Helping Opioid Use Disorder and PTSD with Exposure (HOPE): An Open-Label Pilot Study of a Trauma-Focused, Integrated...

Area of Science:

• Psychiatry and Behavioral Sciences
• Clinical Psychology
• Addiction Medicine

Background:

• Opioid use disorder (OUD) and posttraumatic stress disorder (PTSD) frequently co-occur, presenting a complex clinical challenge.
• Existing treatments are not specifically designed for this dual diagnosis or for integration with OUD medications.
• There is a need for novel, integrated psychotherapy approaches for individuals with OUD and PTSD.

Purpose of the Study:

• To test the feasibility, acceptability, and preliminary efficacy of a novel integrated trauma-focused psychotherapy, Helping Opioid Use Disorder and PTSD with Exposure (HOPE).
• To evaluate HOPE's impact on PTSD symptoms, OUD-related outcomes, and co-occurring mental health symptoms in a pilot trial.

Main Methods:

• An open-label pilot trial involving 6 participants with OUD/PTSD stabilized on OUD medications.
• HOPE therapy was delivered weekly for 10-12 sessions, followed by a 1-month post-treatment follow-up visit.
• Primary outcomes included urine drug screens, Timeline Followback, Desire for Drugs Questionnaire, CAPS-5, and PCL-5, analyzed using mixed-effects models and GEE.

Main Results:

• Significant reductions in PTSD symptoms (CAPS-5, PCL-5), desire for opioids, depression, and anxiety were observed.
• Client satisfaction increased significantly throughout the study.
• High treatment completion rates (83.3%) and no significant changes in opioid or other substance use were noted.

Conclusions:

• The HOPE therapy demonstrated high acceptability and feasibility in individuals with OUD/PTSD.
• This integrated, trauma-focused treatment led to significant improvements in PTSD and associated psychological symptoms.
• HOPE therapy shows potential as an effective intervention for the complex comorbidity of OUD and PTSD.