ABSTRACT
INTRODUCTION AND AIMS: Posttraumatic stress disorder (PTSD) is frequently linked with substance abuse. The self-medication hypothesis suggests that some people may use illicit substances in an attempt to self-treat psychiatric symptoms. This study explores the relationship between substance abuse and PTSD symptom clusters in a methadone maintenance population. DESIGN AND METHODS: Clients of a methadone maintenance program at a public Drug and Alcohol Service were invited to complete the PTSD Checklist-Civilian Version, a screening tool for PTSD. Information about their history of substance use was also collected. RESULTS: Eighty clients (43 female, 37 male), aged 35 ± 8.0 years (mean ± SD), participated in the study, of which 52.7% screened positive for PTSD. Severity of marijuana use was significantly associated with a number of reexperiencing and hyperarousal symptoms and with overall severity of PTSD symptoms. Opiate, amphetamine, and benzodiazepine use did not appear to be related to PTSD symptoms. DISCUSSION AND CONCLUSIONS: In this sample, marijuana may be used to self-treat certain PTSD symptoms, supporting the self-medication hypothesis. Further research is required to confirm the association between a diagnosis of PTSD and substance use. Given the high prevalence of PTSD in the substance-using population, routine PTSD screening in the substance abuse treatment setting may be justified.
Subject(s)
Stress Disorders, Post-Traumatic/diagnosis , Substance-Related Disorders/diagnosis , Adult , Analgesics, Opioid/therapeutic use , Cannabis , Comorbidity , Diagnosis, Dual (Psychiatry) , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Methadone/therapeutic use , Self Medication/psychology , Self Report , Severity of Illness Index , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Substance-Related Disorders/drug therapy , Substance-Related Disorders/psychologyABSTRACT
Abstract Objective. Comorbid mental illness amongst methadone maintenance therapy clients may be common and screening may be warranted. The Mood Disorders Questionnaire (MDQ) is a screening tool for bipolar disorder that has been validated in other treatment settings. Its utility for patients with substance use disorders is assessed in this study. Methods. Clients of a methadone maintenance program were invited to complete the MDQ when they attended a public Drug and Alcohol Service for their regular scheduled appointments. Information about their history of substance use was also collected. Results. Eighty clients (43 females, 37 males) aged 35 ± 8.0 years (mean ± SD) participated in the study. Seventy-four clients completed the MDQ of which 36 (48.6%) obtained a positive screen. A check of client files suggested that only three of the 74 participants had a current working diagnosis of bipolar disorder. These three participants had screened positive on the MDQ. Conclusions. There was a high prevalence of manic symptoms reported by participants, suggesting that screening for bipolar disorder in this population may be warranted. However, there is a risk of false positives with the MDQ, as it does not clearly differentiate between symptoms of mania and drug intoxication.
