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
Randomized Controlled Trial
. 2019 Jun 1:199:70-75.
doi: 10.1016/j.drugalcdep.2019.04.001. Epub 2019 Apr 9.

Veterans with PTSD and comorbid substance use disorders: Does single versus poly-substance use disorder affect treatment outcomes?

Stephanie M Jeffirs  1 , Amber M Jarnecke  2 , Julianne C Flanagan  2 , Therese K Killeen  2 , Taylor F Laffey  2 , Sudie E Back  3
Affiliations
Randomized Controlled Trial

Veterans with PTSD and comorbid substance use disorders: Does single versus poly-substance use disorder affect treatment outcomes?

Stephanie M Jeffirs et al. Drug Alcohol Depend. .

Abstract

Introduction: Substance use disorders (SUD) frequently co-occur with posttraumatic stress disorder (PTSD). Little is known, however, about how individuals with a single SUD diagnosis (relating to only one substance) compare to individuals with poly-SUD diagnoses (relating to more than one substance) on substance use and PTSD treatment outcomes. To address this gap in the literature, we utilized data from a larger study investigating a 12-week integrated, exposure-based treatment (i.e., Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure, or COPE) to examine treatment outcomes by single vs. poly-SUD status.

Method: Participants were 54 Veterans (92.6% male, average age = 39.72) categorized as having single SUD (n = 39) or poly-SUD (n = 15). T-tests characterized group differences in baseline demographics and presenting symptomatology. Multilevel models examined differences in treatment trajectories between participants with single vs. poly-SUD.

Results: Groups did not differ on baseline frequency of substance use, PTSD symptoms, or treatment retention; however, individuals with poly-SUD evidenced greater reductions in percent days using substances than individuals with a single SUD, and individuals with a single SUD had greater reductions in PTSD symptoms than individuals with poly-SUD over the course of treatment.

Discussion: The findings from this exploratory study suggest that Veterans with PTSD and co-occurring poly-SUD, as compared to a single-SUD, may experience greater improvement in substance use but less improvement in PTSD symptoms during integrated treatment. Future research should identify ways to enhance treatment outcomes for individuals with poly-SUD, and to better understand mechanisms of change for this population.

Keywords: PTSD; Polysubstance use; Posttraumatic stress disorder; Prolonged exposure; Substance use disorder; Treatment outcome.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Estimated Change in Substance Use Frequency from First Treatment Session to End of Treatment by SUD Group Note: SUD = Substance use disorder; PDU = Percent days used.
Figure 2.
Figure 2.
Estimated Change in PTSD Severity from First Treatment Session to End of Treatment by SUD Group Note: SUD = Substance use disorder; PCL-M = PTSD Checklist – Military Version.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. American Psychiatric Association (APA), 2000. Diagnostic and Statistical Manual of Mental Disorders, fourth ed, text revision. American Psychiatric Association, Washington, DC.
    1. American Psychiatric Association (APA), 2013. Diagnostic and Statistical Manual of Mental Health Disorders, fifth ed. American Psychiatric Publishing, Arlington, VA.
    1. Anderson RE, Bonar EE, Walton MA, Goldstick JE, Rauch SAM, Epstein-Ngo QM, Chermack ST, 2017. A latent profile analysis of aggression and victimization across relationship types among veterans who use substances. J. Stud. Alcohol Drugs 78, 597–607. doi:10.15288/jsad.2017.78.597 - DOI - PMC - PubMed
    1. Back SE, Killeen T, Badour CL, Flanagan JC, Allan NP, Ana ES, Lozano B, Korte KJ, Foa EB, Brady KT, 2019. Concurrent treatment of substance use disorders and PTSD using prolonged exposure: A randomized clinical trial in military veterans. Addict. Behav 90, 369–377. - PMC - PubMed
    1. Back SE, Foa EB, Killeen TK, Mills KL, Teesson M, Dansky Cotton B, Carroll KM, Brady KT, 2014. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): Therapist guide Treatments that work. US: Oxford University Press, New York.

Publication types