Co-Occurring Opioid Use Disorder and Posttraumatic Stress Disorder and the Efficacy of the IPS Supported Employment Model

Co-occurring posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) present unique challenges in employment and treatment retention. Research has begun to explore the use of a vocational model in assisting these individuals to obtain gainful employment and maintain abstinence. The current study is a secondary data analysis of a 24-month prospective cohort, randomized study assessing the efficacy of the individual placement and support (IPS) model. The original trial examined employment outcomes and treatment retention in a clinic population diagnosed with moderate-to-severe OUD who were receiving medication-assisted treatment (MAT). The current study sought to explore the relationship between co-occurring OUD and PTSD, the usefulness of the IPS model in increasing positive employment outcomes, and possible influences on treatment adherence and completion related to co-occurring diagnoses. One-way ANOVA analyses confirmed that individuals with a co-occurring PTSD diagnosis comprised a higher proportion of program dropout/early termination than did individuals without a co-occurring diagnosis. However, individuals with a co-occurring PTSD diagnosis were not less likely to obtain competitive employment outcomes than were individuals without a co-occurring diagnosis. These findings suggest the importance of additional research to better understand the unique risk and protective factors for individuals with co-occurring diagnoses, to promote entrance and retention in treatment, and to establish effective evidence-based practices for individuals with co-occurring diagnoses who are seeking employment support