Treatment of Co-occurring Posttraumatic Stress Disorder and Substance Use Disorders


There is a significant need for advanced understanding of treatment of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Approximately half of individuals seeking SUD treatment meet criteria for current PTSD, and individuals with co-occurring PTSD-SUD tend to have poorer treatment outcomes compared with those without such comorbidity. However, there is not sufficient empirical evidence to determine a best course of treatment for these individuals. This paper provides a review of the literature relevant to the treatment of co-occurring PTSD-SUD. To date, treatment studies have focused primarily on non-exposure-based psychosocial treatments, exposure-based psychosocial treatments, and medication trials. The most promising outcome data thus far are for psychosocial treatments that incorporate an exposure therapy component; however, further research is needed, particularly as related to how best to implement these approaches in real-world treatment settings.

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This manuscript was supported, in part, by National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant R01AA016816 (PI: S. F. Coffey).


E. C. Berenz: none; S. F. Coffey: grants from National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and Department of Veterans Affairs and consultant to National Institute on Alcohol Abuse and Alcoholism/University of Washington and National Institute on Drug Abuse/Medical University of South Carolina.

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Correspondence to Scott F. Coffey.

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Berenz, E.C., Coffey, S.F. Treatment of Co-occurring Posttraumatic Stress Disorder and Substance Use Disorders. Curr Psychiatry Rep 14, 469–477 (2012).

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  • Posttraumatic stress disorder
  • PTSD
  • Substance use
  • Substance abuse
  • Substance dependence
  • Addiction
  • Alcohol
  • Alcoholism
  • Cocaine
  • Prolonged exposure
  • Comorbidity
  • Anxiety
  • Treatment
  • Selective serotonin reuptake inhibitors
  • SSRI
  • Cognitive behavioral therapy
  • CBT