Influence of Posttraumatic Stress Disorder Severity on Return to Substance Use Immediately Following Residential Substance Use Treatment

The period immediately following residential substance use disorder (SUD) treatment is characterized by high rates of return to substance use. Posttraumatic stress disorder (PTSD) is highly prevalent among individuals in residential SUD treatment and is a primary motive for substance use among individuals with co-occurring PTSD and SUD. Addressing important gaps in the literature, the current study examined the role of PTSD severity on days of substance use during the 30 days immediately following residential SUD treatment over and above demographic, SUD, and clinical factors associated with return to substance use. Participants (N = 65, Mage = 40.6, 52% women, 79% white) completed semi-structured diagnostic interviews for PTSD and SUD and self-report measures of demographics and depression while in residential SUD treatment (approximately one week before discharge), and then a follow-up assessment (timeline follow-back for substance use) approximately one month after discharge. Greater PTSD severity was associated with more days of substance use in the 30 days immediately following residential SUD treatment over and above demographic (i.e., race/ethnicity, gender, employment, housing insecurity), SUD (i.e., alcohol, stimulant, opioid, cannabis, and sedative/hypnotic/anxiolytic use disorder severity), and clinical (i.e., depression severity) factors. Findings underscore the importance of PTSD assessment and intervention during residential SUD treatment and re-entry planning to assist in mitigating return to substance use during community reintegration.