Drug abuse treatment specialists have long noted a link between Post Traumatic Stress Disorder (PTSD) and substance abuse. People who suffer almost any sort of serious stress brought on by physical or psychological abuse or intensely negative personal experiences are much more likely to suffer from substance abuse and addiction as well.
Typically, PTSD is treated with a therapeutic technique called exposure therapy in which the victim faces the source of his or her PTSD in a safe environment. By reliving the trauma that caused the PTSD, patients were more likely to recover. For many years, exposure therapy was considered the only way to treat patients with PTSD. However, doctors have often been reluctant to use exposure therapy on patients who also suffer from addiction because they thought the exposure would exacerbate the substance abuse problem. PTSD and substance abuse has thus been one of the most difficult combinations to treat.
But a new study conducted in Australia and published in the Journal of the American Medical Association (JAMA) shows that detox significantly helps PTSD recovery. In the study, patients who received prolonged exposure therapy and substance abuse treatment experienced greatly reduced PTSD symptoms after detox. Significantly, after nine months, their PTSD symptoms continued to improve. The patients in the control group only received treatment for substance abuse. Their PTSD symptoms did not improve.
Taking Little Steps Is Beginning to Pay Off in the Treatment of Substance Abuse
While this new combined treatment helped patients’ PTSD symptoms, it did not result in a significant decrease in substance abuse. More work will need to be done to understand why, but this study represents an important breakthrough in understanding that exposure therapy is not necessarily incompatible with substance abuse rehabilitation.
One issue to consider is the nature of the substance abuse. In the study, the most commonly abused drug among the participants was heroin, followed by marijuana. Most (93%) had been through rehab before the study. Most participants experienced their trauma in childhood, at the average age of 8, with half experiencing childhood sexual abuse.
The study for the combined therapy group consisted of 13 sessions lasting 90 minutes each. Perhaps significantly, the researchers noted that only 10 (out of 50) patients attended all 13 sessions. Seven patients (five from the control group and two from the treatment group) attempted suicide during the study, but all elected to continue in the study.
According to Psychiatry News, most patients continued using after the study, 82% from the active group and 73% from the control group. However, both groups were using drugs less than before the study and both experienced a reduction in PTSD symptoms. But the treatment group experienced far fewer PTSD symptoms than patients in the control group.
The researchers hope that these results will improve over time. Overcoming a dual diagnosis is difficult under any circumstances, but it’s important to realize that medical science is always advancing, always looking for better ways to treat severe substance abuse. In this case, we have learned that as one diagnosis is treated, the symptoms of the other also decrease.
Time is perhaps the answer. Rehab takes time; recovery takes time; therapy takes time. But the more we know, the better our chances of success.