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Substance use disorders, trauma, and PTSD
Journal of Traumatic Stress. Based on the DIS, The most common reason for patients not completing the treatment program was for use of illegal substances or alcohol while in the program, even though they were aware that to do so meant that they would be either discharged or transferred to another unit. The percentage of other co-diagnoses, and an estimate of currentness for all Axis I diagnoses were also presented on the sample of patients. It was determined that for this population, the symptoms of substance abuse were chronic and were inextricably intertwined with PTSD symptoms and with the initial stressor combat.
Posttraumatic stress disorder PTSD [note 1] is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault , warfare , traffic collisions , child abuse , or other threats on a person's life. Most people who experience traumatic events do not develop PTSD. Prevention may be possible when counselling is targeted at those with early symptoms but is not effective when provided to all trauma-exposed individuals whether or not symptoms are present. In the United States, about 3. Symptoms of PTSD generally begin within the first 3 months after the inciting traumatic event, but may not begin until years later. Trauma survivors often develop depression, anxiety disorders, and mood disorders in addition to PTSD. Drug abuse and alcohol abuse commonly co-occur with PTSD.
Substance use disorders SUDs and traumas frequently co-occur. Finally, some consider that both SUD and PTSD are the result of a shared vulnerability due to some genetic predisposition or early childhood trauma. On the basis of these etiological considerations, it seems that the treatment of PTSD as a causal factor in the development of SUD is more important than the treatment of SUD in patients with both disorders. However, in the course of the disorder, the course of SUD may become rather independent and simultaneous treatment of both disorders would be most preferable. However, this still raises the question of whether treatment should be predominantly psychotherapeutic or pharmacological and, furthermore, what kind of psychotherapy or medication. Both reviews deal with cognitive behavioural therapy aimed at stabilisation without exposure such as Seeking Safety as well as cognitive behavioural therapy with exposure.
Metrics details. Although international guidelines recommend integrated treatment clinicians are still hesitant in offering integrated treatment and more concrete recommendations are needed. This study aims to contribute to a practice-based guideline through the exploration of practice-based decision criteria to determine the indication and treatment of SUD and PTSD. Thirty-one experienced clinicians working in Dutch addiction care facilities filled in 15 vignettes resulting in scored vignettes. Respondents did not report any contra-indications for integrated treatment and the perceived relationship between SUD and PTSD was found to be an important factor in the indication of integrated treatment.