Treating Posttraumatic Stress Disorder in Patients with Opioid Use Disorder

在阿片类药物使用障碍（OUD）患者中，90%报告终身创伤暴露，33%符合 创伤后应激障碍（PTSD）的标准。OUD和PTSD的共同发生与更多的 严重的精神健康症状和与任一诊断相关的阿片类激动剂治疗（OAT）结局更差 一个人延长暴露疗法（PET）是一种有效的手动认知行为治疗， 降低创伤后应激障碍的严重程度。虽然初步研究结果表明，PET可能会降低PTSD症状的严重程度， 在接受伴随OUD治疗的患者中，尚不清楚观察到的改善程度 是PET的功能与OAT本身的精神药理学作用。因此， 在缺乏强化认知行为干预的情况下，单独使用OAT是否可以减轻PTSD的发病率。 鉴于创伤后应激障碍在OAT患者中的患病率和有害影响， 患者，以及在SUD治疗环境中对精神卫生资源的始终存在的限制。

Among patients with opioid use disorder (OUD), 90% report lifetime trauma exposure and 33% meet criteria for posttraumatic stress disorder (PTSD). The co-occurrence of OUD and PTSD is associated with more severe mental health symptoms and worse opioid agonist treatment (OAT) outcomes relative to either diagnosis alone. Prolonged exposure therapy (PET) is an efficacious manualized cognitive-behavioral treatment for reducing PTSD severity. Although preliminary findings indicate that PET may reduce PTSD symptom severity among patients receiving treatment for concomitant OUD, it is unclear to what extent observed improvements were a function of PET versus the psychopharmacological effects of OAT itself. Therefore, the question of whether OAT alone may attenuate PTSD symptomatology in the absence of intensive cognitive-behavioral therapy remains unanswered and is important given the prevalence and deleterious effects of PTSD among OAT patients, as well as the ever-present constraints on mental health resources in SUD treatment settings.