Substance use disorders and PTSD: an exploratory study of treatment preferences among military veterans

Addict Behav. 2014 Feb;39(2):369-73. doi: 10.1016/j.addbeh.2013.09.017. Epub 2013 Oct 5.


Background: Substance use disorders (SUDs) and Post Traumatic Stress Disorder (PTSD) frequently co-occur among Veterans and are associated with poor treatment outcomes. Historically, treatments for SUDs and PTSD have been delivered sequentially and independently. More recently, however, integrated treatments have shown promise. This study investigated Veterans' perceptions of the interrelationship between SUDs and PTSD, as well as treatment preferences.

Methods: Participants were 35 Veterans of recent military conflicts in Iraq and Afghanistan, and prior operations, who completed the Treatment Preferences Questionnaire as well as an in-depth interview.

Results: The majority (94.3%) perceived a relationship between their SUD and PTSD symptoms. Veterans reported that PTSD symptom exacerbation was typically (85.3%) associated with an increase in substance use, and PTSD symptom improvement was typically (61.8%) followed by a decrease in substance use (p<.01). Approximately 66% preferred an integrated treatment approach.

Conclusions: Although preliminary, the findings provide clinically-relevant information that can be used to enhance the development and provision of care for Veterans with SUDs and PTSD.

Keywords: Military; PTSD; Post traumatic stress disorder; Prolonged exposure; Substance use disorders.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Afghan Campaign 2001-
  • Alcoholism / epidemiology
  • Alcoholism / therapy*
  • Analysis of Variance
  • Chi-Square Distribution
  • Cohort Studies
  • Comorbidity
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Gulf War
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Patient Preference
  • Psychotherapy / methods*
  • Socioeconomic Factors
  • South Carolina / epidemiology
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / therapy*
  • Substance Abuse Treatment Centers
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / therapy*
  • Surveys and Questionnaires
  • Veterans / psychology*
  • Veterans / statistics & numerical data