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Heroin Addiction and Related Clinical Problems: 2017, 19, N1 (pages: 5 - 12)

Severe Trauma among Substance Users in Opioid Maintenance Treatment: Users' Assessment of Worst Trauma and Clinical Assessment of PTSD.

Kjøsnes R., Waal H., Hauff E., and Gossop M.

Summary: Background: PTSD is highly prevalent among heroin dependent patients. Achieving a better understanding of the association between trauma symptoms and substance use is important for treatment services. Aims: This study looks at severity of trauma among patients seeking opioid maintenance treatment (OMT), and at associations between types of trauma, substance use and PTSD. Methods: Patients seeking opioid maintenance treatment (OMT) in the Oslo region were interviewed voluntarily signing up for the study. Data were collected using the Life Event Checklist, SCID, PTSD, EuropASI and M.I.N.I. Results: The sample (N=61) reported a range of traumatic events, often on repeated occasions. Almost three quarters (72%) met clinical criteria for lifetime PTSD, and about half (48%) for current PTSD. Those whose worst trauma occurred before age 8 years were most likely to have current PTSD, and the worst trauma typically occurred before onset of heroin use. Conclusions: Symptoms of PTSD have implications for treatment of heroin dependence. The provision of effective treatments for substance users with PTSD remains a challenge to treatment services, which often do not sufficiently address this comorbidity.