Co-occurring prescription opioid use problems and posttraumatic stress disorder symptom severity

Abstract

Background: Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice.

Objective: To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings.

Methods: We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics.

Results: Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p < 0.05). Use of prescription opioids in combination with sedatives (OR: 3.81, p < 0.01) or cocaine (OR: 2.24, p < 0.001) also were associated with PTSD severity. The odds of having co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males (OR: 2.63, p < 0.001). Younger patients (18-34 years old) also were at higher risk (OR: 1.86, p < 0.01).

Conclusions: Prescription opioid use problems are a risk factor for co-occurring PTSD symptom severity. Being female or younger increase the likelihood of this co-morbidity. Further research is needed to confirm these finding, particularly using more rigorous diagnostic procedures. These data suggest that patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms.

Keywords: Co-occurring disorders; opioid use disorders; posttraumatic stress disorder; prescription opioid abuse.

Figure 1

Odds ratios for posttraumatic stress disorder (PTSD) symptom severity with and without a prescription opioid use problem (n = 573). Note: *p ≤ 0.05.

Figure 2

Odds ratios for posttraumatic stress disorder (PTSD) symptom severity by prescription opioid use problem in combination with other substances (n = 573). Note: **p ≤ 0.01; ***p ≤ 0.001; categories are not independent; the reference group was patients without a prescription opioid use problem and specific substance combination.