Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct;24(7):578-81.
doi: 10.1111/ajad.12263. Epub 2015 Aug 24.

To reduce or abstain? Substance use goals in the treatment of veterans with substance use disorders and comorbid PTSD

Brian E Lozano  1   2 , Daniel F Gros  1   2 , Therese Killeen  2 , Maryanne Jaconis  2 , Francis M Beylotte 3rd  2 , Stephen Boyd  2 , Sudie E Back  1   2
Affiliations

To reduce or abstain? Substance use goals in the treatment of veterans with substance use disorders and comorbid PTSD

Brian E Lozano et al. Am J Addict. 2015 Oct.

Abstract

Background: Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur. Previous research demonstrates the utility of goals in attaining improved SUD outcomes, however, no previous studies have examined goal choices in the context of integrated treatment for comorbid PTSD and SUD.

Objectives: The present study investigated correlates of treatment entry goals to either reduce or abstain from substance use.

Methods: Participants (N = 60) were treatment-seeking veterans with current PTSD and SUD. Participants completed self-report and clinician-rated measures of substance use, PTSD, and affective symptoms as part of a larger randomized controlled trial.

Results: Half (30/60) of participants endorsed a treatment entry goal to reduce substance use (reducers). Compared to participants who endorsed a treatment entry goal of abstinence (abstainers), reducers were significantly younger, more likely to be employed, more likely to have served in recent military conflicts (Operations Enduring/Iraqi Freedom), and endorsed significantly fewer symptoms of alcohol dependence.

Conclusions and scientific significance: The findings demonstrate clinically relevant differences based on treatment entry goals, suggesting that individuals are often able to choose conceivably appropriate treatment goals based, most notably, on the severity of their SUD. Collaboratively engaging patients in establishing treatment goals that are consistent with their beliefs and desires in conjunction with empirical findings is particularly relevant in the context of treatment for SUD and PTSD where many patients are ambivalent about treatment and attrition is common.

PubMed Disclaimer

References

    1. Miller WR. Motivation for treatment: A review with special emphasis on alcoholism. Psychol Bull. 1985;98:84–107. - PubMed
    1. Maisto SA, Sobell MB, Sobell LC. Predictors of treatment outcome for alcoholics treated by individualized behavior therapy. Addict Behav. 1980;5:259–264. - PubMed
    1. Lozano BE, Stephens RS, Roffman RA. Abstinence and moderate use goals in the treatment of marijuana dependence. Addiction. 2006;101:1589–1597. - PubMed
    1. Marlatt GA, Witkiewitz K. Harm reduction approaches to alcohol use: Health promotion, prevention, and treatment. Addict Behav. 2002;27:867–886. - PubMed
    1. Heather N, Robertson I. Controlled Drinking. Methuen; New York: 1981.

Publication types