Cannabis use and trauma-focused treatment for co-occurring posttraumatic stress disorder and substance use disorders: A meta-analysis of individual patient data

被引:3
作者
Hill, Melanie L. [1 ,9 ]
Kline, Alexander C. [2 ]
Saraiya, Tanya C. [3 ,4 ]
Gette, Jordan [3 ]
Ruglass, Lesia M. [3 ,5 ]
Norman, Sonya B. [1 ,2 ,6 ]
Back, Sudie E. [4 ,7 ]
Saavedra, Lissette M. [8 ]
Hien, Denise A. [3 ]
Morgan-Lopez, Antonio A.
机构
[1] Univ Calif San Diego, Dept Psychiat, San Diego, CA USA
[2] Vet Affairs San Diego Healthcare Syst, San Diego, CA USA
[3] Rutgers State Univ, Ctr Alcohol & Subst Use Studies, Piscataway, NJ USA
[4] Med Univ South Carolina, Dept Psychiat & Behav Sci, Charleston, SC USA
[5] CUNY City Coll, Dept Psychol, New York, NY USA
[6] Natl Ctr PTSD, Execut Div, White River Jct, VT USA
[7] Ralph H Johnson Vet Affairs Healthcare Syst, Charleston, SC USA
[8] RTI Int, Res Triangle Pk, NC USA
[9] Univ Calif San Diego, Sch Med, 9500 Gilman Dr, La Jolla, CA 92093 USA
关键词
Posttraumatic stress disorder; Cannabis; Marijuana; Attendance; Substance use; FEAR EXTINCTION; EXPOSURE; SEVERITY; OUTCOMES; TRIALS; PTSD;
D O I
10.1016/j.janxdis.2024.102827
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
High rates of cannabis use among people with posttraumatic stress disorder (PTSD) have raised questions about the efficacy of evidence-based PTSD treatments for individuals reporting cannabis use, particularly those with cooccurring alcohol or other substance use disorders (SUDs). Using a subset of four randomized clinical trials (RCTs) included in Project Harmony, an individual patient meta-analysis of 36 RCTs (total N = 4046) of treatments for co-occurring PTSD+SUD, we examined differences in trauma-focused (TF) and non-trauma-focused (non-TF) treatment outcomes for individuals who did and did not endorse baseline cannabis use (N = 410; 70% male; 33.2% endorsed cannabis use). Propensity score-weighted mixed effects modeling evaluated main and interactive effects of treatment assignment (TF versus non-TF) and baseline cannabis use (yes/no) on attendance rates and within-treatment changes in PTSD, alcohol, and non-cannabis drug use severity. Results revealed significant improvements across outcomes among participants in all conditions, with larger PTSD symptom reductions but lower attendance among individuals receiving TF versus non-TF treatment in both cannabis groups. Participants achieved similar reductions in alcohol and drug use across all conditions. TF outperformed non-TF treatments regardless of recent cannabis use, underscoring the importance of reducing barriers to accessing TF treatments for individuals reporting cannabis use.
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页数:11
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