How patients perceive the relationship between trauma, substance abuse, craving and relapse: a qualitative study

In this qualitative study, patients with comorbid substance use disorder (SUD) and post-traumatic stress disorder (PTSD) were interviewed on their ideas about the link between SUD and PTSD. Although they clearly reported self-medication, they also gave a more complex description of how they believe their PTSD influences their SUD. The results suggest that SUD/PTSD patients believe they did not start using substances because of their experienced traumas or PTSD, but that PTSD symptoms are nonetheless important in the maintenance of their addictions. A clear link exists between craving, relapse, and PTSD symptoms. SUD/PTSD patients would prefer a "whole-person approach" when being treated for their PTSD. It is suggested that the integration of skills training and attention for patients who are fearful of PTSD treatment might improve SUD/PTSD treatment results.