Treatment of coexisting substance dependence and posttramatic stress disorder

This paper describes the treatment of a physician who developed posttraumatic stress disorder (PTSD) and a polysubstance use disorder after he was shot and held hostage by a patient. Inpatient treatment combined pharmacological and behavioral approaches, including systematic re-exposure via talking about the event in therapy groups. Standard methods for achieving and maintaining abstinence were used, such as asking for and accepting peer support and discussing painful feelings. Cognitive aspects of treatment included education about interactions between the two conditions. After 12 weeks the physician was free of symptoms and had minimal anxiety when exposed to salient cues of the traumatic event.