Friday, Oct. 28
14:30 – 15:30 (1 hr)
Meeting Room: Sheraton Hall E
Wiplove Lamba*, MD, FRCPC; Ahmed Hassan, MD, FRCPC, MPH
- Medical Expert
At the end of this session, participants will be able to: 1) Describe the controversy in the literature and the different philosophies of care of post-traumatic stress disorder (PTSD) versus complex PTSD; 2) Evaluate the appropriateness of a trauma-informed approach versus treatment for PTSD in someone who uses drugs; and 3) Review the pros and cons of integrated versus sequential treatment for people with opioid use disorder and PTSD.
There is a high comorbidity of trauma of those who use drugs, especially with opioid use disorder. Early trauma increases the risk of people using opiates, and using opioids increases the risk of trauma. In Canada, since the start of COVID, the overdose death rate with opioids has doubled. It is important for psychiatrists to be able to assess and treat the comorbidities, specifically trauma, in an integrated or sequential way, depending on what is indicated. Here, using an interactive, case-based approach, a researcher and a clinician review the evidence for trauma-informed care and post-traumatic stress disorder (PTSD) treatment in people who use drugs. We also describe models that have been implemented to help reduce some of the structural and systemic barriers that prevent access to PTSD treatment. In addition, attendees will be able to describe how they can integrate this knowledge into assessment and treatment in their daily psychiatric practice.
In addition to a thorough literature review of the different evidence-based treatments, we will look at a trauma-informed care approach (seeking safety) in more depth, as well as an actual PTSD treatment (cognitive processing therapy).
- Dahlby L, Kerr T. PTSD and opioid use: implications for intervention and policy. Subst Abuse Treat Prev Policy 2020;15:22.
- Najavits LM. Seeking safety: a treatment manual for PTSD and substance abuse. New York (NY): Guilford Press; 2002.