Posttraumatic Stress and Substance Use Disorders summarizes the state of the field from a biopsychosocial perspective, addressing key domains of interest to clinicians, students, instructors, and researchers. This book is a valuable resource and reference guide for multidisciplinary practitioners and scientists interested in the evidence-based assessment and treatment of posttraumatic stress and substance use disorders. Chapters written by leaders in the field cover the latest research on assessment, diagnosis, evidence-based treatments, future directions, and much more.

This book explores the underdiagnosed connection between drug use and posttraumatic stress disorder (PTSD). Patients with trauma-related distress such as PTSD often use alcohol and drugs in a problematic manner classifiable as substance use disorder (SUD). By not recognizing the connection between symptoms, providers frequently misdiagnose or do not fully attend to SUD-PTSD comorbidity. This book presents research on how often the two disorders co-occur and why. Authors describe the self-medication model and explore how specific PTSD and substance use symptoms are functionally related to each other. In addition, they suggest assessment approaches and practice guidelines to facilitate proper diagnosis and treatment. Particularly valuable are descriptions of several new treatment approaches that have been developed specifically for SUD-PTSD, including cognitive-behavioral and exposure therapy (PsycINFO Database Record (c) 2004 APA, all rights reserved).

The editors of Stress, Trauma, and Substance Use have gathered a collection of innovative chapters written by cutting edge researchers that depict both the breadth of the relationships between stress, trauma, and substance use, as well as how closely these phenomena are all too often linked. Individually, the chapters in this volume present innovative conceptual models, original research findings, and recommendations to service providers that are applicable to a diverse body of individuals affected by a wide variety of stressful and/or traumatic experiences, such as HIV/AIDS, incarceration, homelessness, sexual assault, and other forms of trauma and violence in addition to substance use. Taken as a whole, the content of this text provides a window into the true nature of the multi-layered and interconnected relationship between stress, trauma, and substance use. The untangling of these relationships holds great promise for continued research that develops a better understanding of these phenomena and ultimately improves the lives of individuals touched by these experiences. This book was previously published as a special issue of Stress, Trauma, and Crisis: An International Journal.

Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is a cognitive-behavioral psychotherapy program designed for patients who have posttraumatic stress disorder (PTSD) and a co-occurring alcohol or drug use disorder. COPE represents an integration of two evidence-based treatments: Prolonged Exposure (PE) therapy for PTSD and Relapse Prevention for substance use disorders. COPE is an integrated treatment, meaning that both the PTSD and substance use disorder are addressed concurrently in therapy by the same clinician, and patients can experience substantial reductions in both PTSD symptoms and substance use severity. Patients use the COPE Patient Workbook while their clinician uses the Therapist Guide to deliver treatment. The program is comprised of 12 individual, 60 to 90 minute therapy sessions. The program includes several components: information about how PTSD symptoms and substance use interact with one another; information about the most common reactions to trauma; techniques to help the patient manage cravings and thoughts about using alcohol or drugs; coping skills to help the patient prevent relapse to substances; a breathing retraining relaxation exercise; and in vivo (real life) and imaginal exposures to target the patient's PTSD symptoms.

Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is a cognitive-behavioral psychotherapy program designed for patients who have posttraumatic stress disorder (PTSD) and a co-occurring alcohol or drug use disorder. COPE represents an integration of two evidence-based treatments: Prolonged Exposure (PE) therapy for PTSD and Relapse Prevention for substance use disorders. COPE is an integrated treatment, meaning that both the PTSD and substance use disorder are addressed concurrently in therapy by the same clinician, and patients can experience substantial reductions in both PTSD symptoms and substance use severity. Patients use the COPE Patient Workbook while their clinician uses the Therapist Guide to deliver treatment. The program is comprised of 12 individual, 60 to 90 minute therapy sessions. The program includes several components: information about how PTSD symptoms and substance use interact with one another; information about the most common reactions to trauma; techniques to help the patient manage cravings and thoughts about using alcohol or drugs; coping skills to help the patient prevent relapse to substances; a breathing retraining relaxation exercise; and in vivo (real life) and imaginal exposures to target the patient's PTSD symptoms.

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families.