Psychological treatments for concurrent posttraumatic stress disorder and substance use disorder: A systematic review

This article gives an overview of research into psychological treatments for concurrent posttraumatic stress disorder (PTSD) and substance used disorder (SUD), with a special focus on the effectiveness of treatments addressing both disorders compared to treatments addressing one of the disorders alone. In addition, a distinction is made between trauma-focused versus non-trauma-focused therapies for concurrent PTSD and SUD. The databases Embase, Psychinfo, Medline and Web of science were searched for relevant articles. In total, seventeen studies were identified evaluating ten treatments protocols (six trauma-focused and four non-trauma-focused treatment approaches). In general, the studies showed pre–post reductions for PTSD and/or SUD symptoms. Although most treatments for concurrent PTSD and SUD did not prove to be superior to regular SUD treatments, there are some promising preliminary results suggesting that some patients might benefit from trauma-focused interventions. However, the lack of methodologically sound treatment trials makes it difficult to draw firm conclusions. Methodological limitations are discussed, along with recommendations for future research.

► Prevalence of PTSD is high in individuals suffering from substance use disorders.
► Ten protocols for the combined treatment of PTSD and SUD have been evaluated.
► Non-trauma-focused interventions showed significant effects on SUD and PTSD.
► Non-trauma-focused interventions did not perform superior to SUD treatment alone.
► Some patients may benefit from trauma-focused interventions.