The impact of post-traumatic stress disorder on treatment outcomes for heroin dependence


Katherine Mills, National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia. E-mail:


Aims  To examine the impact of post-traumatic stress disorder (PTSD) on 2-year treatment outcomes for heroin dependence.

Design  Prospective longitudinal study.

Participants  Data were obtained from a predominantly treatment seeking sample of 615 dependent heroin users who were followed-up at 3, 12 and 24 months (follow-up rates: 89%, 81% and 76%, respectively).

Measurements  Outcomes examined include treatment retention and exposure, substance use, general physical and mental health and employment.

Findings  Despite improvements in substance use, PTSD was associated with continued physical (β− 1.69, SE 0.61, P < 0.01) and mental disability (β− 2.07, SE 0.66, P < 0.01), and reduced occupational functioning (OR 0.67, 95% CI: 0.48–0.93) throughout the 2-year follow-up.

Conclusions  Although conventional treatment services are successful in producing improvements in substance use and associated disability, the disability associated with PTSD remains. An intervention targeting both heroin dependence and PTSD may help to improve the outcomes of those with PTSD.