The relationship between substance use and posttraumatic stress disorder in a methadone maintenance treatment program

Introduction and Aims: Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population. Design and Methods: Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. Results: Eighty clients (43 female, 37 male), aged 35 +/- 8.0 years (mean +/- SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms. Discussion and Conclusions: In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified. (C) 2011 Elsevier Inc. All rights reserved.