Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study
Background Exposure to traumatic events is both a risk factor for substance use and an adverse outcome of substance use disorders. Identifying and managing post-traumatic stress disorder (PTSD) in patients with addiction requires attention. Aims To examine the lifetime prevalence of traumatic event...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-07-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421009716/type/journal_article |
| _version_ | 1811156930724364288 |
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| author | Tea Rosic Vivian Y. O. Au Andrew Worster David C. Marsh Lehana Thabane Zainab Samaan |
| author_facet | Tea Rosic Vivian Y. O. Au Andrew Worster David C. Marsh Lehana Thabane Zainab Samaan |
| author_sort | Tea Rosic |
| collection | DOAJ |
| description | Background
Exposure to traumatic events is both a risk factor for substance use and an adverse outcome of substance use disorders. Identifying and managing post-traumatic stress disorder (PTSD) in patients with addiction requires attention.
Aims
To examine the lifetime prevalence of traumatic events and past-month prevalence of PSTD in patients treated for opioid use disorder, and explore the association between trauma, PTSD and treatment outcomes.
Method
Participants (n = 674) receiving methadone treatment in 20 community clinics across Ontario, Canada, were administered the Mini-International Neuropsychiatric Interview to identify self-reported traumatic events and PTSD. Drug use was measured for 12 months by urine drug screens.
Results
Eleven per cent of participants met past-month criteria for PTSD (n = 72), and 48% reported history of traumatic events with no current PTSD (n = 323). Participants with PTSD were more likely to be female (odds ratio 2.13, 95% CI 1.20–3.76) and less likely to be employed (odds ratio 0.31, 95% CI 0.16–0.61) or married (odds ratio 0.51, 95% CI 0.26–0.90) than those with no trauma history. Antidepressants (39 v. 24%) and benzodiazepines (36 v. 18%) were differentially prescribed to patients with and without PTSD. Length of time in treatment and opioid use were not associated with trauma; however, suicidal ideation was more common in PTSD (odds ratio 2.29, 95% CI 1.04–5.01).
Conclusions
Trauma and PTSD are prevalent among patients with opioid use disorder, and consideration of trauma symptoms and associated characteristics is warranted. Patients with and without comorbid PTSD differ clinically and psychosocially, highlighting the relevance of integrating addiction and mental health services for this population.
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| first_indexed | 2024-04-10T04:59:24Z |
| format | Article |
| id | doaj.art-a6b05ef76eae4d32b3cb3c042934ab4f |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:24Z |
| publishDate | 2021-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-a6b05ef76eae4d32b3cb3c042934ab4f2023-03-09T12:29:07ZengCambridge University PressBJPsych Open2056-47242021-07-01710.1192/bjo.2021.971Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort studyTea Rosic0https://orcid.org/0000-0001-7406-4056Vivian Y. O. Au1Andrew Worster2David C. Marsh3Lehana Thabane4Zainab Samaan5https://orcid.org/0000-0002-5974-9361Department of Psychiatry and Behavioral Neurosciences, McMaster University, Ontario, Canada; and Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, CanadaMichael G. DeGroote School of Medicine, McMaster University, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada; and Department of Medicine, McMaster University, Ontario, CanadaNorthern Ontario School of Medicine, Ontario, Canada; Canadian Addiction Treatment Centres, Ontario, Canada; and ICES North, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada; Biostatistics Unit, Research Institute at St Joseph's Healthcare, Ontario, Canada; Department of Pediatrics, McMaster University, Ontario, Canada; and Department of Anesthesia, McMaster University, Ontario, CanadaDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, Ontario, Canada; and Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, CanadaBackground Exposure to traumatic events is both a risk factor for substance use and an adverse outcome of substance use disorders. Identifying and managing post-traumatic stress disorder (PTSD) in patients with addiction requires attention. Aims To examine the lifetime prevalence of traumatic events and past-month prevalence of PSTD in patients treated for opioid use disorder, and explore the association between trauma, PTSD and treatment outcomes. Method Participants (n = 674) receiving methadone treatment in 20 community clinics across Ontario, Canada, were administered the Mini-International Neuropsychiatric Interview to identify self-reported traumatic events and PTSD. Drug use was measured for 12 months by urine drug screens. Results Eleven per cent of participants met past-month criteria for PTSD (n = 72), and 48% reported history of traumatic events with no current PTSD (n = 323). Participants with PTSD were more likely to be female (odds ratio 2.13, 95% CI 1.20–3.76) and less likely to be employed (odds ratio 0.31, 95% CI 0.16–0.61) or married (odds ratio 0.51, 95% CI 0.26–0.90) than those with no trauma history. Antidepressants (39 v. 24%) and benzodiazepines (36 v. 18%) were differentially prescribed to patients with and without PTSD. Length of time in treatment and opioid use were not associated with trauma; however, suicidal ideation was more common in PTSD (odds ratio 2.29, 95% CI 1.04–5.01). Conclusions Trauma and PTSD are prevalent among patients with opioid use disorder, and consideration of trauma symptoms and associated characteristics is warranted. Patients with and without comorbid PTSD differ clinically and psychosocially, highlighting the relevance of integrating addiction and mental health services for this population. https://www.cambridge.org/core/product/identifier/S2056472421009716/type/journal_articleAddictionopioid use disorderpost-traumatic stress disordercomorbidityopioid agonist therapy |
| spellingShingle | Tea Rosic Vivian Y. O. Au Andrew Worster David C. Marsh Lehana Thabane Zainab Samaan Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study BJPsych Open Addiction opioid use disorder post-traumatic stress disorder comorbidity opioid agonist therapy |
| title | Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study |
| title_full | Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study |
| title_fullStr | Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study |
| title_full_unstemmed | Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study |
| title_short | Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study |
| title_sort | trauma and post traumatic stress disorder in patients treated for opioid use disorder findings from a 12 month cohort study |
| topic | Addiction opioid use disorder post-traumatic stress disorder comorbidity opioid agonist therapy |
| url | https://www.cambridge.org/core/product/identifier/S2056472421009716/type/journal_article |
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