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Updated: Apr 30, 2026

A Procedure to Study Stress-Induced Relapse of Heroin Seeking after Punishment-Imposed Abstinence
Published on: March 23, 2022
Towards a unitary perspective between post-traumatic stress disorder and substance use disorder. Heroin use disorder
Liliana Dell'Osso1, Fabio Rugani2, Angelo Giovanni Icro Maremmani3
1Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy, EU.
Background:
Genetic, neurobiological, environmental and psychosocial mechanisms have received considerable attention in exploring the mechanisms that underlie comorbid PTSD and SUD. PTSD and SUD are not necessarily linked by a causal relationship, as the self-medication hypothesis had supposed. They might, in fact, both be caused by a third factor that predisposes these subjects to develop the two disorders (so allowing a unitary perspective).
Methods:
Using a conceptualization of the PTSD spectrum, we studied the PTSD-SUD unitary perspective by testing the correlation between severity of heroin addiction, dose of opioid medication and severity of PTSD spectrum in 82 methadone-treated, heroin-dependent patients.
Results:
Canonical correlation analysis (Wilks Lambda=0.125F=1.41 p=0.014), univariate and multivariate comparisons between subgroups, identified on the basis of addiction severity, showed a highly positive correlation between the PTSD spectrum and the severity of heroin addiction. In addition, negative correlations were found between PTSD spectrum severity and methadone dose (r=0.225; p=0.042).
Conclusions:
This strength and breadth of the correlations encourage us to move towards a unified vision of the two disorders.
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