Co-morbid post-traumatic stress disorder and opioid dependence syndrome

Post-traumatic stress disorder (PTSD) is common among patients with opioid dependence syndrome. The aim of this study was to find the prevalence of PTSD in patients with opioid dependence and to examine the relationship of PTSD with the severity of dependence on opioids in patients attending an outpatient clinic for drug treatment services. An interview using the Maudsley Addiction Profile, the Severity of Dependence Scale, the Impact of Events Scale, and ICD-10 clinical criteria was conducted in a large urban center for addiction treatment in the central United Kingdom. Seventy patients with opioid dependence syndrome were interviewed. On interview, 30% of the patients met ICD-10 criteria for PTSD. Clinically significant levels of intrusive (45.7%) and avoidant (65.7%) symptoms were reported. Participants with PTSD reported higher perceived rate of childhood threat to life including sexual abuse, physical abuse, and witnessing physical fights between parents. In adulthood, the main traumatic events were physical injuries and rape. One-third of this sample of opioid-dependent patients receiving methadone treatment met criteria for a diagnosis of PTSD, with clinically significant self-reported symptoms of intrusion and avoidance. As in other samples, the co-morbidity of PTSD and opioid use is much more common and warrants further study in the area of etiology and management.