TY - JOUR
AU - Sarah Meshberg-Cohen
AU - Anne C. Black
AU - Jason C. DeViva
AU - Ismene L. Petrakis
AU - Marc I. Rosen
A1 - 
AB - INTRODUCTION: Opioid use disorder (OUD) rates are high among veterans. PTSD is also prevalent among veterans; those with comorbidity have worse outcomes than those without comorbidity. This study assessed buprenorphine retention rates in veterans initiating OUD treatment, comparing veterans without PTSD to veterans with PTSD who were receiving versus not receiving concurrent trauma treatment. METHODS: This retrospective chart review examined consecutive referrals to buprenorphine maintenance (N=140). PTSD diagnosis was identified by chart review and retention was defined as continuous buprenorphine maintenance 6-months post-admission. Logistic regression analyses compared buprenorphine retention for veterans without PTSD and PTSD-diagnosed veterans who received concurrent trauma treatment to a reference group of PTSD-diagnosed veterans who did not receive trauma treatment. Models adjusted for opioid type, age, and service-connected status. RESULTS: Sixty-seven (47.9%) buprenorphine-seeking veterans carried a PTSD diagnosis; only 31.3% (n=21) received trauma treatment while in buprenorphine maintenance, with 11.9% (n=8) receiving evidence-based psychotherapy for PTSD. Among PTSD-diagnosed veterans who received trauma treatment, 90.5% (n=19/21) were in buprenorphine maintenance at 6-months, compared to 23.9% (n=11/46) of PTSD-diagnosed veterans without trauma treatment, and 46.6% (n=34/73) of veterans without PTSD. In the full model, veterans with trauma treatment had 43.36 times greater odds of remaining in buprenorphine treatment than the reference group. CONCLUSIONS: Most PTSD-diagnosed veterans in buprenorphine treatment were not receiving trauma treatment. Those receiving concurrent trauma treatment had better retention, suggesting OUD and trauma can be simultaneously addressed. Future clinical trials should investigate trauma-focused treatment for veterans with comorbid PTSD who are seeking buprenorphine for OUD.
AD - VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology Service/Department of Psychiatry, 116A, West Haven, CT 06516, United States; Yale University School of Medicine, Department of Psychiatry, United States. Electronic address: sarah.meshberg-cohen@yale.edu.; VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology Service/Department of Psychiatry, 116A, West Haven, CT 06516, United States; Yale University School of Medicine, Department of Psychiatry, United States.; VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology Service/Department of Psychiatry, 116A, West Haven, CT 06516, United States; Yale University School of Medicine, Department of Psychiatry, United States.; VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology Service/Department of Psychiatry, 116A, West Haven, CT 06516, United States; Yale University School of Medicine, Department of Psychiatry, United States.; VA Connecticut Healthcare System, 950 Campbell Avenue, Psychology Service/Department of Psychiatry, 116A, West Haven, CT 06516, United States; Yale University School of Medicine, Department of Psychiatry, United States.
BT - Addictive Behaviors
C5 - Healthcare Disparities; Opioids & Substance Use
CY - England
DO - 10.1016/j.addbeh.2018.09.010
JF - Addictive Behaviors
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: Opioid use disorder (OUD) rates are high among veterans. PTSD is also prevalent among veterans; those with comorbidity have worse outcomes than those without comorbidity. This study assessed buprenorphine retention rates in veterans initiating OUD treatment, comparing veterans without PTSD to veterans with PTSD who were receiving versus not receiving concurrent trauma treatment. METHODS: This retrospective chart review examined consecutive referrals to buprenorphine maintenance (N=140). PTSD diagnosis was identified by chart review and retention was defined as continuous buprenorphine maintenance 6-months post-admission. Logistic regression analyses compared buprenorphine retention for veterans without PTSD and PTSD-diagnosed veterans who received concurrent trauma treatment to a reference group of PTSD-diagnosed veterans who did not receive trauma treatment. Models adjusted for opioid type, age, and service-connected status. RESULTS: Sixty-seven (47.9%) buprenorphine-seeking veterans carried a PTSD diagnosis; only 31.3% (n=21) received trauma treatment while in buprenorphine maintenance, with 11.9% (n=8) receiving evidence-based psychotherapy for PTSD. Among PTSD-diagnosed veterans who received trauma treatment, 90.5% (n=19/21) were in buprenorphine maintenance at 6-months, compared to 23.9% (n=11/46) of PTSD-diagnosed veterans without trauma treatment, and 46.6% (n=34/73) of veterans without PTSD. In the full model, veterans with trauma treatment had 43.36 times greater odds of remaining in buprenorphine treatment than the reference group. CONCLUSIONS: Most PTSD-diagnosed veterans in buprenorphine treatment were not receiving trauma treatment. Those receiving concurrent trauma treatment had better retention, suggesting OUD and trauma can be simultaneously addressed. Future clinical trials should investigate trauma-focused treatment for veterans with comorbid PTSD who are seeking buprenorphine for OUD.
PP - England
PY - 2018
SN - 1873-6327; 0306-4603
SP - 29
EP - 34
EP - 
T1 - Trauma treatment for veterans in buprenorphine maintenance treatment for opioid use disorder
T2 - Addictive Behaviors
TI - Trauma treatment for veterans in buprenorphine maintenance treatment for opioid use disorder
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 30243036
U3 - 10.1016/j.addbeh.2018.09.010
VL - 89
VO - 1873-6327; 0306-4603
Y1 - 2018
Y2 - Sep 12
ER -