Characterizing and Comparing Evidence-Based Psychotherapy Utilization Among Veterans with Co-occurring PTSD and Substance Use Disorder

Abstract

Objective: The current study sought to describe a nationally representative sample of Veterans diagnosed with co-occurring PTSD and substance use disorder (SUD) who initiated and completed evidence-based psychotherapy (EBP) for PTSD, and explored whether completion rates differed by SUD subtype. Methods: Using electronic health record data from the Veterans Health Administration (VHA) Corporate Data Warehouse, Veterans with a dual diagnosis of PTSD and SUD who initiated either Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) between January 01, 2019 and July 16, 2019 were identified (N = 2,996). Logistic analyses were employed to determine whether there were differences in EBP completion rates among Veterans with an alcohol use disorder (AUD; n = 1,383) versus all other SUDs (n = 1,613). Results: On average, Veterans were 45 years old, and identified as male, White, and non-Hispanic. Logistic regression analyses revealed there was not a significant difference between Veterans with AUD only and other SUDs in the probability of completing EBP treatment, OR = 1.02, 95% CI =0.87, 1.17, p = 0.79. Conclusions: No differences in EBP completion rates were observed between SUD subtypes, indicating that EBPs for PTSD are tolerated well for individuals with various types of SUDs and may be offered as treatment options.

Keywords:

• Posttraumatic stress disorder
• substance use disorder
• treatment utilization
• co-occurring disorders
• veterans

Declaration of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by a VHA Rehabilitation Research & Development Career Development Award [1 IK2 RX002762-01A1] to Dr. Maya O’Neil. Drs. Vanessa Somohano, Lauren Denneson, Travis Lovejoy, and Maya O’Neil are also supported by the VA Health Services Research & Development (HSR&D) Center to Improve Veteran Involvement in Care (CIVIC) at the VA Portland Health Care System. Dr. O’Neil is also supported by the Department of Veterans Affairs VISN 20 Northwest Mental Illness Research, Education, and Clinical Center (MIRECC). Dr. Somohano is also supported by a VA Clinical Science Research and Development (CSR&D) Diversity Supplement (award SDR-SPTD-S20). This material is the result of work supported with resources and the use of facilities at the VA Portland Healthcare System. The contents do not represent the views of the US Department of Veterans Affairs or the United States Government.