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RTI research sheds new light on best treatments for comorbid PTSD and alcohol and drug use

Optimal outcomes were observed when combining trauma-focused therapies with alcohol-targeted pharmacotherapies

RESEARCH TRIANGLE PARK, N.C. — Researchers at RTI International, a nonprofit research institute, have authored a new paper to determine the best treatments for comorbid post-traumatic stress disorder (PTSD) and alcohol and other drug use (AOD). The findings were published by the American Journal of Psychiatry.  

The first-of-its-kind paper, titled “Project Harmony: A Meta-Analysis With Individual Patient Data on Behavioral and Pharmacologic Trials for Comorbid Posttraumatic Stress and Alcohol or Other Drug Use Disorders,” presents an individual patient meta-analysis of data from 36 clinical trials.

“Our study addressed the limitations that come with using summary data for evidence reviews by being the first in this field to pool data from over 4,000 individual patients,” said Antonio Morgan-Lopez, Ph.D., the lead RTI researcher on the paper and RTI Fellow, quantitative psychology. “Our research uncovered previously unknown synergies between the combination of trauma-focused behavioral therapies and AOD-targeted pharmacotherapies.”

Compared with treatment as usual, combining trauma-focused therapy and pharmacotherapy for substance use disorders showed the largest comparative reductions for PTSD severity and alcohol use severity at end of treatment; these effects were sustained after one year. Other treatments that showed comparable reductions included pharmacotherapies for alcohol or other drug use disorders, trauma-focused integrated therapies and trauma-focused non-integrated therapies.

“The findings send an important message to addiction treatment providers about the need to incorporate a trauma-informed perspective for optimal outcomes when treating comorbid PTSD and substance use disorders using a variety of available approaches,” said Lissette Saavedra, Ph.D., senior research psychologist and RTI co-investigator. “Further analysis of these data are needed to uncover the ‘active ingredients’ for each therapy and which treatment(s) are most optimal, particularly for minoritized and vulnerable populations.”

Read the full paper