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Heroin Addiction and Related Clinical Problems: 2011, 13, 3 (pages: 17 - 26)

Life events (loss and traumatic) and emotional responses to them in heroin-dependent patients before and after the dependence age of onset

Rugani F., Maremmani A. G. I., Rovai L., Mautone S., Perugi P., Pani P. P., Dell'osso L., Maremmani I.

Summary: Epidemiological data show frequent associations between post-traumatic stress disorder (PTSD) and substance use disorders. In this study we assessed the life events (loss events and potentially traumatic events) of 82 heroin-dependent patients before and after the dependence age of onset (DAO) and their emotional, physical and cognitive responses to these events, within a trauma and loss spectrum. We also assessed personality traits at risk for Post-Traumatic Stress Disorder (PTSD). In passing from the before-DAO to the after-DAO period, 97.6% of patients continued to experience life events, 82.9% loss events and 91.5% potentially traumatic events. The life events most frequently rated as the most important by patients are “death of a close friend or relative”, “divorce” and “being neglected or abandoned”. Sexual abuse seems to be present, but with a lower percentage. Criminal behaviours become very common after DAO. “Grief reactions” to loss events increase after DAO, as well as “reactions to the most important event”, “re-experiencing”, “avoidance and numbing”, “maladaptive coping” and “arousal”. After DAO, we found an increase in all the emotional, physical and cognitive behaviours typically reported in PTSD patients. This increase in the intensity of emotive reactions during a drug addiction history seems to configure a sort of PTSD spectrum resulting from the addictive process. At a therapeutic level it would be appropriate to consider this higher emotional reactivity in patients as being due to loss events and potentially traumatic events, so as to allow the optimization of therapeutic resources when these life events occur.