Evidence map›Paper›PMID 36989699›Full record

Trial reportAddictive behaviors2023

Prolonged exposure therapy for PTSD in individuals with opioid use disorder: A randomized pilot study.

Kelly R Peck, Gary J Badger, Rebecca Cole, Stephen T Higgins, Nathaniel Moxley-Kelly, Stacey C Sigmon

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Addictive behaviors, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kelly R PeckDepartment of Psychiatry, University of Vermont, 1 S. Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 2 Colchester Avenue, Burlington, VT 05401, United States. Electronic address: Kelly.Peck@uvm.edu.
Gary J BadgerDepartment of Medical Biostatistics, University of Vermont, 105 Carrigan Drive, Burlington, VT 05405, United States.
Rebecca ColeDepartment of Psychiatry, University of Vermont, 1 S. Prospect Street, Burlington, VT 05401, United States.
Stephen T HigginsDepartment of Psychiatry, University of Vermont, 1 S. Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 2 Colchester Avenue, Burlington, VT 05401, United States.
Nathaniel Moxley-KellyDepartment of Psychological Science, University of Vermont, 2 Colchester Avenue, Burlington, VT 05401, United States.
Stacey C SigmonDepartment of Psychiatry, University of Vermont, 1 S. Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 2 Colchester Avenue, Burlington, VT 05401, United States.

Funding

Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI HIGGINS, STEPHEN T · 2013 to 2022
$21.3M
TRAINING IN BEHAV. PHARMACOLOGY OF HUMAN DRUG DEPENDENCET32DA007242 · NIDA · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI HEIL, SARAH H, HIGGINS, STEPHEN T · 1990 to 2025
$8.2M
NIDA NIH HHS T32 DA007242NIGMS NIH HHS P20 GM103644
6 · The paper itself

Abstract

objectiveNearly all individuals with opioid use disorder (OUD) report lifetime trauma exposure and one-third meet diagnostic criteria for posttraumatic stress disorder (PTSD). Although prolonged exposure (PE) therapy is a first-line treatment for PTSD, little is known about the effects of PE in individuals with co-occurring OUD. Furthermore, its efficacy is commonly undermined by poor therapy attendance. This pilot study evaluated the feasibility and initial efficacy of a novel PE protocol for improving PE attendance and PTSD symptoms among buprenorphine- or methadone-maintained adults with PTSD.

methodThirty participants with co-occurring PTSD and OUD were randomized to receive either: (a) continued medications for OUD (MOUD) treatment as usual (TAU), (b) Prolonged Exposure therapy (PE), or (c) PE with financial incentives delivered contingent upon PE session attendance (PE+). Primary outcomes included PE session attendance, PTSD symptom severity, and use of opioids other than prescribed MOUD.

resultsPE+ participants attended significantly more therapy sessions vs. PE (87% vs. 35%; p <.0001). PTSD symptom reductions were also significantly greater in the PE+ vs. TAU group (p =.046). Participants in the two PE conditions submitted significantly fewer urine samples that tested positive for opioids than TAU participants (0% vs. 22%; p =.007).

conclusionsThese findings provide preliminary support for the efficacy of PE+ for improving PE attendance and PTSD symptoms without prompting opioid relapse in individuals with co-occurring PTSD and OUD. These promising results justify a larger scale randomized clinical trial to more rigorously evaluate this novel treatment approach.

Indexed as

Implosive TherapyOpioid-Related DisordersStress Disorders, Post-TraumaticAdultAnalgesics, OpioidHumansPilot ProjectsTreatment OutcomeAnalgesics, OpioidBuprenorphineFinancial incentivesMethadoneOpioid use disorderPosttraumatic stress disorderProlonged exposure therapy

Identifiers

PMID36989699
PMCPMC10291821

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.