HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2020, 22, N3 (pages: 37 - 48)

Prominent Psychopathological and Clinical Characteristics of Heroin Post-Traumatic Stress Disorder Spectrum Patients During Treatment

Maremmani I., Cecchini L., Avella M.T., Novi M., Ciapparelli A., and Maremmani A.G.I.

Summary: Introduction: The overlap between stress and reward system has been documented with growing evidence. Alterations in stress system may increase the vulnerability to drug addiction but harmful drug use may impact on stress reactivity. Methods: The main purpose of this study was to estimate the extent of differences between Heroin Use Disorder (HUD) patients who presented, during the treatment, a Post Traumatic Stress Disorder spectrum (H/PTSD-S) and those who did not. These two groups were compared, using standardized instruments, at univariate and multivariate levels, regarding the natural history of the disorder, the psychopathology and the craving-related behaviors during a treatment with opioid agonist medications (AOT). Results: H/PTSD-S patients were more frequently women without partners and with blue-collar or unemployed jobs. They showed problematic social adjustment and in their natural course of heroin addiction showed increased harmful substance use, especially with regard to benzodiazepines. If they maintained addictive behaviors during treatment, risky-, exchange- and time-behaviors were prominent and were characterized by the inappropriate use of no-rewarding substances when rewarding or substitute drugs came to lack. In addition, they maintained a boost to the use of opioids when stimulated by heroin presence or being in contact with people who intake heroin. Finally, these patients maintained a greater severity of psychopathology during treatment. Conclusion: Detecting of an abnormal stress reaction in HUD patients (H/PTSD-S) may be proposed as a suitable means of monitoring treatment outcomes and effectiveness.