Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders
This survey study (n=121) explored the co-occurrence of PTSD in patients with a substance use disorder (SUD). It was found that SUD patients with PTSD were more likely to use MDMA than those without PTSD and MDMA use was associated with avoidance symptoms. The authors conclude that MDMA use might reflect an attempt to self-medicate to deal with avoidance symptoms however, it may also be the case that MDMA use led to more severe avoidance symptoms.
Authors
- Basedow, L. A.
- Kuitunen-Paul, S.
- Wiedmann, M. F.
Published
Abstract
Background
Adolescent patients with a substance use disorder (SUD) often fulfil the criteria for a co-occurring post-traumatic stress disorder (PTSD). However, it is not clear if these dual-diagnosed adolescents present with unique levels of substance use and how their substance use relates to PTSD symptom clusters.
Objective
To investigate substance use in adolescents with co-occurring PTSD and SUD. Additionally, we explored how the use of specific substances is related to specific PTSD symptom clusters.
Method
We recruited n = 121 German adolescent SUD patients, in three groups: no history of traumatic events (TEs) (n = 35), TEs but not PTSD (n = 48), probable PTSD (n = 38). All groups were administered a trauma questionnaire and were asked to report their past-month substance use.
Results
Adolescents with probable PTSD and SUD report a higher frequency of MDMA use than adolescents with no PTSD and no TE (PTSD vs. no TE: U = 510.5, p = .016; PTSD vs. TE: U = 710.0, p = .010). The use of MDMA was more frequent in adolescents with avoidance symptoms (X2 (1) = 6.0, p = .014). Participants report using substances at a younger age (PTSD vs. no TE: U = 372.0, p = .001; PTSD vs. TE: U = 653.5, p = .022) and PTSD symptom onset was on average 2.2 years earlier than first MDMA use (t (26) = −2.89, p = .008).
Conclusions
Adolescent SUD patients with probable PTSD are more likely to use MDMA than SUD patients without PTSD. The use of MDMA was associated with reported avoidance symptoms. The first age of MDMA use is initiated after PTSD onset. It is unclear whether the association of MDMA use with avoidance symptoms is due to efforts to reduce these symptoms or a result of regular MDMA use.
Research Summary of 'Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders'
Introduction
Lukas and colleagues situate their study in the context of frequent co-occurrence between post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) in adolescents, noting that 20–54% of adolescent SUD patients may meet PTSD criteria while about 30% of adolescent PTSD patients present with SUD. They outline three explanatory frameworks for this co-occurrence: shared genetic or environmental risk, increased exposure to traumatic events (TEs) via high‑risk behaviour, and the self‑medication hypothesis in which PTSD symptoms precede and motivate substance use. The authors note that prior work has established greater SUD severity in adolescents with co-occurring PTSD, but that little is known about the use of specific substances in relation to specific PTSD symptom clusters (intrusion, avoidance, hyperarousal) in this age group. This cross‑sectional exploratory study therefore set out to compare past‑month substance use frequencies across three subgroups of treatment‑seeking adolescent SUD patients — those without trauma exposure (NoTE), those with trauma exposure but not PTSD (TE), and those with probable PTSD — and to examine whether use of particular substances relates to the three PTSD symptom clusters. A secondary aim was to compare ages of first substance use across groups and to test whether onset of PTSD symptoms preceded first use of particular substances, as predicted by the self‑medication hypothesis.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- APA Citation
Basedow, L. A., Kuitunen-Paul, S., Wiedmann, M. F., Roessner, V., & Golub, Y. (2021). Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2021.1968140
References (6)
Papers cited by this study that are also in Blossom
Carlyle, M., Stevens, T., Fawaz, L. et al. · Journal of Psychopharmacology (2019)
Kuypers, K. P. C., Ramaekers, J. G. · Journal of Psychopharmacology (2005)
Mitchell, J., Bogenschutz, M. P., Lilienstein, A. et al. · Nature Medicine (2021)
Papaseit, E., Pérez-Mañá, C., Mateus, J. A. et al. · Neuropsychopharmacology (2016)
Stewart, L., Ferguson, B., Morgan, C. J. A. et al. · Journal of Psychopharmacology (2014)
Vizeli, P., Liechti, M. E. · Journal of Psychopharmacology (2017)
Cited By (1)
Papers in Blossom that reference this study
Kangaslampi, S., Zijlmans, J. · European Child and Adolescent Psychiatry (2023)
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