The lived experiences and treatment needs of women with opioid use disorder and posttraumatic stress symptoms: A mixed methods study

Authors

Tanya C. Saraiya, Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, New Jersey, United States of America; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America. Electronic address: tanya.saraiya@rutgers.edu.
Sarah Helpinstill, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America; George Washington University, Washington D.C.
Daphne Gray, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America; California Institute of Integral Studies, San Francisco, California.
Denise A. Hien, Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, New Jersey, United States of America.
Kathleen T. Brady, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States of America.
Caitlyn O. Hood, Department of Psychiatry, University of Kentucky, Lexington, Kentucky, United States of America.
Sudie E. Back, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States of America.

Document Type

Journal Article

Publication Date

3-15-2024

Journal

Journal of substance use and addiction treatment

Volume

161

DOI

10.1016/j.josat.2024.209344

Keywords

Integrated treatment; Opioid use disorder; Posttraumatic stress disorder; Qualitative; Women

Abstract

INTRODUCTION: Women show a gender-specific risk for co-occurring opioid use disorder (OUD) and posttraumatic stress disorder (PTSD). Expert groups have called for the development of integrated treatments for women with OUD/PTSD, but there remains limited information on such interventions. METHODS: This mixed-methods study interviewed and surveyed 10 women with current or past OUD and co-occurring posttraumatic stress symptoms (PTSS) and 16 providers who work with these women. Interviews and surveys queried patient participants' and providers' experiences of OUD/PTSS and how to best design an integrated, trauma-focused treatment for OUD/PTSD. RESULTS: Patient participants (90 % white, 90 % mothers, M = 45.70) met criteria for severe, lifetime OUD and 40 % met a provisional diagnosis for PTSD. Four themes emerged for participants' experiences of OUD/PTSS: 1) numerous stressors; 2) shame; 3) multiple motivations to use opioids; and 4) a cycle of trauma and opioid use. Four themes emerged regarding patient participants' perceptions on the development of an OUD/PTSD treatment: 1) mixed attitudes towards medications for OUD; 2) barriers to treatment (e.g., insufficient treatments and contextual factors); 3) treatment facilitators (e.g., social support); and 4) preferences in treatment (e.g., trauma-focused, gender-focused, family content, ambivalence around group therapy). Providers (M = 38.94) were primarily white women (76.5 %). Two themes emerged from their experiences working with women with OUD/PTSS: 1) perceiving women to use opioids to regulate emotions and 2) gender differences in trauma types. Three themes emerged for providers' perceptions on the development of an OUD/PTSD treatment: 1) barriers to treatment (e.g., chaotic lives, contextual factors, family); 2) treatment facilitators (e.g., trust and external motivations); and 3) desired treatment modifications (e.g., stabilization, early skills in therapy, flexibility in therapy, social supports, safety guidelines, and assistance in identifying an index trauma). Most participants (90.0 %) and providers (93.5 %) preferred working on OUD/PTSD symptoms simultaneously rather than separately. CONCLUSIONS: Findings demonstrate the need to modify integrated treatments to meet the preferences of providers and women with OUD/PTSS and OUD/PTSD. Treatments should consider therapeutic content, structure, contextual factors, social support, and PTSD severity to enhance uptake and reach.

APA Citation

Saraiya, Tanya C.; Helpinstill, Sarah; Gray, Daphne; Hien, Denise A.; Brady, Kathleen T.; Hood, Caitlyn O.; and Back, Sudie E., "The lived experiences and treatment needs of women with opioid use disorder and posttraumatic stress symptoms: A mixed methods study" (2024). GW Authored Works. Paper 4518.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4518

Department

Public Health Student Works