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Case report
peer-reviewed

Comorbid Post-Traumatic Stress Disorder and Opioid Dependence



Abstract

Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.



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Case report
peer-reviewed

Comorbid Post-Traumatic Stress Disorder and Opioid Dependence


Author Information

Rikinkumar S. Patel Corresponding Author

Department of Psychiatry, Northwell Zucker Hillside Hospital

Department of Global Public Health, Arcadia University

Ahmed Elmaadawi

Psychiatry, Beacon Health System

Suhayl Nasr

Psychiatry, Beacon Health System

John Haskin

Psychiatry, Beacon Health System


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.


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Case report
peer-reviewed

Comorbid Post-Traumatic Stress Disorder and Opioid Dependence

  • Author Information
    Rikinkumar S. Patel Corresponding Author

    Department of Psychiatry, Northwell Zucker Hillside Hospital

    Department of Global Public Health, Arcadia University

    Ahmed Elmaadawi

    Psychiatry, Beacon Health System

    Suhayl Nasr

    Psychiatry, Beacon Health System

    John Haskin

    Psychiatry, Beacon Health System


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: September 03, 2017

    DOI

    10.7759/cureus.1647

    Cite this article as:

    Patel R S, Elmaadawi A, Nasr S, et al. (September 03, 2017) Comorbid Post-Traumatic Stress Disorder and Opioid Dependence . Cureus 9(9): e1647. doi:10.7759/cureus.1647

    Publication history

    Received by Cureus: August 05, 2017
    Peer review began: August 17, 2017
    Peer review concluded: August 28, 2017
    Published: September 03, 2017

    Copyright

    © Copyright 2017
    Patel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.



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Create a free account to continue reading this article.

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Rikinkumar S. Patel, M.D.

Department of Psychiatry, Northwell Zucker Hillside Hospital

For correspondence:
rpatel_09@arcadia.edu

Ahmed Elmaadawi

Psychiatry, Beacon Health System

Suhayl Nasr

Psychiatry, Beacon Health System

John Haskin

Psychiatry, Beacon Health System

Rikinkumar S. Patel, M.D.

Department of Psychiatry, Northwell Zucker Hillside Hospital

For correspondence:
rpatel_09@arcadia.edu

Ahmed Elmaadawi

Psychiatry, Beacon Health System

Suhayl Nasr

Psychiatry, Beacon Health System

John Haskin

Psychiatry, Beacon Health System