Clinical Challenges in the Treatment of Patients With Posttraumatic Stress Disorder and Substance Abuse

Ingo Schäfer; Lisa M. Najavits


Curr Opin Psychiatry. 2007;20(6):614-618. 

In This Article

Abstract and Introduction


Purpose of review: The aim of this article is to review the current literature on co-occuring posttraumatic stress disorder and substance-use disorder, with an emphasis on clinical aspects and emerging treatments.
Recent findings: In clinical populations (focusing on either disorder), about 25-50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures. In recent years, several promising treatment programs have been developed specifically for co-occuring posttraumatic stress disorder and substance-use disorder, with one model having been established as effective thus far.
Summary: Comorbid posttraumatic stress disorder/substance-use disorder is a frequent diagnosis in clinical populations that severely affects course and outcome. Treatment approaches appropriate for this vulnerable population need to be evaluated further and implemented in routine practice.


Over the past few decades, the importance of co-occurring posttraumatic stress disorder (PTSD) and substance-use disorder (SUD) has become increasingly apparent. This article provides an overview of clinical challenges in this population and the emerging evidence on effective treatments. Note that we cover diagnostically based studies for PTSD/SUD only; the literature on trauma per se in SUD patients is beyond the scope of this review.[1,2]


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