TY - JOUR
KW - Adult
KW - Aged
KW - Alcoholism/epidemiology/psychology/rehabilitation
KW - Cocaine-Related Disorders/epidemiology/psychology
KW - Combat Disorders/epidemiology/psychology/rehabilitation
KW - Comorbidity
KW - Female
KW - Follow-Up Studies
KW - Health Status Indicators
KW - Heroin Dependence/epidemiology/psychology/rehabilitation
KW - Humans
KW - Male
KW - Marijuana Abuse/epidemiology/psychology/rehabilitation
KW - Methadone/administration & dosage
KW - Middle Aged
KW - Narcotics/administration & dosage
KW - Opioid-Related Disorders/epidemiology/psychology/rehabilitation
KW - Prognosis
KW - Risk Factors
KW - Street Drugs
KW - Substance Abuse Detection
KW - Treatment Outcome
KW - Veterans/psychology
AU - J. A. Trafton
AU - J. Minkel
AU - K. Humphreys
A1 - 
AB - OBJECTIVE: The purpose of this study was to determine whether opioid-dependent patients with diagnosed posttraumatic stress disorder (PTSD) have poorer long-term outcomes in opioid substitution treatment than do patients without PTSD. METHOD: This prospective observational study examined outcomes of 255 opioid-dependent patients (men = 248) entering opioid substitution treatment at eight clinics in the Veterans Health Administration (VHA). Subjects were interviewed at treatment entry, 6 months, and 1 year about substance use and related problems, health status, treatment satisfaction, and non-VHA health care utilization. Medical records were reviewed to obtain toxicology results, health care utilization data, and diagnoses. Medical record review identified a diagnosis of PTSD in 71 (28%) patients. Substance-use and mental-health outcomes and health care utilization in the first year following treatment entry were compared between patients with and without a diagnosis of PTSD. RESULTS: Patients with and without PTSD had similar treatment responses. Although patients with PTSD had longer histories of drug use at intake, at 1-year follow-up they showed reductions in heroin, cocaine, and alcohol use, comparable to patients without the disorder. PTSD patients received higher doses of opiate medication, attended more psychosocial treatment sessions for substance-use disorder, and had better treatment retention. Psychiatric symptoms for patients with PTSD were more severe at intake and showed little improvement throughout treatment. CONCLUSIONS: Opioid substitution therapy is as effective at reducing substance use in PTSD patients as it is in patients without the disorder, but additional services are needed for treatment of psychological problems that are largely unchanged by treatment for addiction.
BT - Journal of studies on alcohol
C5 - Opioids & Substance Use
CP - 2
CY - United States
IS - 2
JF - Journal of studies on alcohol
N2 - OBJECTIVE: The purpose of this study was to determine whether opioid-dependent patients with diagnosed posttraumatic stress disorder (PTSD) have poorer long-term outcomes in opioid substitution treatment than do patients without PTSD. METHOD: This prospective observational study examined outcomes of 255 opioid-dependent patients (men = 248) entering opioid substitution treatment at eight clinics in the Veterans Health Administration (VHA). Subjects were interviewed at treatment entry, 6 months, and 1 year about substance use and related problems, health status, treatment satisfaction, and non-VHA health care utilization. Medical records were reviewed to obtain toxicology results, health care utilization data, and diagnoses. Medical record review identified a diagnosis of PTSD in 71 (28%) patients. Substance-use and mental-health outcomes and health care utilization in the first year following treatment entry were compared between patients with and without a diagnosis of PTSD. RESULTS: Patients with and without PTSD had similar treatment responses. Although patients with PTSD had longer histories of drug use at intake, at 1-year follow-up they showed reductions in heroin, cocaine, and alcohol use, comparable to patients without the disorder. PTSD patients received higher doses of opiate medication, attended more psychosocial treatment sessions for substance-use disorder, and had better treatment retention. Psychiatric symptoms for patients with PTSD were more severe at intake and showed little improvement throughout treatment. CONCLUSIONS: Opioid substitution therapy is as effective at reducing substance use in PTSD patients as it is in patients without the disorder, but additional services are needed for treatment of psychological problems that are largely unchanged by treatment for addiction.
PP - United States
PY - 2006
SN - 0096-882X; 0096-882X
SP - 228
EP - 235
EP - 
T1 - Opioid substitution treatment reduces substance use equivalently in patients with and without posttraumatic stress disorder
T2 - Journal of studies on alcohol
TI - Opioid substitution treatment reduces substance use equivalently in patients with and without posttraumatic stress disorder
U1 - Opioids & Substance Use
U2 - 16562404
VL - 67
VO - 0096-882X; 0096-882X
Y1 - 2006
ER -