title: Posttraumatic stress disorder and short-term outcome in early methadone treatment.
abstract: The aim of this study was to determine treatment adherence relative to frequency of violence and posttraumatic stress disorders (PTSD) among new methadone patients. Ninety-six opiate-abusing patients were evaluated for childhood physical and sexual abuse (CPSA), adulthood exposures to violence (ADVIOL), PTSD, and treatment adherence. Overall, 43% of the subjects dropped out of treatment within 3 months of intake. Occurrence of trauma or PTSD did not predict drop-out rates. A 2 (Gender) x 2 (PTSD) analysis of covariance (ANCOVA) with severity of other drug use on admission as a covariate, however, revealed a main effect for PTSD, F(4, 71) = 7. 69, p < or =.01, such that those patients with current PTSD revealed significantly more ongoing drug use at 3 months (M = 24.3, SD = 20. 9) than those without (M = 8.9, SD = 11.8). Examination of ongoing cocaine use using a 2 (Gender) x 2 (PTSD) ANCOVA also revealed a main effect for PTSD, F(4, 17) = 8.24, p < or = .005, such that those patients with current PTSD revealed significantly more ongoing cocaine use at 3 months postadmission (M = 51.6, SD = 37.6) than those without (M = 24.3, SD = 20.9). For both genders, CPSA and ADVIOL were associated with higher rates of PTSD, which in turn predicted poorer treatment adherence as measured by ongoing co-occurring drug abuse 3 months postadmission. Results underscore the need for routine assessment and targeted treatment of trauma in methadone patients.
authors.affiliation: St. Luke's/Roosevelt Hospital Center, Women's Health Project, New York, NY 10025, USA. Drhien@aol.com
authors.forename: D A
authors.initials: DA
authors.lastname: Hien
authors.forename: E
authors.initials: E
authors.lastname: Nunes
authors.forename: F R
authors.initials: FR
authors.lastname: Levin
authors.forename: D
authors.initials: D
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019970:Cocaine-Related Disorders / Q000209:etiology* / Q000534:rehabilitation; D003937:Diagnosis, Differential; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000209:etiology* / Q000534:rehabilitation; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone