Trauma and Substance Abuse: A Clinician’s Guide to Treatment

Abstract

Substance use disorder (SUD) frequently co-occurs with posttraumatic stress disorder (PTSD) and trauma symptoms broadly. This comorbidity is clinically important, with research showing that it signifies a more difficult course of recovery and greater impairment than either disorder alone. The presence of SUD also impacts how PTSD is addressed in treatment. The whole is not the sum of its parts-addressing PTSD/SUD is not simply about applying treatments for each, but requires conceptualization of how each disorder affects the other and how to engage in successful strategies to address each without worsening the other It is like a seesaw that needs careful balancing to prevent tipping too far to one side. Splits between PTSD and SUD treatment are well known, and most clinicians never receive formal training in both. Patients have often been left to try to integrate what our field has not. Although PTSD and SUD may be viewed separately, they are strongly intertwined in the day-to-day experience of patients' lives. This chapter offers a brief summary of models for PTSD/SUD, key findings from outcome research, practice principles, and future directions. (PsycInfo Database Record (c) 2020 APA, all rights reserved)