Rural Center of Excellence on SUD Treatment
UVM CORA Co-occurring PTSD and OUD Toolkit

Educational Resources

Below, we provide links to information and educational resources on a variety of topics related to posttraumatic stress disorder (PTSD) and the co-occurrence of PTSD and opioid use disorder (OUD) and other substance use disorders. We also provide information and tools that may be particularly helpful for providers and staff in rural communities who are treating individuals with co-occurring PTSD and OUD.

Below we provide links to two of the most recent guidelines for the assessment, prevention, and treatment of PTSD in adults. Both guidelines have been updated recently and offer specific recommendations for treating PTSD with co-occurring conditions (e.g., substance use disorders). These guidelines are based on systematic reviews of the scientific evidence.

Educational materials can be provided to all patients who are experiencing trauma-related difficulties. Below, we provide links to resources that are accessible and easy-to-understand for patients and families of people with PTSD. These resources provide an overview of the signs and symptoms, risk factors, and treatment options for PTSD and may be useful for facilitating clinical conversations. Several of these resources may also be helpful for addressing concerns that patients have about beginning trauma treatment. We also provide resources with information about how individual differences shape the ways people experience and respond to trauma.

  1. International Society for Traumatic Stress Studies: Trauma During Adulthood
  2. National Institute of Mental Health (NIMH): Post-Traumatic Stress Disorder
  3. SAMHSA: What is PTSD?
  4. National Center for PTSD: PTSD Basics
  5. National Center for PTSD: PTSD Treatment Basics
  6. National Center for PTSD: PTSD Treatment Decision Aid
  7. Department of Health and Human Services, Office on Women’s Health: Information about PTSD that is specific to women
  8. American Psychological Association: PTSD Treatment: Information for Patients and Families
  9. National Center for PTSD: Understanding PTSD: A Guide for Family and Friends
  10. International Society for Traumatic Stress Studies (videos): Survivors Talk About Trauma
  11. U.S. Department of Veterans Affairs: Parenting and PTSD
  12. VA Podcast Series: PTSD Bytes

Adverse childhood experiences and trauma are associated with substance use. Physical and sexual violence, child abuse or neglect, and family or social conflict are related to an increased risk for developing a substance use disorder. Below, we provide links to resources for providers as well as patients who are interested in better understanding the connection between stressful events, traumatic events, and substance use. These resources provide an overview of adverse childhood experiences, stress and trauma, and the relationship between trauma and substance use disorders.

The U.S. opioid crisis continues as opioid-related overdose deaths and health costs have reached staggering levels. There is growing recognition that co-occurring mental health conditions such as PTSD are associated with adverse opioid-related outcomes. The resources provided below are geared toward medications for opioid use disorder (MOUD) and mental health treatment providers. They provide an overview of the literature examining the relationship between opioid use and PTSD and the effect of co-occurring PTSD on MOUD treatment outcomes, evidence-based recommendations for integrated care for both PTSD and OUD, and innovative approaches to providing care for co-occurring PTSD and OUD in rural settings.

In addition to OUD, it is well-established that PTSD often co-occurs with other SUDs. This co-occurrence is associated with a worse, more costly, and more complex clinical course than either disorder alone. The resources provided below are intended for treatment providers who are interested in learning more about the co-occurrence of PTSD and other SUDs. They provide an overview of the prevalence and characteristics of PTSD in people with SUDs. They also summarize conceptual frameworks, assessment, and evidence-based behavioral and pharmacological treatments for co-occurring PTSD and SUD.

In addition to educational materials about PTSD generally, it may be helpful to provide patients with educational materials with specific information about the co-occurrence of PTSD and SUDs. Below, we provide links to resources that are accessible and easy-to-understand for patients and families of people with PTSD. These resources provide definitions of substance use problems, an overview of the relation between substance use and trauma, the effect of substance use on the symptoms of traumatic stress, how these problems can affect important relationships, and treatment options for people with co-occurring PTSD and SUD. These resources may be provided to patients or used to facilitate clinical conversations.

Rural healthcare providers who treat people with PTSD face unique challenges. By recognizing the challenges and benefits specific to rural healthcare, you may be better equipped to adapt your own practice, reduce barriers to care, and provide more effective treatment to people with PTSD. Below we provide information and resources that may be particularly helpful to rural healthcare providers. These resources include published guidelines for delivering evidence-based PTSD treatment via telehealth, a toolkit designed specifically for rural PTSD treatment providers, an overview of challenges and opportunities that may inform evidence-based practice in rural locations, a tool to help identify other treatment providers in your community, and VA-developed apps that can be used in conjunction with therapy to improve adherence to treatment and skill development.