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April 19, 2012

In a recent NIDA-funded study, women responded better to substance abuse treatment after their post-traumatic stress disorder (PTSD) symptoms improved, but reductions in substance abuse did not ease PTSD severity. The 353 participants in the 6-week treatment were patients in seven community-based substance abuse treatment programs in NIDA’s Clinical Trials Network. The women received their programs’ standard drug treatments, plus 12 group sessions of either Seeking Safety—a cognitive-behavioral therapy with components addressing both trauma and substance abuse—or Women’s Health Education, which does not specifically address either problem. The study found that the two added therapies had similar effects.

When the data from the two treatment arms were combined in a secondary study, reductions in the severity of PTSD tended to presage improvements in substance abuse disorder, but there was minimal evidence that reducing substance use improved PTSD symptoms. Lead researcher Dr. Denise Hien of City University of New York and Columbia University says the findings indicate that people with trauma self-medicate with substances of abuse. She suggests that clinicians reconsider the common practice of requiring patients to attain abstinence before treating their trauma symptoms.

American Journal of Psychiatry 167(1):95–101, 2010.

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