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Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a
Katherine L Mills1, Maree Teesson, Sudie E Back
1National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia 2052. k.mills@unsw.edu.au
JAMA
|August 16, 2012
Summary
Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) significantly reduced PTSD symptoms in patients with co-occurring PTSD and substance dependence. This integrated approach improved PTSD symptom severity without worsening substance dependence.
Area of Science:
- Psychiatry and Behavioral Science
- Addiction Medicine
- Trauma Studies
Background:
- Exposure therapy for posttraumatic stress disorder (PTSD) raises concerns about relapse in patients with co-occurring substance dependence.
- An integrated treatment approach may be necessary to address both conditions effectively.
Purpose of the Study:
- To evaluate the efficacy of Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) compared to usual care for substance dependence.
- To determine if COPE can reduce symptom severity in both PTSD and substance dependence.
Main Methods:
- A randomized controlled trial involving 103 participants with diagnosed PTSD and substance dependence.
- Participants were randomized to receive either COPE plus usual treatment or usual treatment alone.
- Outcomes, including PTSD and substance dependence symptom severity, were assessed at 9 months post-baseline.
Main Results:
- The COPE group showed a significantly greater reduction in PTSD symptom severity compared to the usual treatment group (mean difference, -16.09).
- Both groups experienced reductions in PTSD symptoms, but the integrated treatment yielded superior results.
- No significant differences were observed between groups in the improvement of substance dependence severity, substance use, depression, or anxiety.
Conclusions:
- Integrating COPE with usual treatment improves PTSD symptom severity in patients with comorbid PTSD and substance dependence.
- This combined approach is effective without exacerbating substance dependence symptoms.
- COPE represents a viable treatment option for individuals facing the dual challenges of PTSD and substance use disorders.
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