Although research has demonstrated a significant relationship between physical/sexual abuse and substance use disorders, there is a dearth of studies exploring whether symptoms of post-traumatic stress disorder, depression, or anxiety increase in programs that integrate trauma therapy with substance abuse treatment. In this multisite clinical trial, researchers recruited 353 women to examine whether adverse events were more common in patients enrolled in a combined treatment program compared with women enrolled in non–trauma-focused treatment. 

• No difference was seen in the number of women reporting study-related adverse events between the 2 groups.
• Of the 353 participants, only 17% experienced any study-related adverse events.
• Only 8 of all participants reported increased substance use while undergoing treatment.
• No relationship was demonstrated between number of study-related adverse events and length of treatment.

Comments by Norma Finkelstein, PhD, LICSW
Substance-abuse treatment providers frequently express concern that simultaneously addressing trauma will open a Pandora's box, contributing to increased mental health symptoms, substance use, and other negative consequences. This study provides evidence that this is not the case. It is important to note that the trauma intervention in this study was cognitive-behavioral rather than exposure-based, which may have resulted in the observed outcomes. Further research on the efficacy of various kinds of trauma treatment for women with substance use disorders is needed.