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Study: PTSD Exposure Therapy Does Not Trigger Drug Relapse

July 28, 2020

Prolonged exposure therapy for post-traumatic stress disorder (PTSD) did not cause relapses in patients with co-occurring substance use disorder (SUD), according to a study published online in the Journal of Traumatic Stress.

“These findings indicate that the concern that exposure therapy for PTSD will increase SUD patients’ substance use or other psychiatric symptoms may be unwarranted, and, thus, SUD patients, including those who are actively using, should have access to effective treatments for PTSD, like prolonged exposure,” wrote researchers from Johns Hopkins University and the University of Maryland, Baltimore.

The study looked at within-session and session-to-session changes in craving and use of substances in a range of drug classes, as well as symptoms of PTSD and other distress, in 44 patients with PTSD and SUD receiving prolonged exposure therapy.

Traumatic Experiences May Disrupt Brain’s Memory Control System

The study showed no increase in substance use or in reported stress after prolonged exposure therapy sessions. No within-session increases in cravings, except for cocaine, occurred within session 8. Across sessions, cravings for heroin, methadone, benzodiazepines, and cocaine dropped, researchers reported.

By session 9, PTSD severity scores decreased an average 54% compared with session 1.

“Now that we have evidence that treating PTSD won’t impact recovery, patients can request therapy, and mental health providers have a duty to make it available to their patients,” said  researcher Jessica Peirce, PhD, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “There is a lot more resilience within this population than many health care providers give them credit for, and not offering the proper treatment is doing patients a disservice.”

—Jolynn Tumolo


Peirce JM, Schacht RL, Brooner RK. The effects of prolonged exposure on substance use in patients with posttraumatic stress disorder and substance use disorders. Journal of Traumatic Stress. 2020 June 29;[Epub ahead of print].

Traditional PTSD therapy doesn’t trigger drug relapse [press release]. Baltimore, Maryland: Johns Hopkins Medicine; July 20, 2020.

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