12 Jan Treating Co-Existing Trauma and Substance Abuse
A long-held belief has been that when a person is actively addicted to a substance at the same time that they are experiencing a mental health disorder, such as post-traumatic stress disorder (PTSD), nothing could be done until the addiction was conquered.
Both addiction treatment specialists and other mental health professionals have held this conviction for a couple of reasons:
- Confronting trauma issues is painful enough to either spark an increase in substance abuse or to trigger some kind of relapse
- How well can a person zoned-out on drugs or alcohol sort through complicated mental and emotional issues? As long as a person is using substances to escape problems, can problems be dealt with?
The thinking today, however, is quite the opposite. Current treatment methodologies see the two issues as interrelated, and therefore address both problems simultaneously. And patients themselves express a preference for addressing comorbid conditions at the same time.
In the case of PTSD it seems likely that the person is abusing substances as a way to self-medicate and cope. Therefore, treating the PTSD actually lowers a person’s dependency on substances. To underscore this hypothesis several studies have been performed.
One study involved 353 women who were experiencing PTSD and were addicted to a substance. The women were randomly divided into one of two therapy groups. The first group was given integrated treatment for trauma while the second was treated only for addiction. The women were evaluated during their treatment and for up to 12 months following.
The findings showed that women who had been given integrated therapy showed improvement not only in their PTSD symptoms but in their addiction symptoms as well. The women who were treated for addiction alone did show improvement in their substance abuse symptoms, but little or no change in their experience of PTSD.
A similar study has been conducted with subjects who have co-occurring bipolar disorder and substance abuse. That study showed similar positive results from integrated therapy.
Other studies have received attention from the International Society for Traumatic Stress Studies and the Substance Abuse and Mental Health Services Administration which point to integrated treatment rather than sequential treatment as being most effective for patients with co-existing conditions. The hope is that by giving a person new tools for coping their symptoms will decrease over time.
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