Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders
Lukas A Basedow, Sören Kuitunen-Paul, Melina Wiedmann, Veit Roessner, Yulia Golub
European Journal of Psychotraumatology 2021 DOI: 10.1080/20008198.2021.1968140 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 121 |
| Population | German adolescent patients with a substance use disorder |
| Topics | Addiction MDMA PTSD |
| Citations | 15 |
| Key findings | Adolescents with co-occurring probable PTSD and substance use disorder report higher frequency of MDMA use and younger age of first substance use than those without PTSD. |
Abstract
ABSTRACT
Background: Adolescent patients with a substance use disorder (SUD) often fulfil the criteria for a co-occurring post-traumatic stress disorder (PTSD). However, it is not clear if these dual-diagnosed adolescents present with unique levels of substance use and how their substance use relates to PTSD symptom clusters.
Objective: To investigate substance use in adolescents with co-occurring PTSD and SUD. Additionally, we explored how the use of specific substances is related to specific PTSD symptom clusters.
Method: We recruited n = 121 German adolescent SUD patients, in three groups: no history of traumatic events (TEs) (n = 35), TEs but not PTSD (n = 48), probable PTSD (n = 38). All groups were administered a trauma questionnaire and were asked to report their past-month substance use.
Results: Adolescents with probable PTSD and SUD report a higher frequency of MDMA use than adolescents with no PTSD and no TE (PTSD vs. noTE: U = 510.5, p = .016; PTSD vs. TE: U = 710.0, p = .010). The use of MDMA was more frequent in adolescents with avoidance symptoms (X2 (1) = 6.0, p = .014). Participants report using substances at a younger age (PTSD vs. noTE: U = 372.0, p = .001; PTSD vs. TE: U = 653.5, p = .022) and PTSD symptom onset was on average 2.2 years earlier than first MDMA use (t (26) = −2.89, p = .008).
Conclusions: Adolescent SUD patients with probable PTSD are more likely to use MDMA than SUD patients without PTSD. The use of MDMA was associated with reported avoidance symptoms. The first age of MDMA use is initiated after PTSD onset. It is unclear whether the association of MDMA use with avoidance symptoms is due to efforts to reduce these symptoms or a result of regular MDMA use. HIGHLIGHTS We investigated substance use in adolescents with substance use disorders. We observed increased MDMA use and a younger age of first substance use in participants with additional PTSD. Additionally, MDMA use was associated with the presence of specific PTSD symptoms.
Comparable studies
Other observational and cohort studies on MDMA for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Death rates from ecstasy (MDMA, MDA) and polydrug use in England and Wales 1996–2002 Ecstasy-related fatalities in England and Wales, August 1996–April 2002 | 2003 | Observational cohort | n = 202 |
| Screened Attention Deficit/Hyperactivity Disorder as a Predictor of Substance Use Initiation and Escalation in Early Adulthood and the Role of Self-Reported Conduct Disorder and Sensation Seeking: A 5-Year Longitudinal Study with Young Adult Swiss Men Young Swiss men aged 20 at baseline and 25 at follow-up | 2020 | Observational cohort | |
| Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users. 34 regular, largely pure MDMA users and 36 age-, sex-, and education-matched MDMA-naive... | 2023 | Case-control study | n = 70 |
| Intensity dependence of auditory evoked dipole source activity in polydrug ecstasy users: evidence from an 18 months longitudinal study. Polydrug ecstasy users | 2006 | Observational cohort | n = 18 |