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Vogel, Lea; Koller, Gabriele and Ehring, Thomas (2021): The relationship between posttraumatic stress symptoms and craving in patients with substance use disorder attending detoxification. In: Drug and Alcohol Dependence, Vol. 223, 108709

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Abstract

Background: Substance use disorder (SUD) and posttraumatic stress disorder (PTSD) are highly comorbid. Self-medication hypothesis (SMH) is a seminal theory aiming to account for the relationship between these disor-ders. The current study examined hypotheses based on SMH in SUD patients during the very first days of detoxification. Based on SMH we expected a positive association between PTSD and craving concurrently as well as on each following day. Methods: A time series with 108 SUD patients used daily self-report questionnaires assessing PTSD symptom severity (PCL-5) and craving (MaCs) for six consecutive days. Daily associations between PTSD symptom severity and craving on the same and on the following day during the first week of detoxification were estimated using linear mixed models . Results: There was a significant decrease in PTSD symptom severity during detoxification (ss =-2.06, p < 0.001). Further, PTSD symptom severity predicted craving on the same day (ss = 0.36, p < 0.001) but did not predict craving on the next day (ss =-0.01, p = 0.82). Conclusion: Results of the current study only partially support assumptions based on SMH, and points towards a more complex and reciprocal relationship between PTSD and SUD.

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