Posttraumatic stress disorder and substance use disorder are challenging disorders for any individual on their own, and they often become comorbid as individuals use substances to cope with PTSD symptoms. This comorbidity increases the dysfunction substantially. There is currently no gold standard treatment available for this comorbidity, so there is a great need for a treatment that effectively addresses both of these disorders at the same time. A literature review was conducted to examine psychotherapy and medication treatments for this comorbidity. The main treatments were COPE (a form of psychotherapy for PTSD with added elements of substance use education and relapse prevention techniques), CBT (psychotherapy focused on changing patterns of thinking and behavior), Structured Writing Therapy (psychotherapy that involves journaling around PTSD), oxytocin (a neuropeptide that attenuates HPA axis dysregulation), sertraline (an SSRI that can be used to treat co-occurring symptoms of alcohol dependence and PTSD), and naltrexone (an opiate antagonist that can treat alcohol dependence). With respect to both PTSD and substance use, we conclude that COPE has the most evidence for better symptom reduction and the best remission rates. This is a preliminary conclusion; more research is needed in this area of treatment due to the few studies currently completed on the topic.
