Two-year mental health service use and course of remission in patients with substance use and posttraumatic stress disorders

Objective: Comorbid diagnoses of substance abuse/dependence and posttraumat ic stress disorder (SUD-PTSD) adversely affect substance abuse patients' tr eatment outcomes. Recently, several practices have been recommended for the treatment of SUD-PTSD patients based on empirical findings, including prov iding PTSD-specific care. Accordingly, this study examines the association between outpatient PTSD treatment and the long-term course of SUD-PTSD pati ents. Method: Male substance abuse/dependence patients (N = 125) with a com orbid diagnosis of PTSD completed 1-and 2-year follow-ups. Based on these r eports, 26 patients were stably remitted from substance abuse, 39 were part ially remitted and 60 were not remitted at either follow-up. These three gr oups were compared on mental health service use indices gathered from patie nts' self-reports of inpatient treatment and nationwide Veterans Affairs (V A) databases abstracting outpatient visits. Results: SUD-PTSD patients who attended more outpatient substance abuse, psychiatric and PTSD services in the first year following treatment land cumulatively over the 2-year follow -up) were more likely to maintain a stable course of remission from substan ce use in the 2 years following inpatient SUD treatment. When the three typ es of sessions were examined in regression analyses, PTSD sessions in the s econd year and the total number of PTSD sessions over the 2 years following the index treatment episode emerged as the most significant predictors of remission. Self-help group participation was also associated with a remitte d course for SUD-PTSD patients. Conclusions: These data suggest that PTSD-f ocused treatment services are an essential treatment component for substanc e abuse/dependence patients with PTSD.