals with a single SUD diagnosis (relating to only one substance) compare to individuals with poly-SUD diagnoses (relating to more than one substance) on substance use and PTSD treatment outcomes. To address this gap in the literature, we utilized data from a larger study investigating a 12-week integrated, exposure-based treatment (i.e., Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure, or COPE) to examine treatment outcomes by single vs. poly-SUD status.
Participants were 54 Veterans (92.6% male, average age = 39.72) categorized as having single SUD (n = 39) or poly-SUD (n = 15). T-tests characterized group differences in baseline demographics and presenting symptomatology. Multilevel models examined differences in treatment trajectories between participants with single vs. poly-SUD.
Groups did not differ on baseline frequency of substance use, PTSD symptoms, or treatment retention; however, individuals with poly-SUD evidenced greater reductions in percent days using substances than individuals with a single SUD, and individuals with a single SUD had greater reductions in PTSD symptoms than individuals with poly-SUD over the course of treatment.
The findings from this exploratory study suggest that Veterans with PTSD and co-occurring poly-SUD, as compared to a single-SUD, may experience greater improvement in substance use but less improvement in PTSD symptoms during integrated treatment. Future research should identify ways to enhance treatment outcomes for individuals with poly-SUD, and to better understand mechanisms of change for this population.
物质使用障碍（SUD）经常与创伤后应激障碍（PTSD）共病。然而，对于仅有单一 SUD 诊断（仅与一种物质相关）的个体与具有多 SUD 诊断（与多种物质相关）的个体在物质使用和 PTSD 治疗结果方面的差异，我们知之甚少。为了弥补文献中的这一空白，我们利用了一项更大规模研究的数据，该研究调查了一种为期 12 周的综合、基于暴露的治疗方法（即，使用延长暴露治疗 PTSD 和物质使用障碍，COPE），以检查单一 SUD 与多 SUD 状态下的治疗结果。
参与者为 54 名退伍军人（92.6%为男性，平均年龄为 39.72 岁），分为具有单一 SUD（n=39）或多 SUD（n=15）。T 检验描述了基线人口统计学和表现症状方面的组间差异。多层次模型检查了具有单一 SUD 与多 SUD 的参与者之间治疗轨迹的差异。
两组在基线物质使用频率、PTSD 症状或治疗保留方面没有差异；然而，与具有单一 SUD 的个体相比，具有多 SUD 的个体在物质使用的天数百分比减少方面表现出更大的改善，而在治疗过程中，具有单一 SUD 的个体在 PTSD 症状方面的改善大于具有多 SUD 的个体。
这项探索性研究的结果表明，与单一 SUD 相比，患有 PTSD 和共病多 SUD 的退伍军人在综合治疗中可能在物质使用方面有更大的改善，但 PTSD 症状的改善较少。未来的研究应确定如何提高多 SUD 个体的治疗效果，并更好地理解该人群的变化机制。
