The impact of post-traumatic stress disorder on treatment outcomes for heroin dependence

Abstract

Aims: To examine the impact of post-traumatic stress disorder (PTSD) on 2-year treatment outcomes for heroin dependence.

Design: Prospective longitudinal study.

Participants: Data were obtained from a predominantly treatment seeking sample of 615 dependent heroin users who were followed-up at 3, 12 and 24 months (follow-up rates: 89%, 81% and 76%, respectively).

Measurements: Outcomes examined include treatment retention and exposure, substance use, general physical and mental health and employment.

Findings: Despite improvements in substance use, PTSD was associated with continued physical (beta - 1.69, SE 0.61, P < 0.01) and mental disability (beta - 2.07, SE 0.66, P < 0.01), and reduced occupational functioning (OR 0.67, 95% CI: 0.48-0.93) throughout the 2-year follow-up.

Conclusions: Although conventional treatment services are successful in producing improvements in substance use and associated disability, the disability associated with PTSD remains. An intervention targeting both heroin dependence and PTSD may help to improve the outcomes of those with PTSD.