Treatment of substance use disorders: Effects on patients with higher or lower levels of PTSD symptoms

•SUD patients with higher levels of PTSD symptoms score higher on craving, depression, anxiety and stress•SUD patients with higher levels of PTSD symptoms show the same decrease in symptoms following SUD treatment•SUD patients with PTSD symptoms still report higher levels of depression, anxiety and stress after 6 months of SUD treatment

While guidelines advise integrated treatment of patients with substance use disorder (SUD) and posttraumatic stress disorder (PTSD), recent studies and reviews find no convincing evidence of different outcomes following treatment between non-trauma focused integrated programs and SUD treatment alone. In this study, we analyzed whether SUD patients with higher levels of PTSD symptoms receiving standard, non-integrated SUD treatment (N = 145) differed in outcomes compared to patients with lower levels of PTSD symptoms (N = 152). Patients with higher levels of PTSD symptoms showed no difference in days of substance use, but significantly more craving and psychiatric symptoms (depression, anxiety and stress) were measured at baseline. After 3 and 6 months of SUD treatment, there was no difference between the groups in decreased days of substance use. After 6 months of SUD treatment, depression, anxiety and stress were significantly diminished in both groups. However, those with higher levels of PTSD symptoms at the start of the SUD treatment still reported significantly higher scores on depression, anxiety and stress after 6 months of SUD treatment. These findings corroborate earlier studies that SUD patients with PTSD symptoms do not necessarily have poorer addiction treatment outcomes. However, as anxiety and PTSD symptoms predict relapse, future research should note the effect of higher symptom levels on long-term SUD treatment results. Additionally, more research is needed to determine which patients need additional treatment in conjunction with or following SUD treatment.