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Heroin Addiction and Related Clinical Problems: 2015, 17, 6 (pages: 49 - 58)

Life events (loss and traumatic) and emotional responses to them in acute catastrophe survivors and long-lasting heroin use disorder patients never exposed to catastrophic events

Dell'Osso L., Massimetti E., Rugani F., Carmassi C., Fareed A., Stratta P., Rossi A., Massimetti G., and Maremmani I.

Summary: Background. Symptoms of PTSD denote alterations in several neurobiological systems, including the opioid system. In a previous work on methadone treated heroin use disorder (HUD) patients we demonstrated strong correlations between the severity and progression of HUD and the consequent higher severity of PTSD spectrum symptoms, suggesting a unitary perspective. Methods. A comparative cross-sectional study was carried out evaluating the post-traumatic spectrum reactivity to loss and traumatic events in acute catastrophic event survivors experiencing (N=77) and not experiencing PTSD (N=77) with a group of long-lasting HUD subjects, never exposed to catastrophic events (N=77). Results. To obtain an index of the magnitude of emotional response to losses and traumatic events we conducted a preliminary ROC analysis on TALS-SR total scores observed in our L'Aquila 2009 earthquake data-base after having classified subjects as PTSD and No-PTSD (according to SCID-questionnaire). The analysis determined the cut-off value assuring the best balance between sensitivity and specificity. The rate of over threshold subjects in HUD group resulted almost the same of the one observed in PTSD earthquake survivors group [51 (66.2%) vs 56 (72.7%), Chi-square=0.49, p=.484] while it resulted significantly higher than the one observed in No-PTSD earthquake survivors group [51 (66.2%) vs 11 (14.3%), Chi-square=41.07, p<.001]. Furthermore the discriminant analysis utilizing TALS-SR domains score as predictive variables, was not able to discriminate between HUD group and PTSD earthquake group while seems well differentiate No-PTSD earthquake group from the two others. Conclusions. This study, providing evidence of similarities in type of reaction to loss and traumatic events between HUD patients and Earthquake survivors with PTSD further supports the possible implication of the opioid system in the aetio(patho)logy of PTSD.