A collaborative multi-site randomized controlled trial at the University of Houston and the Medical University of South Carolina is set to prove the effectiveness of treating alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) together.
It's a one-two punch whose time has come. No integrative treatment combining Cognitive processing therapy (CPT) for PTSD and relapse prevention (RP) for AUD currently exists.
A substantial proportion of individuals with AUD also meet criteria for PTSD. The co-occurrence of AUD/PTSD is characterized by more severe symptomatology, greater functional impairment, increased suicide risk, and poorer treatment outcomes as compared to either disorder alone."
Anka Vujanovic, Professor of Psychology and Director of the Trauma and Stress Studies Center at the University of Houston
She and Sudie Back, professor of psychiatry and behavioral sciences at MUSC, have received a grant of $3,461,217 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to conduct the randomized clinical trial.
"Cognitive processing therapy for PTSD and relapse prevention for AUD are two of the most widely used and efficacious behavioral treatments for these conditions," said Back. Vujanovic successfully developed and pilot tested a therapy manual that combines CPT with RP. "The preliminary data demonstrate safety, feasibility, high rates of retention and patient satisfaction," said Back.
The trial's primary objective is to examine the efficacy of CPT-RP, as compared to RP alone, in reducing alcohol use frequency and quantity and PTSD symptom severity among individuals with current AUD/PTSD.
The team will also evaluate behavior change on a daily basis using innovative mobile technology.
"This study aligns closely with the mission of NIAAA in that it aims to produce maximally efficacious behavioral interventions for AUD and comorbid psychiatric disorders such as PTSD. The findings from this study will provide new information to advance the science of AUD/PTSD comorbidity and innovate clinical practice," said Vujanovic.
"The intervention to be tested is supported by promising preliminary data and a high level of enthusiasm from national providers, conferring strong potential for uptake in diverse clinical settings and delivery by a range of clinical providers," Back said.
The findings have the potential to open a new avenue of trauma-focused integrative treatment for AUD/PTSD and significantly enhance patient reach, retention and clinical outcomes, according to the team.
Binge drinking in high school linked to risky drinking in midlife