Treatment outcomes in individuals diagnosed with comorbid opioid use disorder and Posttraumatic stress disorder: A review. (November 2021)

• Record Type: Journal Article
• Authors: Meshberg-Cohen, Sarah; Ross MacLean, R.; Schnakenberg Martin, Ashley M.; Sofuoglu, Mehmet; Petrakis, Ismene L.
• Is Part Of: Addictive behaviors. Volume 122(2021)
• Publication Date: 2021-11
• Subjects: Opioid use disorder -- PTSD -- Posttraumatic stress disorder -- OUD -- Opioids -- Comorbidity; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2021.107026
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: Posttraumatic stress disorder is highly comorbid with opioid use disorder. PTSD is associated with more severe addiction, depression, and attempted suicide. PTSD diagnosis does not necessarily predict reduced OUD treatment retention. Participation in a PTSD-focused treatment might improve OUD treatment outcomes. Research needed to develop brief, integrative, feasible PTSD interventions with OUD. Abstract: Objectives: Opioid use disorder (OUD) is a public health emergency. Evidence suggests that posttraumatic stress disorder (PTSD) is common among individuals with OUD; however, few studies evaluate whether concurrent diagnoses affect treatment outcomes. This review examines the impact of concurrent diagnoses of OUD and PTSD on treatment outcomes. Methods: A search was performed using articles identified through June 30, 2020 in PubMed, PsycINFO, and EMBASE. Included peer-reviewed articles evaluated individuals with OUD and a PTSD diagnosis via standardized assessment and/or medical record diagnoses, and reported relationships between diagnosis and treatment outcomes and/or other psychiatric conditions. Results: Out of 412 articles, 17 studies met inclusion criteria for this review (from 13 databases). Articles included had a total of n = 2190 with OUD, with n = 79 non-OUD comparison participants. Studies examining individuals with OUD revealed comorbid PTSD was associated with more severe addiction, higher rates of depression, attempted suicide, and psychosocial problems. Conclusions: Among individuals with OUD, presence of PTSD is associated with multiple mental health problems. The impact of PTSD on drug use is inconclusive. Although only 5 studies examined psychosocial PTSD treatment, all found PTSD-focused treatment to be effective for those with comorbid OUD. Overall, results suggest the need to better identify PTSD among those with OUD, and to develop and evaluate interventions that are brief, integrative, and easy to implement in clinical settings.