Does Posttraumatic Stress Disorder Affect Post-Treatment Methamphetamine Use?

Objective: Although trauma is a well-established risk factor for substance use disorders, little is known about the association between posttraumatic stress disorder (PTSD) and treatment outcomes among methamphetamine users. In the present study, we examine the relationship between PTSD and post-treatment methamphetamine use outcomes, hospitalizations, and overall psychiatric impairment. Methods: Using data from 526 adults in the largest psychosocial clinical trial of methamphetamine users conducted to date, this study examined (a) treatment outcomes of methamphetamine users with concomitant PTSD 3years after psychosocial treatment for methamphetamine dependence and (b) PTSD symptom clusters as risk factors for post-treatment relapse to methamphetamine use. Results: PTSD was associated with poorer methamphetamine use outcomes; methamphetamine use frequency throughout the 3-year follow-up was significantly greater among individuals with a PTSD diagnosis, and those with PTSD had more than five times the odds of reporting methamphetamine use in the 30days prior to the follow-up interview, odds ratio (OR) = 5.2, 95% CI [2.013.3]. Additionally, higher levels of other Axis I psychopathology were observed among methamphetamine users with PTSD. Avoidance and arousal symptoms predicted post-treatment methamphetamine use. Conclusions: Addressing these high-risk PTSD symptoms and syndromes in methamphetamine users may be helpful as a means of improving treatment outcomes in this population. (Journal of Dual Diagnosis, 9: 123-128, 2013)