COURSE AND TREATMENT OF PATIENTS WITH BOTH SUBSTANCE USE AND POSTTRAUMATIC STRESS DISORDERS

Posttraumatic stress disorder (PTSD) is a common co-occurring diagnosi s in patients with substance use disorders (SUDs). Despite the documen ted prevalence of this particular ''dual diagnosis,'' relatively littl e is known about effective treatment for SUD-PTSD patients. This artic le reviews empirical research on the course and treatment of SUD-PTSD comorbidity and highlights clinically relevant findings. Based on this review, the following is noted: PTSD is highly prevalent in SUD patie nts, consistently associated with poorer SUD treatment outcomes, and r elated to distinct barriers to treatment. Specific treatment practices are recommended for substance abuse treatment providers: (a) All pati ents should be carefully screened and evaluated for trauma and PTSD; ( b) referrals should be provided for concurrent treatment of SUD-PTSD, if available, or for psychological counseling with the recommendation that trauma/PTSD be addressed; and (c) increased intensity of SUD trea tment should be offered in conjunction with referrals for family treat ment and self-help group participation. (C) 1998 Elsevier Science Ltd.