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Prospective effects of traumatic event re‐exposure and post‐traumatic stress disorder in syringe exchange participants
Author(s) -
Peirce Jessica M.,
Brooner Robert K.,
Kolodner Ken,
Schacht Rebecca L.,
Kidorf Michael S.
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2012.04003.x
Subject(s) - medicine , traumatic stress , heroin , prospective cohort study , substance abuse , odds ratio , psychiatry , confidence interval , cohort study , drug
Aim Determine the effect of traumatic event re‐exposure and post‐traumatic stress disorder ( PTSD ) symptom severity on proximal drug use and drug abuse treatment‐seeking in syringe exchange participants. Design Prospective longitudinal 16‐month cohort study of new syringe exchange registrants enrolled in a parent study of methods to improve treatment engagement. Setting Data were collected in a research van next to mobile syringe exchange distribution sites in Baltimore, Maryland. Participants Male and female ( n = 162) injecting drug users ( IDU s) registered for syringe exchange. Measurements Traumatic event re‐exposure was identified each month with the T raumatic L ife E vents Q uestionnaire. PTSD symptoms were measured with the M odified PTSD S ymptom S cale– R evised, given every 4 months. Outcome measures collected monthly were days of drug use (heroin, cocaine) and drug abuse treatment‐seeking behavior (interest, calls to obtain treatment, treatment participation). Findings Each traumatic event re‐exposure was associated with about 1 more day of cocaine use after accounting for the previous month's cocaine use [same month adjusted B, standard error = 1.16 (0.34); 1 month later: 0.99 (0.34)], while PTSD symptoms had no effect. Traumatic event re‐exposure increased interest in drug abuse treatment [same month adjusted odds ratios with 95% confidence intervals = 1.34 (1.11–1.63)] and calling to obtain treatment [same month 1.58 (1.24–2.01); 1 month later 1.34 (1.03–1.75)]. Each 10% increase in PTSD symptom severity was associated with persistent increased interest in treatment [same month 1.25 (1.10–1.42); 1 month later 1.16 (1.02–1.32); 2 months later 1.16 (1.02–1.32)] and calling to obtain treatment [same month 1.16 (1.02–1.32)]. Neither traumatic events nor PTSD symptoms were associated with participants receiving treatment. Conclusions Becoming exposed again to traumatic events among injecting drug users is associated with an increase in cocaine use up to 1 month later, but drug use is not related to post‐traumatic stress disorder symptoms. Both traumatic event re‐exposure and post‐traumatic stress disorder symptoms predict drug abuse treatment‐seeking behavior for up to 2 months.