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PTSD and opioid use: implications for intervention and policy.

Lucia Dahlby¹, Thomas Kerr^2,3

¹British Columbia Centre for Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.

Substance Abuse Treatment, Prevention, and Policy

|March 18, 2020

Summary

North America faces a severe opioid overdose crisis, fueled by synthetic opioids. Co-occurring Post-Traumatic Stress Disorder (PTSD) and Opioid Use Disorder (OUD) require integrated treatment, yet access to care remains inadequate.

Keywords:

Mental health Opioid use disorder Overdose epidemic Posttraumatic stress disorder Public policy

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Area of Science:

Public Health
Mental Health Research
Addiction Medicine

Background:

The opioid overdose epidemic in North America is exacerbated by synthetic opioids like fentanyl.
Individuals with Opioid Use Disorder (OUD) frequently experience high rates of Post-Traumatic Stress Disorder (PTSD), complicating treatment.
Current treatment options and outcomes for comorbid PTSD and OUD are suboptimal, despite the significant disease burden.

Discussion:

Comorbid PTSD and OUD present complex challenges for diagnosis, assessment, and early intervention.
Simultaneous or integrative treatment approaches yield the best outcomes for individuals with both conditions.
Affected individuals often face inadequate and inequitable access to healthcare services.

Key Insights:

Canadian mental healthcare services are chronically underfunded, contradicting WHO recommendations for equitable public spending.
The Mental Health Parity Act advocates for equitable public spending across all healthcare aspects in Canada.
Prohibitory drug-use legislation marginalizes substance-using populations, increasing risks of violence and trauma.

Outlook:

Urgent policy changes are needed to address regulatory drug-use frameworks and public healthcare policies perpetuating inequalities.
Implementing and evaluating alternative regulatory frameworks for drugs and mental health parity is crucial.
These changes aim to reduce violence, trauma, and ultimately, opioid-related overdose deaths.