Six-month treatment outcomes of cocaine-dependent patients with and without PTSD in a multisite national trial.

Abstract

OBJECTIVE:

This study examined 6-month treatment outcomes among 428 cocaine-dependent outpatients with (n = 34) and without (n = 394) posttraumatic stress disorder (PTSD) in a randomized controlled multisite clinical trial of manual-based psychotherapies for substance use disorder (SUD).

METHOD:

Assessments were completed at baseline and monthly during the 6-month treatment. With longitudinal mixed-effects models, we compared outcomes between SUD-PTSD and SUD-only patients and also examined rates of within-group change.

RESULTS:

Results indicated a highly consistent pattern: the SUD-PTSD patients were more impaired to begin with and remained so across time compared with SUD-only patients (with the exception of substance use and addiction-related legal and employment problems, which did not differ between groups). Also, the SUD-PTSD patients improved less than SUD-only patients in alcohol use and the majority of addiction-related psychosocial problems. However, the two groups did not differ significantly in improvement over time on drug use or global psychological severity.

CONCLUSIONS:

The greater impairment and relative lack of improvement of SUD-PTSD patients, compared with those with SUD-only, suggest a need for dual-diagnosis treatments that more directly target their areas of difficulty.

• Authors: Lisa M Najavits, Melanie S Harned, Robert J Gallop, Stephen F Butler, Jacques P Barber, Michael E Thase, Paul Crits-Christoph
• Journal: Journal of studies on alcohol and drugs (J Stud Alcohol Drugs) Vol. 68 Issue 3 Pg. 353-61 (May 2007) ISSN: 1937-1888 [Print] United States
• PMID: 17446974 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Hypnotics and Sedatives

Topics

• Adult
• Alcoholics Anonymous
• Alcoholism (diagnosis, epidemiology, rehabilitation)
• Cocaine-Related Disorders (diagnosis, epidemiology, rehabilitation)
• Cognitive Behavioral Therapy (methods)
• Comorbidity
• Counseling (methods)
• Diagnosis, Dual (Psychiatry)
• Female
• Follow-Up Studies
• Humans
• Hypnotics and Sedatives
• Male
• Marijuana Abuse (diagnosis, epidemiology, rehabilitation)
• Psychoanalytic Therapy (methods)
• Psychotherapy (methods)
• Social Support
• Stress Disorders, Post-Traumatic (diagnosis, epidemiology, rehabilitation)
• Substance-Related Disorders (diagnosis, epidemiology, rehabilitation)
• United States