Posttraumatic stress disorder and short-term outcome in early methadone treatment

The aim of this study was to determine treatment adherence relative to freq uency of violence and posttraumatic stress disorders (PTSD) among new metha done patients. Ninety-sis opiate-abusing patients were evaluated for childh ood physical and sexual abuse (CPSA), adulthood exposures to violence (ADVI OL), PTSD, and treatment adherence. Overall, 43% of the subjects dropped ou t of treatment within 3 months of intake. Occurrence of trauma or PTSD did not predict drop-out rates. A 2 (Gender) x 2 (PTSD) analysis of covariance (ANCOVA) with severity of other drug use on admission as a covariate, howev er, revealed a main effect for PTSD, F(4, 71) = 7.69, p less than or equal to .01, such that those patients with current PTSD revealed significantly m ore ongoing drug use at 3 months (M = 24.3, SD = 20.9) than those without ( M = 8.9, SD = 11.8). Examination of ongoing cocaine use using a 2 (Gender) x 2 (PTSD) ANCOVA also revealed a main effect for PTSD, F(4, 17) = 8.24, p less than or equal to .005, such that those patients with current PTSD reve aled significantly more ongoing cocaine use at 3 months postadmission (M = 51.6, SD = 37.6) than those without (M = 24.3, SD = 20.9). For both genders , CPSA and ADVIOL were associated with higher rates of PTSD, which in turn predicted poorer treatment adherence as measured by ongoing co-occurring dr ug abuse 3 months postadmission. Results underscore the need for routine as sessment and targeted treatment of trauma in methadone patients. (C) 2000 E lsevier Science Inc. All rights reserved.