Addressing PTSD with Concurrent Substance Use Following Occupational Trauma

Dr. Hester Dunlap September 13th 1:30-3:00pm Clipper Room


It is common for PTSD and Substance Use Disorders to co-occur among individuals attending treatment for operational stress injuries. This presentation will discuss common presenting issues in the context of treatment following occupational trauma and the relationship between PTSD and Substance Use. The empirical literature examining recommended treatments for comorbid addiction and traumatic stress will be reviewed. Clinical considerations when addressing both in treatment will be discussed including stigma challenges specific to the respective conditions,  addressing safety, and optimizing relapse prevention.

Learning Objectives:

Participants will be able to:
1. Describe particular issues related to stigma for addiction and operational trauma
2. Identify key components in recommended treatments and integrated approaches for PTSD with co-occurring addiction
3. Name findings from the literature regarding safety and relapse prevention as well as practical considerations to optimize these


American Psychiatric Association. (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults.

Back, S., Foa, E., Killeen, T., et al. (2014). Concurrent treatment of PTSD and substance use disorders using prolonged exposure (COPE): A treatment manual. Oxford University Press

Back, S., Killeen, T., Teer, A., et al. (2014). Substance use disorders and PTSD: An exploratory study of treatment preferences among military veterans. Addictive Behaviors, 39, 369–373.

Flanagan, J., Korte, K., Kileen, T. & Back, S. (2016). Concurrent Treatment of Substance Use and PTSD. Current Psychiatry Reports

Najavits, L. & Hien, D. (2013). Helping Vulnerable Populations: A Comprehensive Review of the Treatment Outcome Literature on Substance Use Disorder and PTSD. Journal of Clinical Psychology, 69, 433 – 479

D., Snead, A., Allan, N., et all (2017). Integrated, exposure-based treatment for PTSD and comorbid substance use disorders: Predictors of treatment dropout, Addictive Behaviors, 73, 30-35.

Lozano, B., Gros, D., Kileen, T, Jaconis, M. (2015). To Reduce or Abstain? Substance Use Goals in the Treatment of Veterans With Substance Use Disorders, American Journal on Addiction, 24, 578-581.

Kaysen, D., Schumm, J., Pedersen, E., Sein, R, et al. (2014). Cognitive Processing Therapy for veterans with comorbid PTSD and alcohol use disorders, Addictive Behaviors, 39, 420-427.

Killeen, T., Back, S., Brady, K. (2015). Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs. Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston.


Dr. Dunlap is the Lead Psychologist in the Trauma and Psychological Injury Program at Bellwood Health Services. She provides residential treatment for Operational Stress Injuries among veterans and first responders. She is the former Clinic Head of the Work, Stress, and Health Program at the Centre for Addiction and Mental Health and has been providing assessment and treatment following occupational trauma for over 10 years. She has extensive experience working with stress related disorders including PTSD, depression, anxiety, substance use, and chronic pain.

Recovery Capital Conference – Toronto 

September 13th and 14th, 2018

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 Recovery Capital Conference of Canada – Toronto Conference Centre