Dowling Frank G, Lowe Sandra M
Department of Psychiatry, Renaissance School of Medicine, Stony Brook, NY, USA.
World Trade Center Health Program, Stony Brook Clinical Center of Excellence, Commack, NY, USA.
Arch Environ Occup Health. 2023;78(5):261-266. doi: 10.1080/19338244.2023.2180614. Epub 2023 Feb 27.
A growing body of research supports the association between direct exposure to the September 11, 2001, terrorist attacks, increased rates of alcohol and substance use and elevated risk of subsequent diagnosis with trauma-related and substance use disorders. Posttraumatic stress disorder (PTSD) is the most diagnosed psychiatric illness in individuals who witnessed the 9/11 attacks or participated in disaster response efforts, and substance use disorders (SUDs) are highly comorbid with PTSD. The presence of both conditions poses challenges for clinical management and highlights the importance of screening and offering intervention to this at-risk population. This paper provides background on substance use, SUDs, and co-occurring PTSD in trauma exposed populations, describes best practices for identifying harmful substance use, the role of psychotherapy and medication for addiction treatment (MAT), and recommendations for management of co-occurring SUD and PTSD.
越来越多的研究支持这样一种关联，即直接暴露于2001年9月11日的恐怖袭击事件与酒精和物质使用比率的增加以及随后被诊断为创伤相关障碍和物质使用障碍的风险升高之间存在关联。创伤后应激障碍（PTSD）是目睹9·11袭击或参与灾难应对工作的个体中诊断最多的精神疾病，物质使用障碍（SUDs）与PTSD高度共病。这两种情况的存在给临床管理带来了挑战，并凸显了对这一高危人群进行筛查和提供干预的重要性。本文提供了创伤暴露人群中物质使用、SUDs以及共病PTSD的背景信息，描述了识别有害物质使用的最佳实践、心理治疗和药物辅助治疗（MAT）在成瘾治疗中的作用，以及对共病SUD和PTSD管理的建议。
