TRAUMA AND STRESSOR-RELATED AND SUBSTANCE USE DISORDERS IN ADOLESCENCE: A PRACTITIONER’S GUIDE TO UNDERSTANDING AND TREATING THESE CO-OCCURRING DISORDERS

Abstract

We will review clinical impacts and explore overlapping symptoms and neurobiological functional domains. Practical approaches to engaging families and a transdiagnostic approach to understanding and treating co-occurring trauma and substance use disorders (SUDs) in adolescents will be presented. First, Destiny Pegram, MD, will present a case vignette to demonstrate the interaction of early-life trauma and SUD. She will highlight the prevalence, risk factors, and treatment outcome implications of co-occurring trauma and SUD. Iliyan Ivanov, MD, will provide an update on trauma and SUD in the context of the COVID-19 pandemic. Second, Jesse Hinckley, MD, PhD, will discuss the biologic intersections of trauma and SUD. He will present clinical vignettes to illustrate overlapping symptoms and functional domains, review shared neurobiological factors, and explore how these factors may maintain or exacerbate the co-occurring disorders. Third, Abita Raj, MD, will present video clinical vignettes to demonstrate Solution-Focused Brief Therapy as an evidence-based approach to engage families in the treatment of trauma and SUD. Fourth, Liza Suarez, PhD, will present an integrated treatment approach for youth with traumatic stress and co-occurring substance use problems. Steve Berkowitz, MD, director of the Stress, Trauma, Adversity Research, and Treatment (START) Center at the University of Colorado and co-chair of the AACAP Disaster and Trauma Issues Committee will serve as the discussant. At the end of this Clinical Perspectives, participants will identify the importance of co-occurring trauma and SUD and will better understand the clinical and biological factors that maintain or exacerbate co-occurring disorders. Participants will learn best practices and practical approaches for screening in a trauma-informed process and for implementing Solution-Focused Brief Therapy to engage families in treatment. Participants will be introduced to a transdiagnostic approach to understand and treat co-occurring PTSD and SUD in adolescents through an in-depth case presentation. Trauma and SUD commonly co-occur in youth. There is a need for mental health clinicians to implement trauma-informed screening processes and to identify principles of treating these co-occurring disorders.