Alcohol, cannabis, and other drug use: Engagement and outcome in PTSD treatment.
Alcohol, cannabis, and other drug use: Engagement and outcome in PTSD treatment.
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酒精，大麻和其他药物使用：PTSD治疗中的参与和结果。
DOI：
10.1037/adb0000355
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发表时间：
2018-05
影响因子：
3.4
通讯作者：
Feeny, Norah C
中科院分区：
文献类型：
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作者：
Bedard-Gilligan, Michele;Garcia, Natalia;Zoellner, Lori A;Feeny, Norah C
创伤后应激障碍 (PTSD) 和药物滥用的同时发生与创伤治疗结果较差和退出率增加有关。调查创伤后应激障碍和物质使用可以为我们的干预方法提供信息。探索大麻的使用尤其重要，因为随着最近的合法化趋势，大麻的使用率不断增加。需要更好地了解药物使用与创伤后应激障碍 (PTSD) 患者的治疗过程和结果之间的关系，以加强护理。在这项研究中，对 200 名接受长期暴露 (PE) 或舍曲林治疗的患有慢性 PTSD 的男性和女性进行了终生酒精和药物使用障碍诊断以及当前酒精和药物使用严重程度的检查。没有一生或当前的饮酒变量可以预测退出、坚持或较差的结果。然而，终生诊断为酒精和药物障碍（OR = 3.42）以及最近使用大麻（OR = 3.38）强烈预测辍学率较高。最近的大麻使用和药物使用严重程度预示着对 PE 的依从性较差（β = -.22 至 -.29），但对舍曲林则不然。药物使用严重程度 (β = -.22) 也预示着更差的治疗结果，终身诊断酒精和药物障碍 (β = -.48) 也是如此。总体而言，吸毒患者的治疗效果有所改善，但治疗保留率、依从性和症状减轻程度较低。这些患者可能需要采取提高参与度和保留率的策略。使用大麻或其他药物的个人可能面临更高的未完成 PTSD 治疗的风险，可能会延长 PTSD 和药物使用的周期。
The co-occurrence of posttraumatic stress disorder (PTSD) and substance use is related to poorer outcome and increased dropout from trauma-focused treatment. Investigating PTSD and substance use can inform our intervention approaches. Exploring cannabis use in particular is especially important as rates of cannabis use are increasing with recent legalization trends. A better understanding of how substance use is associated with treatment processes and outcome for individuals with PTSD is needed to enhance care. In this study, both lifetime diagnoses of alcohol and drug use disorders and current alcohol and drug use severity were examined in 200 men and women with chronic PTSD who received either prolonged exposure (PE) or sertraline. No lifetime or current alcohol use variables predicted drop out, adherence, or poorer outcome. However, lifetime diagnosis of both an alcohol and drug disorder (OR = 3.42) and recent cannabis use (OR = 3.38) strongly predicted higher dropout. Recent cannabis use and drug use severity predicted poorer adherence to PE (β = −.22 to −.29), but not to sertraline. Drug use severity (β = −.22) also predicted worse treatment outcome, as did lifetime diagnosis of an alcohol and drug disorder (β = −.48). Overall, patients with drug use improved with treatment, but had less treatment retention, adherence, and symptom reduction. Strategies to increase engagement and retention may be indicated for these patients. Individuals who are using cannabis, or other drugs, may be at higher risk for not completing PTSD treatment, potentially prolonging the cycle of PTSD and substance use.