• Drug Alcohol Depend · Jun 2019

    Randomized Controlled Trial Comparative Study

    Veterans with PTSD and comorbid substance use disorders: Does single versus poly-substance use disorder affect treatment outcomes?

    • Stephanie M Jeffirs, Amber M Jarnecke, Julianne C Flanagan, Therese K Killeen, Taylor F Laffey, and Sudie E Back.
    • 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. Electronic address: jeffirs@musc.edu.
    • Drug Alcohol Depend. 2019 Jun 1; 199: 70-75.

    IntroductionSubstance 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.MethodParticipants 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.ResultsGroups 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.DiscussionThe 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.Copyright © 2019 Elsevier B.V. All rights reserved.

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