Substance use disorders (SUDs) are highly comorbid with posttraumatic stress disor- der (PTSD). The relationship between substance abuse and trauma is complex and bidirectional, with shared social risk factors and biological pathways. Youth with cooc- curring PTSD and SUD often have more severe challenges than teens with either dis- order alone, with treatment needs that may involve multiple community systems. Integrated treatment principles and recommendations are discussed. Two clinical cases are reviewed to illustrate these treatment principles.
When a dear colleague goes down with a traumatic stress injury, the whole squad suffers. And sadly, those instances of trouble are too common and PTSD has become a familiar acronym for those working as paramedics, police and firefighters.
Posttraumatic stress disorder (PTSD) is defined as a psychiatric disorder; however, PTSD co-occurs with multiple somatic manifestations. People living with PTSD commonly manifest dysregulations in the systems that regulate the stress response, including the hypothalamic-pituitary-adrenal (HPA) axis, and development of a pro-inflammatory state. Additionally, somatic autoimmune and inflammatory diseases and disorders have a high rate of co-morbidity with PTSD. Recognition and understanding of the compounding effect that these disease states can have on each other, evidenced from poorer treatment outcomes and accelerated disease progression in patients suffering from co-morbid PTSD and/or other autoimmune and inflammatory diseases, has the potential to lead to additional treatment opportunities.